Blood pressure distribution in a rural Ghanaian population

Hypertension and related complications appear, from clinical impression, to be increasing problems in urban Ghanaians. In early 1973 we conducted a blood pressure survey in 20 rural Ghanaian villages to determine the prevalence of hypertension, in comparison with studies done in Accra residents and black Americans. Rural Ghanaians had mean systolic and diastolic blood pressures which were lower at all ages than the urban groups. 2·5% of the subjects aged 16 to 54 years had diastolic blood pressures of 95 or higher mm Hg. These findings are discussed in view of the proposed hypertension control programme in Accra. We conclude that hypertension is not a significant health problem in rural Ghanaians and that large-scale hypertension case-finding and intervention programmes should be confined to urban populations.     

我国成年人单纯性收缩期高血压患病率调查

目的评估我国成年人单纯性收缩期高血压的患病率及其人群分布。方法亚洲国际心血管病合作研究(InterASIA)于2000至2001年进行,应用多阶段抽样方法选择15540名35～74岁成年人为代表性样本,分析单纯性收缩期高血压和其他亚型高血压的患病率。应用标准问卷调查高血压病史及其治疗情况。血压值为休息5min后3次坐位血压测量值的平均值。未接受抗高血压治疗的个体通过以下标准确定高血压亚型单纯性收缩期高血压为收缩压≥140mmHg(1mmHg=0133kPa),舒张期血压<90mmHg;单纯性舒张期高血压为收缩压<140mmHg,舒张压≥90mmHg,而收缩期和舒张期联合性高血压为收缩压≥140mmHg,舒张压≥90mmHg。结果15540名35～74岁成年人样本中,76%(1181人)患有单纯性收缩期高血压,74%(1150人)患有收缩期和舒张期联合性高血压,而44%(683人)患有单纯性舒张期高血压。收缩期高血压的患病率随着年龄的增长而增加,且老年女性比老年男性更为常见。南方与北方地区的单纯性收缩期高血压患病率没有明显差异;农村单纯性收缩期高血压患病率高于城市。结论我国收缩期高血压患病率较高,应引起重视。     

上海市成年居民高血压流行特点及防治现状

目的了解上海市居民高血压的流行现状。方法于2007年10月—2008年1月采用多阶段分层随机抽样的方法,对上海市17174名15～69岁常住人群进行问卷调查和血压测量。结果调查人群平均收缩压和舒张压分别为(129.3±17.1)mmHg和(81.3±9.5)mmHg,并均随年龄增加而升高(P0.001)。其中高血压患者4056人,高血压患病率为23.62%,标化患病率14.50%。中心城区高于非中心城区(P=0.001)。上海居民的高血压知晓率、治疗率和控制率分别为85.5%,74.2%和31.5%,中心城区高于非中心城区,女性高于男性,差别均有统计学意义(P0.01)。结论上海市居民平均血压较高,高血压知晓率和治疗率较高,但治疗率还有待进一步提高。     

Prevalence of hypertension in the urban and rural Zulu.

In a house-to-house study of 994 urban Zulus the prevalence of hypertension according to WHO criteria was 25% (23% men, 27% women). In a rural Zulu study of 987 the prevalence age corrected to the urban distribution was 9.4% (8.7% men, 10% women). Thus there was a pronounced difference between the prevalence of hypertension in the urban and rural Zulu (p less than 0.0005). There was an earlier onset of hypertension in the urban compared with the rural Zulu. Contrasting biosocial factors in the urban and rural Zulu could explain the differences in prevalence. Our study suggests that hypertension is not a major health problem in rural Zulus. Large-scale case finding and intervention programmes should be confined to the urban black population of South Africa.     

高血压防治相关知识对患者血压控制状况的影响

目的 探讨城乡患者的高血压防治相关知识水平与高血压控制率的关系。方法 对北京市城乡4个社区卫生服务中心经常就诊的726名高血压患者进行问卷调查并测量血压。结果 城乡患者高血压控制(血压低于140／90mm Hg，1mm Hg=0．133kPa)率分别为46．4％和23．9％。城乡高血压控制率均随患者防治知识知晓的积分增加而升高，在城市具有统计学显著性。相关知识的差异可解释高血压控制率城乡的差异(30．0％)。结论 患者高血压防治知识水平对其高血压是否得到控制有显著影响。对患者普及高血压防治基本知识，可有效提高高血压的控制率。     

口服α一硫辛酸对超重或肥胖患者脉搏波速度和卧位血压影响的随机、双盲、安慰剂对照、交叉试验研究

目的 探讨超重或肥胖患者口服抗氧化剂α-硫辛酸(ALA)对臂踝脉搏波速度(baPWV)、卧位收缩压(sSBP)和卧位舒张压(sDBP)的影响,为超重或肥胖相关心血管疾病的预防提供理论依据.方法 采用随机、双盲、安慰剂对照和交叉试验设计.按照入选标准(20～60岁汉族、BMI≥25 kg/m2和未服用任何抗氧化剂等)纳入研究对象103人(男性63人、女性40人).采用分层区组随机化设计方法将研究对象随机分到ALA组(52人)或安慰剂组(51人)进行为期8周的干预,剂量为1200mg/d.经过4周洗脱期后,两组干预措施交换再干预8周.基线测量包括问卷调查、人体测量、血压测量、脉搏波速度、卧位血压、血液生化指标的检测.两阶段起始和终末均采用统一的检测方法和同一批调查员.采用Stata 11.0软件进行混合效应模型分析.结果 ALA组和安慰剂组人体测量指标和生化指标的基线水平均衡可比(P＞0.05).经口服ALA 8周后,ALA组baPWV降低(-33.03±130.70)cm/s,安慰剂组升高(5.66±139.89)cm/s,两组差异无统计学意义(P=0.078).ALA组sSBP降低(-4.09±9.18)mm Hg,安慰剂组降低(-2.32±8.16)mm Hg,两组差异无统计学意义(P=0.067);ALA组sDBP降低(-1.29±6.55)mm Hg,安慰剂组降低(-0.48±6.63)mm Hg,但两组差异无统计学意义(P=0.595).混合效应模型分析结果显示,在控制了试验顺序、阶段等因素后,两组间baPWV、sSBP和sDBP的差异均无统计学意义.结论 ALA 1200mg/d口服8周,不能明显降低动脉硬度和卧位血压水平.

Abstract：

Objective To investigate the effect of oral alpha-lipoic acid (ALA) supplement on brachial-ankle pulse wave velocity (baPWV),supine systolic blood pressure (SBP) and diastolic blood pressure (DBP) in overweight/obese individuals.An 8-week double-blind,randomized,placebo-controlled and cross-over trial with a 4-week washout between cross-over periods.Methods Sixty-three males and 40 females aged 22-57 years old who met the inclusion criteria as (1) Han ethnicity;(2) 20-60 years old;(3) BMI≥25 kg/m2 and having at least one of the following risk factors:borderline hypertension (130 mm Hg≤SBP＜140 mm Hg and/or 85 mm Hg≤supine DBP＜90 mm Hg),dyslipidemia(fasting total cholesterol≥5.2 mmol/L or HDL-C＜1.04 mmol/L),or impaired fasting glucose (6.1 mmol/L≤fasting glucose＜7.0 mmol/L);(4)Not on any antioxidant gender.Group 1 received 8 weeks ALA (1200 mg/day) followed by 4-week washout period and followed by another 8 weeks placebo;while Group 2 received 8 weeks placebo (1200 mg/day)followed by 4-week washout period,and followed by ALA treatment for 8 weeks.BaPWV and supine blood pressure were measured at the beginning of 1st phase and 2nd phase and at the endpoint of the whole trial.Mixed effect linear regression model was performed to compare the change of baPWV and supine blood pressure between ALA group and placebo group.Results BaPWV decreased -33.03 cm/s ± 130.70 cm/s for ALA group and increased 5.66 cm/s ± 139.89 cm/s for placebo group,supine systolic blood pressure decreased -4.09 mm Hg±9.18 mm Hg for ALA group and -2.32 mm Hg±8.16 mm Hg for placebo group.Supine diastolic blood pressure decreased -1.29 mm Hg ± 6.55 mm Hg for ALA group and -0.48 mm Hg±6.63 mm Hg for placebo group.These three mix-effect models did not show significant effect of ALA treatment after adjustment on baseline values,sex,age,treatment sequence or period.Conclusion The current trial did not provide evidence that oral intake of ALA for 8 weeks had significant effects on lowering baPWV,supine systolic blood pressure or supine diastolic blood pressure.     

Occult Nighttime Hypertension in Daytime Normotensive Older Patients With Obstructive Sleep Apnea

ObjectivesTo assess nighttime blood pressure (BP), the dipping phenomenon and the relationships between nighttime BP, and polysomnography parameters in older patients with obstructive sleep apnea (OSA) who have been identified by their primary care physician as being normotensive during the daytime.DesignCross-sectional study.SettingUniversity hospital-based geriatric sleep center.ParticipantsDaytime normotensive, community-dwelling older adults, consecutively referred by their primary care physicians for suspicion of OSA.MeasurementsOvernight polysomnography and 24-hour ambulatory blood pressure measurement (ABPM). Daytime hypertension defined as systolic BP ≥135 mm Hg and/or diastolic BP ≥85 mm Hg. Nighttime hypertension defined as systolic BP ≥120 mm Hg and/or diastolic BP ≥70 mm Hg. Dipper pattern characterized by nighttime fall of mean BP ≥10%.ResultsForty-five participants (30 OSA; 15 non-OSA) completed the study (76.9 ± 6.2 years old). ABPM indicated clinically significant nighttime systolic (132.5 ± 16.0) and diastolic (72.6 ± 9.4) hypertension in patients with OSA previously classified as daytime normotensives and found only a mild degree of nighttime systolic hypertension (123.7 ± 16.1) in patients without OSA (P = .105). A significant nondipping phenomenon was found in patients with OSA (–0.5 ± 7.4 vs 5.4 ± 6.4; P = .016). Nighttime mean BP (r = 0.301; P = .049) and dipping status (r = –0.478; P = .001) were correlated with apnea-hypopnea index. A significant correlation was found between systolic BP (r = 0.321; P = .035), diastolic BP (r = 0.373; P = .013), mean BP (r = 0.359; P = .018), and hypoxia (sleep time spend with SaO2 <90%).ConclusionDaytime normotensive older adults with OSA are at high risk for having occult nighttime hypertension. Thus, 24-hour ABPM may be appropriate for older patients with OSA whose clinical blood pressure does not display any daytime elevation.     

北京市中关村社区高血压病例管理方案实施效果评价

目的探索适合社区应用的、规范有效的高血压病例管理方案。方法采取以正常血压值为管理目标,以《中国高血压防治指南》为指导的社区高血压病例管理方案,对中关村社区卫生服务中心567例签约的高血压患者进行随访研究。结果6个月后,高血压患者的血压控制率明显上升(P<0.0001),由原来的50.44%上升到69.84%,整体血压水平显著下降(P<0.0001),收缩压(SBP)下降了3.72mmHg(1mmHg=0.133kPa),舒张压(DBP)下降了2.67mmHg,基线血压异常者SBP下降了8.59mmHg,DBP下降了5.26mmHg。患者的危险行为如吸烟、食盐过多、不参加体育锻炼的比例明显下降(P<0.05)。家庭医生对患者6个月内人均随访次数为7.69次±2.37次,按要求随访患者的血压控制率明显高于不按要求随访患者的血压控制率(P<0.0001),随年龄、文化程度的增高按时随访率有升高趋势(P<0.001)。结论社区卫生服务机构实施的高血压病例管理方案,对提高社区患者的血压控制率是一种有效的管理模式,患者按照家庭医生的要求随访有利于血压控制。     

An inter-racial study of the prevalence of hypertension in an urban South African population

This study was done to compare and contrast the prevalence of hypertension in the three racial groups of Durban, namely the Africans (Zulus), Indians and Whites, and was a random house-to-house study of 1,000 of each group. The prevalence of hypertension according to World Health Organization (WHO) criteria was highest in the African (25%), intermediate in the White (22·8%) and lowest in the Indian (19%). Age-corrected prevalence rates were: African 25%, Whites 17·2% and Indians 14·19%. Prevalence of hypertension was more common in females than in males in the African and Indian population, unlike the Whites. In all racial groups the mean arterial pressure rose with age. Unlike the White study, African females between the ages of 35 and 40 years had a higher prevalence than males. There was an association between hypertension and diabetes mellitus in the Indian population. This study showed that all three population groups had hypertension which was undiagnosed, undetected or inadequately treated. The high prevalence of hypertension in the White and Indian population could explain the high incidence of ischaemic heart disease (IHD) in South Africa. In the African population, whilst they are spared IHD, hypertension is a major factor for the high incidence of cerebrovascular episodes. The lower prevalence of hypertension in the rural Zulu population and the difference in the years of residence between the hypertensive and normotensive urban Zulu suggests that urbanization plays an important part in the aetiology of hypertension in the Zulu.     

Incidental blood pressure elevations: a MIRNET project

BACKGROUND. A prospective study was undertaken to determine the prevalence of hypertension in office patients with an incidental diastolic blood pressure greater than or equal to 90 mm Hg. METHODS. During routine screening of 14,890 patients, 174 patients with elevated diastolic blood pressures but no previous diagnosis of hypertension were identified over a 3-month period. Only 115 (64%) returned as requested for two subsequent blood pressure readings. RESULTS. Sixty percent of those returning fit the definition for hypertension using the criteria of the Joint National Committee on Detection, Evaluation, and Treatment of Hypertension. Sixty-nine percent (43/62) of the men and 49% (26/53) of the women were hypertensive. Women under 40 years old were less likely to be hypertensive, but age did not predict hypertension in men. Among those patients with a diastolic pressure reading below 105 mm Hg, progressively higher diastolic readings on the first visit did not predict a higher probability of hypertension. Among those patients with a diastolic pressure reading above 105 mm Hg, however, 90% (9/10) were hypertensive. CONCLUSIONS. Physicians should take incidental elevation of diastolic pressure seriously because of the high prevalence of confirmed hypertension in this group of patients.     

The distribution and associations of blood pressure in an adolescent population.

In this report we describe the distributions of blood pressure and its associations in adolescence. Six hundred and twenty-five subjects aged 13 to 18 were drawn from three general practices in different urban and rural settings. Systolic pressures were higher and rose with age in boys (mean = 119 mm Hg) compared with girls (mean = 114 mm Hg), who showed no age association. Diastolic pressures (phase 5) were higher in girls (mean = 64 mm Hg) than in boys (mean = 60 mm Hg) and showed no association with age in either sex. Initial blood pressures were generally higher than those recorded after a further five minutes' rest in the sitting position, although diastolic pressures rose on the second reading in the older subjects. Systolic pressures of subjects from the suburban practice and in the late autumn were relatively low; diastolic pressures tended to be lower in the spring and in subjects from the rural practice. Systolic pressures were lower in the morning and this was found to be primarily related to fasting status. Individuals with a positive family history of hypertension had significantly higher blood pressures than those with a negative history. Boys who frequently played sports had lower diastolic pressures, largely accounting for the above sex difference. We conclude that although blood pressure measurement in adolescence is a difficult screening procedure it should be offered to selected groups such as those with a family history of hypertension.     

Oscillometric finger blood pressure versus brachial auscultative blood pressure recording

In this study, a recently marketed proprietary finger blood pressure monitor, the Marshall, Astro F-88, was compared with the standard auscultative brachial mercury sphygmomanometer on 125 subjects. Measurements were undertaken according to the standards set by the American Heart Association. Sensitivity of the finger blood pressure measurement was 76% for systolic and 75% for diastolic blood pressure in diagnosis of high blood pressure (systolic greater than 140 mm Hg and diastolic greater than 90 mm Hg). Specificity was 86% for systolic and 82% for diastolic blood pressure. Positive predictive values were 58% for systolic and 38% for diastolic blood pressure in the study population in which prevalence of hypertension was 12%. The correlation coefficient (Pearson) for systolic values between devices was 0.76 (P less than .0001) and 0.57 (P less than .0001) for diastolic pressure. Values obtained by the finger monitor were found to be higher than those obtained by the mercury sphygmomanometer. Mean differences and standard deviations (paired t test) for systolic and diastolic pressures between the two devices were 2.3 +/- 14.9 mm Hg (P less than .08) and 2.9 +/- 14.5 mm Hg (P less than .02), respectively. These values are not in accordance with the proposed national standards because only 48% of the systolic and 37% of the diastolic blood pressure measurements were within 5 mm Hg of the mercury sphygmomanometer measurements. Therefore, although these differences may well be due to different techniques of monitoring employed by the devices, this device is not recommended for evaluation of blood pressure.     

中国中年人群高血压患病率及知晓率、治疗率、控制率的演变趋势

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。     

Different Associations of Blood Lead,Meso 2,3-Dimercaptosuccinic Acid (DMSA)-Chelatable Lead,and Tibial Lead Levels with Blood Pressure in 543 Former Organolead Manufacturing Workers

In this study, the authors' objective was to determine the influence of blood lead, meso 2,3-dimercaptosuccinic acid (DMSA)-chelatable lead, and tibial lead on systolic and diastolic blood pressures and on hypertension in 543 former organolead manufacturing workers. All workers had past exposure to inorganic and organic lead. The authors used linear regression to model systolic and diastolic blood pressure separately, and logistic regression was used for the modeling of hypertension status (i.e., systolic blood pressure > 160 mm Hg, diastolic blood pressure ≥ 96 mm Hg, or current use of antihypertensive medications). Blood lead, DMSA-chelatable lead, and tibial lead levels had means (standard deviations appear within parentheses) of 4.6 μmlg/dl (2.6 μmlg/dl), 19.3 μmlg (17.2 μmlg), and 14.4 μmlg/g (9.3 μmlg/g) respectively. The authors adjusted for covariates, and they found that blood lead was a predictor of (1) both systolic and diastolic blood pressures and (2) hypertension status in men ≤ 58 y of age. DMSA-chelatable lead and tibial lead were not associated with any of the blood pressure measures. Systolic blood pressure was elevated by blood lead levels as low as 5 μmlg/dl. We speculate that lead may have a transient influence on blood pressure that is related to target dose levels obtained once release of lead from body stores has occurred.     

Studies in hypertension: implications for clinical medicine

Population studies that demonstrated risk from elevation of blood pressure were a necessary foundation for a sound clinical approach to hypertension. Clinical trials then demonstrated that lowering pressure with drug therapy dramatically reduced risk of cardiovascular catastrophes, including death. The U.S. Veterans Administration (VA) study proved the need to treat moderate and severe hypertension, but left unproven the benefit for so-called mild hypertension (diastolic blood pressure 90–104 mm Hg). The Hypertension Detection and Follow-up Program (HDFP) investigated applicability of VA findings to the “average” hypertensive, particularly to the majority in the range 90–104 mm Hg. Two randomly constituted groups, Stepped Care (SC) and Referred Care (RC), included 10,940 hypertensives, age 30–69, identified in population-based screening in 14 communities, and followed for 5 years. Almost $\text{3}\text{4}$ (71%) were so-called mild hypertensives. SC patients were treated vigorously in special clinical centers to lower pressure to a diastolic goal no higher than 80–90 mm Hg (depending on entry level), starting with low dose diuretics and adding medication stepwise as needed, until the goal was reached. RC patients were treated by usual sources of medical care. A larger proportion of SC than RC patients were on therapy and at the goal each year of the study. The fifth year diastolic average was 84 mm Hg in SC and 89 mm Hg in RC. The 5-year all causes mortality rate was 17% lower in SC than RC. In the mild hypertension stratum, this difference was 20%. Clinical implications from the HDFP trial include demonstration of: the validity of the VA findings on the benefit of treating moderate and severe hypertension; the benefit of treatment also for those with sustained average diastolic pressures 90–104 mm Hg; the utility of lowering pressure before target organ damage; the utility of stepwise drug treatment to a normotensive goal; the ability to achieve long-term patient adherence; the contribution of nonphysician personnel in helping achieve these aims. The possible role of non-pharmacologic measures was not tested in these trials and remains an important question in determining best methods for control of hypertension.     

The effect of cuff size on blood pressure measurement in adults

We measured blood pressure differences by cuff size in 181 adults aged 25 to 74 years, allocated to a random sequence that involved the measurement of blood pressure using a small cuff, a large cuff, and an appropriate cuff as determined by standardized arm circumference measurement. Systolic and diastolic blood pressure were underestimated by 3-5 mm Hg in men and 1-3 mm Hg in women when the cuff was one size larger than appropriate. Systolic and diastolic blood pressure were overestimated by 2-6 mm Hg in men and 3-4 mm Hg in women when the cuff was one size smaller than appropriate. In addition, 30-40% of subjects were "misclassified" when blood pressure cutpoints were used to define hypertension.     

中老年人血压水平与脑卒中患病率及患病风险的相关性研究

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。     

Green tea catechins and blood pressure: a systematic review and meta-analysis of randomised controlled trials

Purpose

Although previous literature has reported that regular green tea consumption may improve blood pressure, the evidence from these studies is not consistent. The present study systematically reviewed randomised controlled trials and examined the effect of green tea consumption on blood pressure using meta-analysis.

Methods

Search of ProQuest, PubMed, Scopus and Cochrane Library (CENTERAL) was conducted, to identify eligible articles. Articles from 1995 to 2013 were included. A random-effect model was chosen to calculate the effect of combined trials.

Result

Thirteen studies were included in the meta-analysis. Green tea consumption significantly changed systolic blood pressure, by ?2.08 mm Hg (95 % CI ?3.06, ?1.05), and diastolic blood pressure, by ?1.71 mm Hg (95 % CI ?2.86, ?0.56), compared to the control. Changes in lipid profile, blood glucose and body mass index were also assessed in the meta-analysis. A significant reduction was found in total cholesterol (?0.15 mmol/L [95 % CI ?0.27, ?0.02]) and low-density lipoprotein cholesterol (?0.16 mmol/L [95 % CI ?0.22, ?0.09]). Changes in other parameters did not reach statistical significance. Subgroup analysis suggested a greater reduction in both systolic and diastolic blood pressure in studies that included participants with a baseline mean systolic blood pressure of ≥130 mm Hg, and studies involving consuming green tea as an extract.

Conclusion

The present meta-analysis suggests that green tea and its catechins may improve blood pressure, and the effect may be greater in those with systolic blood pressure ≥130 mm Hg. The meta-analysis also suggests that green tea catechins may improve total and low-density lipoprotein cholesterol.     

农村居民高血压患病及影响因素分析

目的 了解山东省中西部地区25岁~农村常住居民高血压流行现状及其影响因素,为制定干预措施提供科学依据。方法 采用多阶段分层随机抽样的方法,对该地区的调查对象进行问卷调查、体格检查以及实验室检测,应用Logistic回归分析方法分析高血压相关影响因素。结果 该地区农村居民收缩压和舒张压平均水平分别为135,84 mmHg,男性收缩压和舒张压平均水平均高于女性,高血压粗患病率为43.8%,其中1,2,3级高血压患病率分别为24.4%,11.9%和5.8%。高血压标化患病为37.8%,男性为40.8%,女性为34.8%,男性高于女性。男、女高血压患病率均随着年龄的增高而升高。高血压患病的主要危险因素为年龄、体质指数(BMI)、高血压家族史、糖尿病、静态活动时间长、高饮酒量和碳水化合物供能比高;女性和高蔬菜摄入量为高血压的保护因素。结论 该地区农村居民高血压患病率较高,预防控制肥胖和糖尿病是高血压防治的重点。     

Race, rural residence, and control of diabetes and hypertension

PURPOSE: African Americans are at increased risk for diabetes mellitus and hypertension, and rural residents have historically had decreased access to care. It is unclear whether living in a rural area and being African American confers added risks for diagnosis and control of diabetes and hypertension. The purpose of this study was to examine the prevalence of diagnosed diabetes and hypertension, as well as control of both conditions, among rural and urban African Americans and whites. METHODS: We conducted an analysis of the Third National Health and Nutrition Examination Survey (1988-1994). Non-Hispanic African Americans and non-Hispanic white adults 20 years and older were classified according to rural or urban residence (n = 11,755). Investigated outcomes were previously diagnosed diabetes mellitus and hypertension and control of diabetes and hypertension. RESULTS: The prevalence of diagnosed diabetes was 4.5% for urban whites, 6.5% for rural whites, 6.0% for urban African Americans, and 9.5% for rural African Americans. Among patients with diagnosed diabetes, 33% of rural whites, 43% of urban whites, 45% of urban African American, and 61% of rural African Americans had glycosylated hemoglobin (HbA(1c)) levels of 8% or higher (P < .01). Among patients with diagnosed hypertension, 11% of rural whites, 13% of urban whites, 20% of urban African Americans, and 23% of rural African Americans had diastolic blood pressure greater than 90 mmHg (P < .01). In regression models controlling for relevant variables, including body mass index, health status, access to care, education, income, and insurance, compared with rural African Americans, rural and urban whites were significantly more likely to have better glycemic control and diastolic blood pressure control. Urban African Americans also had better diabetes control than rural African Americans. CONCLUSIONS: In this nationally representative sample, rural African Americans are at increased risk for a lack of control of diabetes and hypertension.