Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries.
Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries.
复制标题
DOI：
10.1161/circulationaha.115.018912
复制
发表时间：
2016-08-09
期刊：
影响因子：
37.8
通讯作者：
He J
中科院分区：
文献类型：
--
作者：
Mills KT;Bundy JD;Kelly TN;Reed JE;Kearney PM;Reynolds K;Chen J;He J
高血压是世界范围内可预防的过早死亡的主要原因。我们研究了2010年全球高血压患病率、意识、治疗和控制的差异，并比较了2000年至2010年的长期变化。我们检索了MEDLINE从1995年到2014年，并辅以人工检索检索到的文章参考文献。我们纳入了135项基于人群的研究，涉及来自90个国家的968,419名成年人。每个国家不同性别、年龄的高血压患病率被应用于人口数据，以计算区域和全球高血压成年人的数量。将每个国家高血压人群的知晓、治疗和控制比例应用于获得区域和全球估计数。2010年，31.1%（95%可信区间30.0-32.2%）的世界成年人患有高血压；高收入国家为28.5%(27.3-29.7%)，低收入和中等收入国家为31.5%（30.2-32.9%）。2010年估计有1.39亿（13.34 - 14.4亿）人患有高血压；高收入国家为3.49亿（3.37 - 3.61），低收入和中等收入国家为10.4亿（0.99- 10.9）。从2000年到2010年，高收入国家的年龄标准化高血压患病率下降了2.6%，但在低收入和中等收入国家上升了7.7%。在同一时期，在高收入国家，认识（58.2%对67.0%）、治疗（44.5%对55.6%）和控制（17.9%对28.4%）的比例大幅增加，而在低收入和中等收入国家，认识（32.3%对37.9%）和治疗（24.9%对29.0%）的增加较少，控制（8.4%对7.7%）甚至略有下降。全球高血压差异很大，而且还在不断扩大。迫切需要合作努力，以应对低收入和中等收入国家新出现的高血压负担。
Hypertension is the leading preventable cause of premature death worldwide. We examined global disparities of hypertension prevalence, awareness, treatment, and control in 2010 and compared secular changes from 2000 to 2010. We searched MEDLINE from 1995 through 2014 and supplemented with manual searches of retrieved article references. We included 135 population-based studies of 968,419 adults from 90 countries. Sex-age-specific hypertension prevalences from each country were applied to population data to calculate regional and global numbers of hypertensive adults. Proportions of awareness, treatment, and control from each country were applied to hypertensive populations to obtain regional and global estimates. In 2010, 31.1% (95% confidence interval, 30.0-32.2%) of the world's adults had hypertension; 28.5% (27.3-29.7%) in high-income countries and 31.5% (30.2-32.9%) in low- and middle-income countries. An estimated 1.39 (1.34-1.44) billion people had hypertension in 2010; 349 (337-361) million in high-income and 1.04 (0.99-1.09) billion in low- and middle-income countries. From 2000 to 2010, the age-standardized prevalence of hypertension decreased by 2.6% in high-income countries but increased by 7.7% in low- and middle-income countries. During the same period, the proportions of awareness (58.2% vs 67.0%), treatment (44.5% vs 55.6%), and control (17.9% vs. 28.4%) increased substantially in high-income countries, whereas awareness (32.3% vs 37.9%) and treatment (24.9% vs 29.0%) increased less, and control (8.4% vs 7.7%) even slightly decreased in low- and middle-income countries. Global hypertension disparities are large and increasing. Collaborative efforts are urgently needed to combat the emerging hypertension burden in low- and middle-income countries.