Trends in the prevalence of hypertension, antihypertensive therapy, and left ventricular hypertrophy from 1950 to 1989
Trends in the prevalence of hypertension, antihypertensive therapy, and left ventricular hypertrophy from 1950 to 1989
复制标题
DOI：
10.1056/nejm199904223401601
复制
发表时间：
1999-04-22
影响因子：
158.5
通讯作者：
Levy, D
中科院分区：
文献类型：
--
作者：
Mosterd, A;D'Agostino, RB;Levy, D
背景：男性和女性高血压患者患心血管疾病的风险增加，特别是当左心室肥厚时。我们研究了使用抗高血压药物的时间趋势，并研究了它们的使用，高血压的患病率之间的关系，并存在心电图证据的左心室hypertrophy.Methods共10，333名参与者在心脏研究的Frachial Heart谁是45至74岁，从1950年至1989年共进行了51，756次检查。获得血压和抗高血压药物使用的数据，并评估左心室肥大的心电图。结果从1950年到1989年，抗高血压药物的使用率在男性中从2.3%增加到24.6%，在女性中从5.7%增加到27.7%。收缩压至少160毫米汞柱或舒张压至少100毫米汞柱的年龄调整患病率在男性中从18.5%下降到9.2%，在女性中从28.0%下降到7.7%。这种下降伴随着年龄调整后的左心室肥大心电图证据的患病率下降，男性从4.5%降至2.5%，女性从3.6%降至1.1%。结论我们的研究结果支持了这样一种观点，即抗高血压药物的使用增加导致了高血压患病率的降低，并伴随着左心室收缩功能的下降。一般人群中的肥胖。我们的观察可以部分解释自20世纪60年代末以来观察到的心血管疾病死亡率的大幅下降。（N Engl J Med 1999;340：1221-7）（C）1999，马萨诸塞州医学会。
Background Men and women with hypertension are at increased risk for cardiovascular disease, especially when left ventricular hypertrophy is present. We examined temporal trends in the use of antihypertensive medications and studied the relation between their use, the prevalence of high blood pressure, and the presence of electrocardiographic evidence of left ventricular hypertrophy.Methods A total of 10,333 participants in the Framingham Heart Study who were 45 to 74 years of age underwent a total of 51,756 examinations from 1950 to 1989. Data were obtained on blood pressure and the use of antihypertensive medications, and electrocardiograms were assessed for left ventricular hypertrophy. The generalized-estimating-equation method was used to test for trends over time.Results From 1950 to 1989, the rate of use of antihypertensive medications increased from 2.3 percent to 24.6 percent among men and from 5.7 percent to 27.7 percent among women. The age-adjusted prevalence of systolic blood pressure of at least 160 mm Hg or diastolic blood pressure of at least 100 mm Hg declined from 18.5 percent to 9.2 percent among men and from 28.0 percent to 7.7 percent among women. This decline was accompanied by age-adjusted reductions in the prevalence of electrocardiographic evidence of left ventricular hypertrophy, from 4.5 percent to 2.5 percent among men and from 3.6 percent to 1.1 percent among women.Conclusions Our findings support the notion that the increasing use of antihypertensive medication has resulted in a reduced prevalence of high blood pressure and a concomitant decline in left ventricular hypertrophy in the general population. Our observations may in part explain the considerable decline in mortality from cardiovascular disease observed since the late 1960s. (N Engl J Med 1999;340:1221-7) (C) 1999, Massachusetts Medical Society.