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1.
苯那普利上市后流行病学监测   总被引:4,自引:0,他引:4       下载免费PDF全文
目的 了解苯那普利在一般高血压患者中长期应用的药效及安全性。方法 对上海市某社区1831例原发性高血压患者进行为期3年的药物上市后流行病学监测。结果 3年随访74.3%的患者坚持服药,且具有理想的服药依从性。用药3年后,按规定服药者的收缩压达标率为75.7%,舒张压达标率为87.4%,总达标率为71.5%。总体收缩压水平较服药前降低了近15mm Hg(1mmHg=0.133kPa),舒张压降低了约10mmHg,脉压降低了近5mmHg。用药期间,未见有严重不良反应发生。咳嗽是该药主要的一种不良反应。3年累积咳嗽发生率,女性达23.6%,高于男性的18.8%。结论 苯那普利应用于一般高血压患者群体时,具有较好的长期效果和安全性。  相似文献   

2.
BACKGROUND: It has been proposed that pet ownership improves cardiovascular health. This study examines the relation of pet ownership with systolic and diastolic blood pressure, pulse pressure, mean arterial pressure, and hypertension in a large sample of older men and women. METHODS: Participants were 1179 community-dwelling men (n = 498) and women (n = 681) age 50-95 years. Participants responded to a 1991-1992 mailed questionnaire ascertaining pet ownership, and they attended a 1992-1996 clinic visit at which systolic (SBP) and diastolic (DBP) blood pressures were measured and use of antihypertensive medication was validated. Pulse pressure was calculated as SBP minus DBP. Mean arterial pressure was calculated as (SBP+DBP)/2. Body mass index, waist-hip ratio, and information on other potential confounders were obtained. RESULTS: Average age of participants was 70.4 +/- 10.8 years; 30.0% reported current pet ownership. Mean SBP was 137.5 +/- 21.4 mm Hg, and DBP was 76.1 +/- 9.3 mm Hg; 55.6% were hypertensive (SBP >or= 140, DBP >or= 90 or taking hypertension medication). Pet owners were younger and slightly more overweight and they exercised less than nonowners; owners were somewhat more likely to have diabetes and to use beta-blockers. In unadjusted analyses, pet owners had lower SBP, pulse pressure, and mean arterial pressure, and a reduced risk of hypertension (odds ratio = 0.62; 95% confidence interval = 0.49-0.80). However, after adjustment for age and other confounders, pet ownership was not associated with systolic or diastolic blood pressure, pulse pressure, mean arterial pressure or risk of hypertension. CONCLUSIONS: Results suggest that pet ownership is not independently associated with blood pressure, vascular reactivity, or hypertension.  相似文献   

3.
In 1973–1974, the Hypertension Detection and Follow-up Program (HDFP) conducted a two-stage screening (home, clinic) for high blood pressure in fourteen communities. A similar two-stage screening was repeated in 1976–1977 for a stratified probability sample of those persons whose blood pressures were not definitely elevated at the 1973–1974 survey. This sample included: normotensives (not on antihypertensive medication), labile hypertensives (hypertensive at home visit but normotensive at the subsequent clinic visit) and controlled hypertensives (on medication with DBP less than 95 mm Hg at home screen). Of this sample, 86.1% were reexamined. A hypertensive in 1976–1977 was defined as an individual having DBP 95 mm Hg or greater or receiving physician-prescribed antihypertensive medication. The three-year incidence rate of hypertension was estimated to be 11.8% after one stage (home) screening and 9.0% after a two-stage (home and clinic) screening, with a black/white ratio > 2. Black men had higher rates than black women, but white women had higher rates than white men. The three-year incidence of hypertension was directly related to the initial blood pressure level. More than 51% of the new hypertensives were receiving treatment at the time of rescreening, and almost 90% of those treated were under control (DBP < 95 mm Hg). Among individuals under treatment in 1973–1974, 81.2% were still on treatment three years later. Of those who discontinued treatment prior to the 1976–1977 rescreening, blacks had higher blood pressure levels than whites.  相似文献   

4.
BACKGROUND: The long-term longitudinal evidence for a relation between coffee intake and hypertension is relatively scarce. OBJECTIVE: The objective was to assess whether coffee intake is associated with the incidence of hypertension. DESIGN: This study was conducted on a cohort of 2985 men and 3383 women who had a baseline visit and follow-up visits after 6 and 11 y. Baseline coffee intake was ascertained with questionnaires and categorized into 0, >0-3, >3-6, and >6 cups/d. Hypertension was defined as a mean systolic blood pressure (SBP) >or=140 mm Hg over both follow-up measurements, a mean diastolic blood pressure (DBP) >or=90 mm Hg over both follow-up measurements, or the use of antihypertensive medication at any follow-up measurement. RESULTS: Coffee abstainers at baseline had a lower risk of hypertension than did those with a coffee intake of >0-3 cups/d [odds ratio (OR): 0.54; 95% CI: 0.31, 0.92]. Women who drank >6 cups/d had a lower risk than did women who drank >0-3 cups/d (OR: 0.67; 95% CI: 0.46, 0.98). Subjects aged >or=39 y at baseline had 0.35 mm Hg (95% CI: -0.59, -0.11 mm Hg) lower SBP per cup intake/d and 0.11 mm Hg lower DBP (95% CI: -0.26, 0.03 mm Hg) than did those aged <39 y at baseline, although the difference in DBP was not statistically significant. CONCLUSIONS: Coffee abstinence is associated with a lower hypertension risk than is low coffee consumption. An inverse U-shaped relation between coffee intake and risk of hypertension was observed in the women.  相似文献   

5.
To provide baseline data for a state program to coordinate hypertension resources, a blood pressure (BP) survey was undertaken in Maryland in 1978. A statewide probability sample of households was chosen; each adult member was eligible for interview and measurement of BP. A total of 6,425 adults were interviewed for an overall response rate of 79.5%. Using a definition of diastolic blood pressure (DBP) of 95 mm Hg or higher or use of antihypertensive medication, 15.1% of state residents were estimated to be hypertensive. Of these, 85.8% were estimated to be aware of their condition, 77.6% of them were treated, and 67.6% had their BP controlled to a normal level by medication. Data are also presented using DBP 90 mm Hg or higher. A comparison of data from the Hypertension Detection and Follow-up Program (HDFP) home screen in 1973–1974 and comparable information from this survey showed lower rates of awareness, treatment, and BP control in hypertensives at HDFP home screen. Results of this survey will be compared with those of a second statewide survey conducted four years later to assess changes in rates of hypertension awareness, treatment, and control.  相似文献   

6.
Hypertension is arbitrarily defined as diastolic blood pressure (DBP) of 90 mm Hg or higher, systolic blood pressure (SBP) of 140 mm Hg or higher, or both, on 3 separate occasions. Essential hypertension is hypertension without an identifiable cause. Essential hypertension, also known as primary or idiopathic hypertension, accounts for at least 95% of all cases of hypertension. According to the third National Health and Nutrition Examination Survey (NHANES III), approximately 60% of the 50 million Americans with hypertension are at increased risk for cardiovascular disease resulting from uncontrolled hypertension. This is because only 53% of hypertensive patients are being treated and only 24% have their hypertension under control. Physicians must play an active role in identifying and treating hypertension. In an earlier Applied Evidence article, an approach to the diagnosis of hypertension was presented. This article reviews the treatment of essential hypertension in adults and the prognosis of untreated hypertension. Risk stratification, alternative therapies, lifestyle modification, drug therapy, and prognosis will each be reviewed sequentially.  相似文献   

7.
目的探讨高血压前期人群高血压的预防。方法97例BP120~139/80~89mmHg高血压前期的居民被管理一年,列为试验组。92例BP131~139/85~89mmHg高血压前期的居民未被管理,列为对照组。853例原发性高血压也被列为对照。结果97例管理后BP120~139/80~89mmHg高血压前期人群的收缩压、舒缩压和体重指数分别较管理前和92例未被管理的高血压前期的居民低(均P〈0.05)。血压120—139/80~89mmHg的人群的收缩压、舒张压、性别分别与原发性高血压之间具有非常显著意义的差别(均P〈0.005)。结论对高血压前期人群进行管理对预防原发性高血压疗效明显。  相似文献   

8.
目的 了解中年人群高血压患病率及知晓率、治疗率和控制率的演变趋势。方法 利用国家“八五”(1992~1994年)和“九五”(1998年)期间年龄在35~59岁的13组可比人群资料进行分析。结果 高血压的标化患病率有小幅增加,“九五”期间达到24.0%。城市的增幅要大于乡村。高血压知晓率“九五”期间较“八五”期间增加了5.3%,达到42.6%;治疗率“八五”期间27.3%、“九五”期间为31.1%;控制率“九五”期间较“八五”期间增加了近50%,但也只有6.0%。在接受治疗的高血压患者中,不同时期的控制率分别为12.7%、19.9%,为同期整体控制率的3倍多。无论患病率、知晓率、治疗率和控制率,城乡之间、性别之间都存在差异。结论 不断上升的高血压患病率和低水平的知晓率、治疗率、控制率仍是高血压防治面临的主要现状。必须认真开展有效的措施以降低高血压的患病率,提高治疗率和控制率。  相似文献   

9.
社区人群综合干预对预防和控制高血压效果评价   总被引:4,自引:0,他引:4  
目的评价社区人群综合干预对预防和控制高血压的效果。方法按照类实验设计,于1996年在北京市选取干预、对照社区各5万人群,对干预社区开展为期3.5 a的高血压一、二级预防,期间对确诊高血压患者进行随访管理,并分别于1997年和2000年先后对干预、对照社区各整群随机抽取800人左右进行基线和干预后血压水平及相关知识、态度、行为(KAB)调查。结果干预社区的2 478名确诊高血压患者的随访管理过程中,1998、1999和2000年确诊高血压患者管理率分别为64.15%,73.82%和82.56%,血压控制率分别为54.28%,62.04%和62.42%,管理率和血压控制率逐年提高。经过干预活动后,与对照社区比较,干预社区人群KAB水平及人群关心保健知识、受知识影响和规律性锻炼率变化更明显(P〈0.05)。干预社区高血压人群收缩压、舒张压水平降低幅度和高血压知晓率、治疗率、控制率提高程度均大于对照社区,但差别无统计学意义。结论社区综合干预措施能有效地规范人群的健康相关行为,对控制人群高血压具有重要意义。  相似文献   

10.
PURPOSE: This study examined the cross-sectional and prospective associations between employment status and hypertension among middle-aged, African-American (AA) and European-American (EA) women participating in the Atherosclerosis Risk in Communities Study. METHODS: Employed women and homemakers from the baseline examination (1987-89) were included in the cross-sectional study (n = 7351). Associations between employment and the incidence of hypertension ascertained at visit 2 (1990-92) were determined among those who at baseline, had low-normal blood pressure (not hypertensive and systolic blood pressure (SBP) < or = 120 mm Hg systolic and diastolic blood pressure (DBP) < or =80 mm Hg (n = 3194). Logistic regression analysis was used to examine the association between employment status and hypertension by ethnicity, taking into account covariates. RESULTS: At baseline, employed women were less likely to be hypertensive (SBP > or =140 mm Hg or DBP > or =90 mm Hg or current use of antihypertensive drugs) than were homemakers (prevalence odds ratio) (POR) = 0.70; 95% confidence interval (CI) = 0.62-0.79), controlling for age, body mass index, and education. Among the subgroup who had low-normal blood pressure at baseline, employed women were less likely to develop hypertension during the three-year time period than were homemakers (odds ratio (OR) = 0.68; 95% CI = 0.44-1.05). The inverse association was stronger among AA (RR = 0.37; 95% CI = 0.16-0.88) than EA (OR = 0.83; 95% CI = 0.50-1.38) women. CONCLUSIONS: These findings suggest that the inverse association between hypertension and employment status is not due to a healthy worker effect, and that employment may confer protection against incident hypertension in women.  相似文献   

11.
目的 应用多水平分析模型分析社区老年高血压患者血压水平的影响因素.方法 通过多阶段随机抽样,抽取上海市23个社区的927例老年高血压患者作为研究对象,采用两水平线性多层模型分别分析社区老年高血压患者收缩压(SBP)和舒张压(DBP)的影响因素.结果 研究对象的平均血压水平为SBP(139.2±11.7)mm Hg、DBP(85.6±8.6)mm Hg(I mm Hg=0.133 kPa).在社区水平上,辖区高血压患者/站点医师数(医患比)"高"的社区较医患比"低"的社区患者的SBP低3.86 mm Hg、DBP低2.51 mm Hg.在个体水平上,年龄、性别、超重/肥胖是血压升高的危险因素;规律服药、限盐、疾病管理自我效能的提高可降低血压,特别是在控制其他影响因素后仅限盐1项就可降低SBP 2.44 mm Hg、DBP 2.03 mm Hg.结论 多水平分析模型可以灵活有效地处理具有层次结构的数据,社区因素和个体因素对老年高血压患者的血压水平均有影响.  相似文献   

12.
目的 研究中老年人群中血压水平与脑卒中患病率及患病风险之间的关系。方法 采用分层整群抽样方法,对扬州市广陵区40岁及以上常住居民开展问卷调查、体格检查和实验室检查。通过对年龄分层,采用单因素和多因素logistic回归分析不同年龄组血压与脑卒中患病率及患病风险的关系。结果 3 999例有效样本中,男性1 904例(47.61%),女性2 095例(52.39%);其中脑卒中243例(6.08%),高血压1 900例(47.51%),糖尿病929例(23.23%),血脂异常943例(23.58%),高血压患者中脑卒中211例(86.83%)。男性(χ2 = 9.539,P = 0.002)、高龄(t = - 13.683,P<0.001)、缺乏运动(χ2 = 15.568,P<0.001)、吸烟史(χ2 = 40.799,P<0.001)、高血压(t = - 9.149,P<0.001)、高血糖(t = - 6.832,P<0.001)、低高密度脂蛋白胆固醇(t = 3.509,P<0.001)、肥胖(t = - 4.964,P<0.001)均是脑卒中重要危险因素。随着年龄和血压的增加,脑卒中的患病率增加。对年龄进行分层,并对危险因素进行校正,60岁以下人群中脑卒中患病风险随血压升高而显著增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压<130 mm Hg的8.13倍;舒张压≥110 mm Hg脑卒中患病风险是舒张压<80 mm Hg的28.54倍。60岁及以上人群中收缩压≥150 mm Hg脑卒中患病风险开始增加;收缩压≥160 mm Hg脑卒中患病风险是收缩压<130 mm Hg的2.12倍;舒张压与脑卒中患病风险之间无显著相关性。结论 高血压是脑卒中的重要危险因素,根据不同的年龄,设定相应的降压目标是有效预防脑卒中的重要途径。  相似文献   

13.
A cross-sectional population survey using a random, stratified sample into phases was conducted in order to assess the prevalence, awareness, treatment, and control of hypertension in Albacete (a south-eastern province in Spain) with 248 000 inhabitants over 18 years of age. The sample size was of 1322 people. Both systolic and diastolic BP were higher in men than in women and showed an increasing trend with age independently of gender. Assuming a cut-off for hypertension of <140/90 mm Hg and <160/95 mm Hg, we found a prevalence of hypertension of 32.7% and 23.1%, respectively. Overall, 56.5% of hypertensive subjects were aware of their condition. The degree of this awareness was significantly higher in women and in the elderly. The percentage of patients who were receiving antihypertensive treatment was 49.1%. This proportion was also higher among women, elderly people, and subjects living in urban areas. High BP was successfully controlled in 10.9% of the total hypertensive population which accounted for 24.4% of the treated patients. The corresponding figures for the <160/95 mm Hg cut-off were 38.5% and 60.6%, respectively. In the logistic regression model, male gender and size of the local community were significantly associated with a better pharmacological control of hypertension. We found a high prevalence of hypertension with low degree of awareness and control, despite the general progress made in the diagnosis and treatment of hypertension in Spain. Specific intervention programs are necessary to increase the extent of control of hypertension in our country.  相似文献   

14.
目的了解广州市15~69岁常住居民的高血压患病率、知晓率、治疗率和控制率情况,为高血压的综合防治工作提供依据。方法采用多阶段抽样的方法,抽取7026名广州市常住居民进行问卷调查和血压测量。结果高血压患病率为15.1%,标化率为18.0%,知晓率为31.6%,药物治疗率为28.8%(包括只按医嘱服药者16.9%和综合治疗者11.9%),非药物治疗率为1.2%,高血压控制率为12.6%。结论广州市成人高血压患病率近年有增加的趋势,而知晓率、治疗率及控制率偏低,尤其是在农村地区,需要进一步加强高血压知识的宣传教育,提倡综合治疗及社区的系统管理工作,做到早诊断、早治疗、早控制。  相似文献   

15.
The objective of the study was to assess the association between systolic and diastolic blood pressure (SBP and DBP) and the use of oral contraceptives (OC) in hypertensive women. In a prospective cross-sectional study, we evaluated 171 women who were referred to the Hypertension Outpatient Clinic of Hospital de Clínicas de Porto Alegre; 66 current users of OC, 26 users of other contraceptive methods and 79 women who were not using contraception. The average of six blood pressure readings was used to establish the usual blood pressure of the participants. Current OC users were compared with users of other methods and with patients not using contraception. Main outcome measures were SBP and DBP among the different groups, and prevalence of uncontrolled hypertension (SBP >or= 140 mmHg and DBP >or= 90 mmHg). DBP was higher in OC users (100.2 +/- 15.9 mmHg) than in patients using other contraceptive methods (93.4 +/- 14.7 mmHg) and not using contraceptives (93.3 +/- 14.4 mmHg, p = 0.016). Women using OC for more than 8 years presented higher age-adjusted blood pressure levels than women using OC for shorter periods. Patients using OC had poor blood pressure control (p for trend = 0.046) and a higher proportion of them presented moderate-severe hypertension. These results were independent of antihypertensive drug use. In a logistic regression model, we found that current OC use was independently and significantly associated with prevalence of uncontrolled hypertension. It is concluded that hypertensive women using OC present a significant increase in DBP and poor blood pressure control, independent of age, weight and antihypertensive drug treatment.  相似文献   

16.
The prevalence of hypertension in the three first-screened age cohorts of an ongoing multifactor, primary preventive trial, the distributions of unknown and/or untreated hypertensive subjects, and the percentage of hypertensives under treatment are presented and compared to the results in earlier examined population samples in the same town. Using cut-off points SBP ? 175 and DBP ? 115 and patients treated for hypertension included, 11% of both men and women aged 54–55 yr had hypertension. If cutting points SBP ? 165 and DBP ? 95, as recommended by the WHO, had been adopted, 55% would have been considered hypertensive. The mean BP were calculated from the BP recorded at the screening and it was shown that a morning BP taken about 2 wk later was considerably lower. Thus, the “afternoon cut-off points”: 175115 should be compared with “morning cut-off points”: 162101.The diagnostic work-up and future control program including the use of paramedical personnel and special means for the education of patients in a special Hypertension Clinic is described. The cost of the Hypertension Clinic is calculated in working-hours for physicians, nurses and secretarial staff.  相似文献   

17.
The aim of the study was to evaluate the relationship between marital status and blood pressure, and to assess the risk of hypertension in adult Polish men, after adjustment for BMI. Material comprised the data of 2,271 healthy men, aged 25–60, occupationally active inhabitants of Wroclaw (south-western Poland). Arterial hypertension was diagnosed when systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg. The following categories of marital status and educational level were applied: never married vs. currently married, and well-educated vs. poorly educated, respectively. The data on lifestyle elements were obtained from questionnaires. Multifactorial analyses of covariance (ANCOVA) were used to compare mean values of SBP and DBP in married vs. never married in subsequent age categories with BMI as a covariate. Independent effects of marital status, life-style variables and body mass index (BMI) on the risk of hypertension in men were analysed using the multifactorial models of logistic regression. In our analysis an interesting epidemiological phenomenon was observed. Never married men had on average higher SBP and DBP than married men. Never married had also a higher risk of hypertension when compared to married men, even when adjusted for different demographic, socio-economic, life-style variables, and even that never married men had lower BMI than married subjects. Marital differences in psychological status (prolonged stress and low social support), dietary intake (mainly sodium and potassium intake) and economic aspects of living alone are suggested as factors, which might explain at least partly the marital diversity in blood pressure and the risk of hypertension in men.  相似文献   

18.
首都钢铁公司人群心血管病24年干预效果评价   总被引:15,自引:0,他引:15  
目的 探讨心血管病防治策略在我国城市企业人群中实施的可行性及其效果。方法 (1)干预措施:根据危险因素调查的特点,在厂区人群中开展卫生宣教和健康促进,重点加强对高血压患者的管理,在高危人群中推广以减盐为重点的合理膳食结构,指导减重、戒烟及限酒等;(2)效果评价:用非干预研究协作人群作横向比较人群间危险因素水平的变化;用首都钢铁公司(首钢)内干预样本的平行对照比较干预对危险因素的影响。用首钢全人群疾病监测资料来评价脑卒中、冠心病事件发病率和死亡率的变化趋势及其干预效果。结果 9组协作人群14年横向对比,除首钢外的8组协作人群男性平均收缩压升高2-11mmHg,女性平均升高6—8mmHg,首钢男、女性平均下降0.8和4mmHg;5组协作人群男性平均舒张压升高2~6mmHg,4组女性升高3~6mmHg,但首钢男女两性仍保持基线时水平。血清胆固醇水平除首钢男工与石景山男性农民仅轻度升高外,其他7组男性升高在0.35-0.97mmol/L之间。8组女性胆圊醇平均升高在0.29~1.05mmoL/L,但首钢女性却下降了0.26mmol/L。另9组人群超重患病率与基线时比较,除首钢仅增加58,7%(男性)和11.3%(女性)外,其他8组则增加1—22倍。平行对照8年干预结果表明,加强干预厂卫生知识水平较一般干预厂提高明显,平均收缩压、舒张压分别净下降2.5和2.2mmHg。24年来首钢人群脑卒中发病率和死亡率分别下降了54.7%和74.3%,但冠心病事件的发病率和死亡率还在波动中缓慢上升。结论 在我国城市企业人群中开展心血管病的防治不仅是可行的,而且是有效的,但需坚持。  相似文献   

19.
BACKGROUND: Hypertension is a major cardiovascular risk factor. The aim of this study was to establish the prevalence of high blood pressure in a European region in Northern Spain (Cantabria), and also levels of detection, treatment, and control. METHODS: On a random multi-stage sample of 1197 individuals aged 18 or over, stratified by sex and age, blood pressure measurements were taken and other general data were collected from 2002 to 2004. RESULTS: A prevalence of hypertension of 29% was found. The prevalence among males and females was similar, being 29% and 28%, respectively. Sixty five per cent of the hypertensive subjects were aware of their condition, 53% were undergoing treatment, and 22% presented readings below 140/90 mm Hg. CONCLUSIONS: Hypertension constitutes a public health problem in Cantabria, since it affects 1 in 3 of the adult population. Although levels of detection, treatment, and control are superior to those previously described in this region in 1989, the situation could clearly be improved.  相似文献   

20.
This article reports on the prevalence, awareness, treatment, and control of hypertension in a predominantly black population residing in the inner city of Detroit, Michigan. The data reported come from a cross-sectional survey of approximately 800 adults conducted in the fall of 1978. The prevalence of hypertension in the population studied, 38%, was similar for men and women below age 55; above age 55, women were more likely to have high blood pressure than men. Hypertension was positively related to the respondent's age and weight, but was not associated with having a family history of hypertension, or with the amount of cigarettes smoked daily. Compared with estimates of awareness, treatment, and control status of hypertensives derived from community surveys conducted in the 1960s, our findings indicate substantial improvement in hypertension management among a predominately black, urban population during the past decade. Of the hypertensives identified in our sample, 80% were aware of their hypertension before participation in the survey, 86% of those previously detected were being treated for their hypertension, and 26% of those being treated were adequately controlled (BP < 140/90 mm Hg). Awareness, treatment, and control rates appear to be age-related, with younger respondents less likely to be aware of their hypertension, on antihypertensive therapy, and successfully controlled. Below age 54, women were much more likely to be aware of their hypertension condition than men. Because of the lower detection rates among younger age groups it is recommended that future blood pressure screening efforts in the inner city be directed at younger adults (between the ages of 18 to 44), especially men.  相似文献   

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