黑龙江省高血压病流行病学的研究

目的 了解黑龙江省高血压病流行病学特点,为该地区高血压的防治工作提供科学依据。方法 1959、1979、1991和1999年4次在黑龙江省采取随机整群抽样方法,按国际通用血压测量方法和有关质量控制规定,对年龄≥15岁城乡自然人群289157人（男154091人,女135066人）进行血压测量及影响血压水平的相关因素调查。结果 该地区为我国高血压病高发区;高血压患病率逐年增高,40年共增高105％,而且近10年增高迅速加快;男性患病率高于女性（P＜0．01）;随年龄增高高血压患病率升高,且发病年龄年轻化,目前35－45岁人群高血压患病率为20．47％;地区、城乡及不同职业高血压患病率不同;年龄、体重指数、饮酒、高盐食等因素是黑龙江地区高血压的主要危险因素;在该地区高血压的知晓率、服药率及控制率较低。结论 根据本地特点加强该地区的高血压防治力度。     

浙江省高血压流行趋势及影响因素分析

目的　探讨浙江省人群高血压流行水平以及影响我省的主要危险因素。方法　采用心血管流行病学的调查研究方法和标准 ,对浙江省十一市城市、农村≥ 15岁的自然人群 11916人进行高血压抽样调查 ,所得数据采用X2 检验、相关系数、危险度强弱指标分析。结果　①浙江省高血压患病率 33 4 % ,标化患病率18 7% ,其中 :城市 35 4 % ,农村 31 5 % ;②收缩压 /舒张压均随年龄增长递增 ,4 0岁开始患病率明显增高 ,与本省 1990年高血压调查相比 ,显示高血压的患病年龄提前了 10年 ;③血压水平与年龄、BMI、血糖水平、血脂水平、高血压家族史以及心脑血管病病史呈正相关 ;④危险强度指标RR >1 5的主要影响因素顺位为 :年龄、心脑血管疾病史、超重、糖尿病或高血糖、高血脂 ;结论　①浙江省人群高血压患病率 13年间成倍上升 ,以农村人群增长为显著 ;②高血压患病年龄提前 10年 ;③影响我省高血压的主要危险因素为高血糖、超重、高血脂 ;④我省高血压防治工作形势严峻 ,迫切需要开展社区高血压综合防治工作。     

2004年乌鲁木齐市社区高血压患病情况的调查与分析

目的 了解乌鲁木齐市社区人群高血压的患病率、服药率和血压控制率以及相关危险因素,为制定高血压防治措施提供依据.方法 2004年4～6月对乌鲁木齐市18岁以上人群随机抽取2 100人进行现况调查,并对相关危险因素进行分析.结果 本次调查社区人群高血压患病率为32.55%.其中男性高血压患病率32.86%,女性高血压患病率32.55%.调查人群已知高血压病史的患者中,规律服药占80.47%,不规律服药占13.80%,不服降压药物的占5.73%.目前血压控制在正常水平的占29.95%,血压仍然偏高的占70.05%.本次调查新检出的高血压患者占总数的41.91%.结论 本次调查人群总体高血压患病率与1991年相比显著上升,规律服药率较高,血压控制率低.与高血压有关的因素主要是家族史、肥胖、年龄和睡眠时间短等.     

中山市862名中小学教师高血压患病率的调查分析

目的调查中小学教师原发性高血压的患病情况及其特点与分析其危险因素。方法对中山市12所中小学862名教师和981名非教师健康检查获得的血压情况等进行对比统计分析。结果中小学教师高血压病患病率随着年龄和教龄而增高,30岁以上的各年龄组的患病率均高于非教师人群,随着教龄的延长,高血压患病率均有明显增高的趋势,其中高血压患的血脂水平高于血压正常组。结论提示做好中小学教师高血压防治工作十分重要。     

兖州矿区煤矿工人高血压流行病学分析

目的了解兖州矿区煤矿工人高血压流行状况,探讨高血压的防治对策。方法选择2006年兖州矿区健康查体全部煤矿工人为这次调查的对象,对30410人进行血压测量及相关危险因素调查。结果查出高血压病病人4619例,其中Ⅰ级、Ⅱ级、Ⅲ级高血压病病人分别为2326例、2123例和170例,总患病率为15.19%。45岁以下高血压患病率仅为14.31%(4016/28064),45岁以上为25.70%(603/2346)。各年龄组间发病率差异有统计学意义(P<0.01)。结论兖州矿区人群高血压发病率高于全国平均发病率(11.88%)水平,高血压是危害人群健康的常见心血管疾病,应引起广泛重视。     

黑龙江省高血压流行病学50年研究

目的 了解黑龙江省高血压及其相关因素流行病学特点,为该地区高血压防治工作提供科学依据.方法 于1958、1979、1991、1999和2007年共5次在黑龙江省采取随机整群抽样方法 ,按国际通用血压测量方法 和相关质量控制规定,对年龄≥15岁城乡自然人群299 677人(男158 782人,女140 895人)进行血压测量及影响血压相关因素横断面调查.结果该地区为我国高血压高发区,高血压患病率逐年增高,50年共增高3倍多,且1999-2007年8年时间里增长速率最快,从17.06%增至25.69%.随年龄增加,高血压患病率升高,且高血压发病年龄日趋年轻化.城乡及不同职业人群高血压患病率不同,机关企事业单位负责人高血压患病率最高(41.67%).55岁以前男性高血压患病率明显高于女性(P<0.0001).BMI、性别、高TG血症、年龄、HDL-C降低和遗传史等是该地区高血压发病的主要危险因素.本地区目前高血压知晓率、治疗率及控制率分别为48.90%、25.33%和4.32%.结论 黑龙江省高血压患病率仍较高,受许多危险因素影响,需以社区医疗为基础,加大力度改善高血压的预防、检测和治疗状况.     

定西市公职人员高血压患病现状及危险因素分析

目的了解甘肃省定西市公职人员高血压患病情况,分析可能存在的危险因素,为探寻该人群适宜的健康管理模式提供依据。方法收集2016—2019年在定西市人民医院完成健康体检和调查问卷的所有公职人员资料,采用Logistic回归方法分析该人群发病的主要影响因素。结果 2016—2019年定西市政府部门及企事业单位职工高血压患病率为26.6%(15 629/58 768),标化患病率27.9%;男女患病率分别为29.3%和21.7%,标化患病率为31.0%和24.7%,不同性别患病率差异有统计学意义(χ~2=403.439,P0.05);患病率随年龄的增长呈上升趋势(趋势χ~2=606.979,P0.05),患病率随体重指数(BMI)的增加呈上升趋势(趋势χ~2=781.727,P0.05);多因素Logistic回归分析结果显示,性别、年龄、血糖、体重指数、腰围、嗜盐、吸烟、饮酒和负性情绪均是高血压的危险因素。结论定西市公职人员高血压患病率较高;应加强血压、体重指数、腰围等危险因素的监测,针对重点人群积极开展健康教育与干预措施。     

江西省城乡居民高血压患病现状调查及影响因素分析

目的明确江西省年龄15岁人群高血压患病现状及其主要危险因素,为制订高血压防治策略提供科学依据。方法采用多阶段分层随机抽样的方法,抽取江西省年龄15岁的常住居民15 296人于2013年11月至2014年8月开展心血管病患病现况调查,分析高血压患病流行情况及其相关影响因素。结果江西省年龄15岁人群高血压患病率29.00%,标化患病率为15.69%,知晓率、治疗率和控制率分别为64.77%、27.07%和12.58%;城市和农村居民高血压患病率分别为33.76%、24.04%,标化率分别为17.49%、13.98%,城市高于农村(χ~2=175.32,P0.01)。男女患病率分别为30.07%,28.26%,标化率分别为17.43%、14.51%,男性高于女性(χ~2=5.71,P0.05)。不同性别人群的高血压患病率随年龄增长有上升趋势,经趋势χ~2检验,差异有统计学意义(P0.01)。随着体质量指数(BMI)和(或)腰围的增加,人群高血压患病率呈明显的上升趋势。多因素回归分析结果显示:增龄、高BMI、腹型肥胖、高身体脂肪率为男、女高血压的独立危险因素,绝经为女性高血压的危险因素,而适当饮酒是女性高血压的保护因素。结论应加强对江西省居民尤其是城市人群血压和体质量监测,积极开展患者及高危人群健康教育与干预。     

父母高血压史对子女高血压患病率及血压水平的影响

目的探讨高血压家族史对人群血压的影响.方法利用1991年全国血压抽样调查的940323人的资料,分析父母高血压史与血压水平和高血压患病率的关系,并分析不同民族人群的遗传背景与血压水平的关系.利用多因素Logistic回归调整年龄、体重指数、吸烟饮酒状况及文化程度后,探讨高血压家族史与高血压患病之间的关系.结果高血压家族史阳性率均为19.3% .有高血压家族史者比无家族史者的血压水平和高血压患病率明显升高(P<0.01),而父母双亲均有高血压者的血压水平和高血压患病率又比父母一方有高血压者明显升高(P<0.01),父母双亲均有高血压史者的高血压患病率为无家族史者的2倍.父亲有高血压者与母亲有高血压者的血压均值及高血压患病率没有显著差异.多因素Logistic回归显示,有高血压家族史者患高血压病的危险是无高血压家族史者的1.79倍.结论遗传因素在中国人群的高血压发病中起重要作用.     

嘉兴市高血压流行趋势及影响因素分析

目的　通过对嘉兴市社区人群高血压抽样调查 ,及时掌握我市高血压流行现状 ,为进一步加强高血压社区综合防治、评价防治效果提供科学依据。方法　 2 0 0 3年 9～ 10月在嘉兴市随机抽取 15岁以上人群12 77人进行高血压抽样调查。结果　高血压患病率为 2 9 6 7% ,其中城市患病率为 2 5 4 0 % ,农村患病率为32 6 0 % ;男性患病率为 33 33% ,女性患病率为 2 7 72 % ;血压与年龄有显著相关 ;糖尿病史、高血糖、超重、高甘油三酯、高胆固醇、高血压家属史、饮酒为高血压重要危险因素 ;高血压患者服药率为 4 2 11% ,血压控制率为 9 74 %。结论　高血压患病率明显上升 ,农村患病率高于城市 ;患病率随年龄增长而增长 ,男性发病高峰比女性早 10年出现 ;高血糖、超重、高血脂是我市人群高血压的最主要危险因素 ;高血压患者服药率和血压控制率均明显高于 1991年全国普查结果 ,服药率和控制率两者均是城市高于农村。     

Automated ambulatory blood pressure monitoring: a study in age-matched normotensive and hypertensive men

Noninvasive automated techniques have been used in this study in 29 ambulatory normotensive and hypertensive men to monitor blood pressure during a full 24-hour period. The two groups of men were carefully matched for age. The data were analyzed with respect to possible differences in the circadian pattern of blood pressure, in the variability of blood pressure, and differences in the prevalence of abnormal blood pressures between the two groups. The circadian pattern of blood pressure in hypertensive patients was displayed parallel to that in normotensive control subjects but at a significantly higher level. The difference between daytime and nighttime systolic blood pressure was greater in normotensive than in hypertensive men. However, variability of blood pressure was not different between the two subgroups. Hypertensive men showed on average a greater incidence of abnormal blood pressures than normotensive subjects. However, nine of the normotensive control subjects showed more than 25% of abnormal readings of systolic or diastolic blood pressures during a 24-hour recording period. In contrast, fewer than 25% of abnormal blood pressure readings were found in nine of the hypertensive patients. The data reported here may help to better define the use of ambulatory blood pressure monitoring techniques in the diagnosis of hypertension.     

浙江省社区人群高血压患病率、知晓率、服药率和血压控制状况分析

目的　评估浙江省社区人群高血压的患病率、知晓率、服药率以及血压的控制状况。方法　根据《心血管病流行病学方法》手册中的方法在浙江省 11市年龄≥ 15岁的自然人群中进行高血压抽样调查 ,应用标准问卷询问高血压病史以及高血压的治疗情况。结果　浙江省的高血压患病率为 33.4 % ,标化率 18 7% ,较 1991年全国高血压抽样调查时全省高血压患病率 13.11%增长了 15 5 % ;在高血压患者中有 5 6 .6 %的患者知道自己患有高血压 ,4 4 .9%患者正在服药 ,9.3%患者血压得到控制。结论　①本省高血压患病率成倍增加以中青年人群为显著 ;②与高血压患病率较高相比较高血压的知晓率、服药率和控制率偏低 ;③迫切需要进行社区人群高血压的综合干预。     

Hypertension and health-related quality of life: an epidemiological study in patients attending hospital clinics in China

OBJECTIVE: To examine the relationship between hypertension and health-related quality of life in patients attending hospital clinics in China. DESIGN AND METHODS: A cross-sectional survey. Patients over the age of 35 years attending outpatient clinics in 18 hospitals of eight major cities of northern and southern China were interviewed between June and July, 1999. Trained fieldworkers completed questionnaires regarding demographics, hypertension knowledge and awareness, treatment history and quality of life issues. Qualified physicians performed blood pressure assessments. RESULTS: A total of 9703 volunteers were enrolled; 4510 (46.5%) had hypertension. The results showed that hypertensive subjects scored lower in the multiple linear regression analyses in most questions on the quality of life questionnaire than those without hypertension after controlling for age, sex, sociodemographic factors, and co-morbidity. There was a strikingly high prevalence of physical complaints or symptoms. Among the variables considered, age, sex, hypertension, body mass index, educational level, smoking, history of cholesterol, family history of cardiovascular diseases and history of diabetes were statistically significantly correlated with health-related quality of life. Subjects aware of having high blood pressure had a lower health-related quality of life score than subjects with high blood pressure but unaware of the diagnosis. Among treated subjects, those with controlled hypertension had higher health-related quality of life scores than those with poorly controlled hypertension. CONCLUSIONS: Hypertensive individuals represent a vulnerable population that merits special attention from healthcare providers and systems. This is especially important given that low health-related quality of life can be a risk factor for subsequent cardiovascular events or complications.     

辽宁省阜新市农村男性人群高血压的患病情况及危险因素调查

目的了解辽宁省农村地区成年男性人群高血压的流行病学特征和相关危险因素，为其高血压的防治和干预提供科学依据。方法采用分层整群随机抽样对阜新市8个乡镇≥35岁的22747名农村常住（≥5年）成年男性进行调查。由培训过的医师对调查对象进行血压测量和资料的收集。结果辽宁省阜新市农村男性居民高血压患病率为37．0％。随着年龄的增长，高血压患病率呈明显增高趋势。男性高血压患者未知晓率高达74．1％，已明确为高血压的患者对自己的保护意识较弱。多元Logistic逐步回归显示年龄、超重、肥胖、吸烟、饮酒、家族史、饮食不良等因素是高血压患病的危险因素。结论辽宁省阜新市农村男性居民高血压患病率高，知晓率低，应注重加强高血压防治知识宣传及采取全面的高血压预防控制措施，提高农村居民对高血压危险因素和相关知识的认识度，减少高血压的患病率。     

云南省居民高血压的患病率、知晓率及治疗率调查

目的:了解云南省15～69岁人群高血压患病率以及知晓率、治疗率和控制率。方法:对云南省8个州(市)的16个县(区)15～69岁常住居民进行高血压抽样调查,应用标准问卷询问高血压病史以及高血压的治疗情况,采用电子血压计进行血压的测量。结果:总人群高血压患病粗率24.8%,标化率21.5%;高血压知晓率、治疗率和控制率分别为22.9%、12.7%和1.0%。结论:本省高血压患病率呈现增长趋势;与全国比较,高血压患病率较高,高血压的知晓率、治疗率和控制率较低。     

Emergency Room Management of Hypertensive Urgencies and Emergencies

Hypertensive crisis affects upward of 500,000 Americans each year. Although the incidence of hypertensive crisis is low, affecting fewer than 1% of hypertensive adults, more than 50 million adult Americans suffer from hypertension. Presentation of a patient with severe hypertension to the emergency room demands immediate evaluation, prompt recognition of a hypertensive emergency or urgency, and the prompt institution of appropriate therapeutic measures to prevent progression of target-organ damage and to avoid a catastrophic event. Hypertensive emergencies are severe elevations in blood pressure that are complicated by evidence of progressive target-organ dysfunction such as coronary ischemia, disordered cerebral function, a cerebrovascular event, pulmonary edema, or renal failure. Although therapy with parenteral antihypertensive agents may be initiated in the emergency department, these patients warrant prompt admission to an intensive care unit where continuous monitoring of blood pressure can be assured during therapy.     

高血压患者伴高同型半胱氨酸血症与脑动脉狭窄程度的相关性

目的探讨高血压患者伴高同型半胱氨酸(Hcy)血症与脑大动脉狭窄程度的相关性。方法选择行全脑数字减影血管造影术(DSA)检查的急性缺血性脑卒中患者269例。根据DSA显示动脉狭窄是否≥50%为依据,分为2组:狭窄组150例,患者颅内、外脑大动脉至少1支血管狭窄率≥50%;对照组119例,患者无狭窄或狭窄<50%。检测2组血浆Hcy水平及血压变化,并将所有入选的患者分为Hcy和血压均正常者(1组)、单纯Hcy升高者(2组)、单纯高血压者(3组)、高血压伴高同型半胱氨酸血症者(4组),观察血管狭窄≥50%的发生率。结果狭窄组Hcy和收缩压水平明显高于对照组[(15.5±4.9)μmol/L vs(14.2±4.0)μmol/L,(154.1±22.9)mm Hg vs(145.6±25.6)mm Hg(1 mm Hg=0.133 kPa)]。4组脑动脉狭窄≥50%的发生率最高(P<0.05);3组和4组脑动脉狭窄≥50%的发生率比1组和2组明显增高(P<0.05);2组与1组比较差异无统计学意义(P>0.05)。结论 Hcy升高及高血压均与脑动脉狭窄程度密切相关,二者共同存在时脑动脉狭窄≥50%的发生率显著增加,其协同作用以高血压为主要因素。     

Sex steroid hormones are altered in essential hypertension

Little is known about the relationship between blood pressure and endogenous sex steroid hormones in patients with essential hypertension. Studies in hypertensive men have described decreased androgens. Men with cardiovascular disease may have estrogen levels which are increased or similar to healthy controls. We measured selected sex steroid hormones in 24 medication-free patients with uncomplicated essential hypertension (diastolic blood pressure less than or equal to 90 mmHg) and 24 normotensive subjects. The groups were equally divided by race, gender, age and weight. Hypertensive men had lower levels of both free and total testosterone and androstenedione than controls. The converse was true for hypertensive women. Androgen levels were similar in blacks and whites regardless of gender or blood pressure. Estradiol levels were higher in hypertensive men and women than controls and in blacks than whites. Levels of luteinizing hormone and sex hormone binding globulin were similar in all subjects. The clinical and pathophysiological significance of our findings merits further investigation.     

Hypertension in the intensive care unit

PURPOSE OF REVIEW: The severity of hypertensive crises is determined by the presence of target organ damage rather than the level of blood pressure. Hypertensive urgencies with no signs of organ dysfunction can therefore be distinguished from hypertensive emergencies in which the presence of severe end-organ damage requires prompt therapy. Hypertensive emergencies include acute aortic dissection, hypertensive encephalopathy, acute myocardial ischaemia, severe pulmonary oedema, eclampsia, and acute renal failure. RECENT DEVELOPMENTS: Malignant hypertension is a severe form of hypertensive emergency demanding special consideration because of the risks of permanent blindness and renal failure. Catecholamine excess and postoperative hypertension may also sometimes require urgent treatment. The management of patients with hypertensive emergencies must be ensured in an intensive care unit, and must include the parenteral administration of antihypertensive drugs and accurate blood pressure monitoring. SUMMARY: Except for acute aortic dissection, the recommended goals of treatment are a reduction of mean arterial pressure by no more than 20% during the first few hours, because an abrupt fall in blood pressure in patients with preexisting hypertension may induce severe ischaemic injury in major organs as a result of the chronic adaptation of autoregulation mechanisms. Hypertension in the context of acute stroke should be treated only rarely and cautiously because of the presence of impaired autoregulation.