Trends in Prevalence and Control of Hypertension According to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline.
Trends in Prevalence and Control of Hypertension According to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline.
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DOI：
10.1161/jaha.118.008888
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发表时间：
2018-06-01
影响因子：
5.4
通讯作者：
He J
中科院分区：
文献类型：
--
作者：
Dorans KS;Mills KT;Liu Y;He J
高血压是心血管疾病和全因死亡的主要危险因素。与之前的指南相比，2017年美国心脏病学会/美国心脏协会（ACC/AHA）高血压指南建议降低定义高血压的血压阈值，开始降压药物治疗和降压药物治疗目标。为了更好地了解2017年指南的潜在影响，我们研究了1999年至2016年美国≥20岁成年人群的平均收缩压和舒张压、高血压患病率和负担以及高血压控制比例的趋势。我们使用了来自全国健康和营养调查的38276名成年人的数据。高血压的年龄标准化患病率从1999-2000年的48.4%下降到2015-2016年的45.4%。然而，高血压的绝对负担持续增加，从1999-2000年的8700万增加到2015-2016年的1.082亿。在接受抗高血压药物治疗的成人中，高血压控制的年龄标准化比例从1999-2000年（25.6%）增加到2015-2016年（43.5%）。在非西班牙裔黑人、年龄≥60岁的个体或患有糖尿病、慢性肾脏疾病或心血管疾病高风险的个体中，整个期间的控制没有一致的改善。根据2017年指南，从1999年到2016年，高血压的年龄标准化患病率下降，高血压治疗者中控制的比例提高。然而，绝对高血压负担增加。在接受治疗的患者中，所有亚组的控制率均未持续改善。这些数据强调需要持续努力预防和控制美国普通人群的高血压。
Hypertension is a major risk factor for cardiovascular disease and all‐cause mortality. Compared with prior guidelines, the 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guideline recommends lower blood pressure thresholds for defining hypertension, for initiating antihypertensive medication, and for antihypertensive medication treatment goals. To better understand potential impacts of the 2017 guideline, we studied trends in mean systolic blood pressure and diastolic blood pressure, prevalence and burden of hypertension, and proportion of controlled hypertension in the US adult population aged ≥20 from 1999 through 2016. We used data from 38 276 adults from the National Health and Nutrition Examination Survey. Age‐standardized prevalence of hypertension decreased from 48.4% in 1999–2000 to 45.4% in 2015–2016. However, absolute burden of hypertension consistently increased, from 87.0 million in 1999–2000 to 108.2 million in 2015–2016. The age‐standardized proportion of controlled hypertension among adults receiving antihypertensive pharmacologic treatment increased from 1999–2000 (25.6%) to 2015–2016 (43.5%). There was not consistent improvement in control throughout the full period among non‐Hispanic blacks, individuals aged ≥60, or those with diabetes mellitus, chronic kidney disease, or high cardiovascular disease risk. Based on the 2017 guideline, from 1999 to 2016, the age‐standardized prevalence of hypertension decreased and the proportion of control among those treated for hypertension improved. However, the absolute hypertension burden increased. Among those treated, the control rate did not consistently improve in all subgroups. These data emphasize the need for continuous efforts in the prevention and control of hypertension in the US general population.