长沙市中老年社区人群高血压的流行病学研究

目的：研究中老年城市居民高血压的流行情况，方法：1997年在长沙市进行35岁以社区人群血压的随机抽样调查。结果：长沙市35岁以上居民高血压的患病率为32．25％，在男女性之间无差异；高血压患病率随着年龄的增长而升高；不同职业，不同劳动强度人群之间高血压现率存在差异，结论：长沙市中老年社区人群中近三分之一的人患有高血压病，不同职业和不同劳动强度人群高血压患病率不同。     

火车司乘人员高血压流行病学特点调查研究

目的调查火车司乘人员高血压流行病学特点。方法选取2011年1—7月某机务段某运转车间火车司乘人员769例作为暴露组,另选取同单位非司乘人员1 000例作为对照组,由经过培训的专业人员负责测量被调查者身高、体质量、腹围及血压,并发放设定的调查问卷,采血测定空腹血糖、血脂,检查尿十项及餐后2 h血糖(末梢血)。比较两组不同危险因素及并发症、工龄、年龄人群间高血压发病率。结果暴露组高血压发病率为34.72%(267/769),高于对照组的18.70%(187/1 000)(P0.05)。暴露组不同危险因素人群、不同年龄段人群及不同工龄人群间高血压发病率均高于对照组(P0.05);且危险因素越多、年龄越大、工龄越长高血压发病率越高。结论火车司乘人员高血压患病率明显升高,有年轻化趋势,可能受工作环境不稳定、工作压力大、劳动强度高以及噪声等因素影响有关。     

稳定控制区布氏菌病防治工作的设想

以往，布氏菌病(简称布病)的重点职业人群非常集中，布病感染率及发病率的高低主要取决于他们与病畜接触的密切程度和机会的多少。只要把住牲畜检、免疫、病畜淘汰及重点职业人群的个人防护关，就可以有效的控制布病的发生。而在商品市场非常开放的今天，传统意义上的重点职业人群被社会人群所取     

关注肥胖性高血压诊治的特殊性

随着经济发展和生活方式的改变，国内外肥胖发病率显著增加，据统计我国居民超重率为17．6％，肥胖率为5．6％，超重及肥胖人群已接近总人口的四分之一。肥胖相关疾病，如高血压、代谢综合征、糖尿病和冠心病的发病率也随之增加。高血压是最常见的肥胖相关性疾病，流行病学调查表明，肥胖人群中高血压患病率超过50％，     

职业司机高血压流行现状以及相关影响因素分析

目的:研究职业司机高血压的流行现状以及相关影响因素。方法:纳入2015年5月至2015年9月进入深圳市级医院进行体检的职业司机共2693例。根据是否患有高血压,所有职业司机被分为高血压组(759例)和血压正常组(1934例)。分析比较两组的一般资料,并采用Logistic回归分析职业司机患高血压的危险因素。结果:本研究纳入的2693例职业司机中,高血压患者有759例(28.18%)。与血压正常组比较,高血压组≥45岁(3.78%比41.37%)、男性(66.03%比81.29%)、小学及以下文化程度(81.75%比92.22%)、喜爱腌制品(14.48%比70.75%)、从不运动(24.15%比50.33%)和糖尿病比例(11.17%比36.10%)均显著升高(P均0.01)。将一般资料带入Logistic回归分析方程,结果显示年龄、男性、文化程度、喜爱腌制品、每日活动时间和糖尿病均是职业司机患高血压的危险因素(OR=1.095~1.393,P均0.01)。结论:对于职业司机,应提倡其进行规律运动并控制饮食,加强有关高血压的健康宣教,以降低该职业人群的高血压发病率。     

中北社区糖尿病及糖调节受损患者流行病学调查与研究

通过对中北大学社区人群2000人进行OGTT试验,确定糖尿病及糖调节受损人群,并与其年龄分布、体重指数、血压、及职业特点进行相关性分析.结果DM发病率为3.1%,IGR的发生率为5.03%,且随年龄增长而增加,BMI≥23者DM、IGR发病率较BMI＜23者高,DM和IGR人群中高血压的患病率明显高于正常人群,有显著统计学意义,而DM及IGR分布也有其职业特点.结论早期发现DM和IGR人群,进行积极的防治,可有效控制、延缓糖尿病及其并发症的发生.     

高血压合并糖尿病临床分析

在糖尿病患者中，高血压的发病率是正人群的1．5—3倍，糖尿病与高血压并存相当常见，高血压是糖尿病患者发生动脉硬化和肾衰竭的重要原因，因此降压治疗至关重要。     

不同职业人群与心血管发病危险因素的关系

目的探讨不同职业人群与心血管发病危险因素的关系。方法选择3370名不同职业人群进行健康检查，测定血压、心电图、胆固醇、甘油三酯的含量，应用职业紧张测试表OSI测量职业紧张评分，根据职业紧张评分将队列分为高、中、低职业紧张暴露组。结果职业紧张度高-教师组与职业紧张度中-有害作业高温工人心血管发病率明显高于职业紧张度低-营业人员，差异有显著性（P〈0．005），并且随年龄、工龄的增加，心血管发病率也增高。结论职业紧张是职业人群发生心血管疾病的危险因素之一；职业紧张引起心血管疾病是在长期慢性紧张刺激下发生发展的。     

高血压小动脉硬化与慢性肾功能衰竭

高血压小动脉硬化与慢性肾功能衰竭第二军医大学长征医院（上海，２００００３）梅长林高血压病是我国常见病之一，近年来我国普查发现，高血压在人群中的发病率为１１．８８％，其中临界高血压发病率为５．２６％，确诊高血压发病率为６．６２％。高血压可引起遍及全身的...     

2003年新乡市铁路职工高血压患病率调查

近年随生活方式改变，高血压发病率进一步增加。据已有资料表明，我国人群中高血压患者已超过1亿。高血压是心脑血管疾病诸多危险因素中最重要的独立危险因素，预防和治疗高血压，可以使心脑血管病的发病率和致死率下降。故防治高血压是心脑血管疾病防治的关键。而了解高血压的流行情况是进行有效高血压防治的基础。新乡市现有铁路职工近10000名，职工长年在铁路沿线工作，生     

Stress,Coping, Lifestyle and Hypertension: A Paradigm for Research,Prevention and Non-Pharmacological Management of Hypertension

Lifestyle related factors such as obesity, drinking habits, sodium and potassium intake and physical inactivity are well established determinants of high blood pressure. The role of psycho-social stressors, and in particular environmental work or home stress is far less clear. Some but not all studies using the Karasek ‘job-strain’ model have found a relationship with ambulatory blood pressure levels. Other studies using more ‘subjective’ measures of occupational stress have found no relationship or even inverse associations with blood pressure. The possibility that relationships between external stressors, personality factors and blood pressure levels might be mediated or confounded by coping mechanisms influencing lifestyle factors known to directly affect blood pressure has not been adequately studied. This paper briefly explores the paradigm relating environmental psychosocial stress, individual coping mechanisms, lifestyle behaviours and blood pressure levels.The issues are critical for research methodology in this area and for the development of better behavioural strategies for the prevention and nonpharmacologicalmanagement of hypertension.     

Hypertension,a linchpin between environmental noise exposure and the development of cardiovascular disease?

Environmental noise exposure has been considered one of the most common hazards worldwide, especially in the workplace environment, and could produce a variety of health issues. Some epidemiological evidence supports the association between occupational noise exposition and a high risk for hypertension and cardiovascular diseases. Wang et al. has conducted an observational cross-sectional study using occupational data of 4746 workers, 32.4% were exposed to high occupational noise. These exposed individuals had a moderate increase in the risk for hypertension (adjusted odds ratio [OR], 1.30; 95% confidence interval [CI], 1.05–1.62). The subgroup analyses showed that the relationship between noise and hypertension prevalence was stronger in young participants (OR, 1.70; 95% CI, 1.21–2.40). Noise exposure activates the sympathetic and endocrine systems producing an increase in blood pressure and the changes in other biological risk factors. Moreover, a recently published study showed that oxidative stress and DNA damage were significantly higher in subjects exposed to noise. Emotional stress reactions and unconscious physiological stress could also be potential mechanisms for hypertension. Finally, physiological stress caused by noise exposure may also increase indulgence in unhealthy behaviors, such as smoking and alcohol consumption, and indirectly result in an increased risk of hypertension and cardiovascular diseases. Previously published studies showed relationships between environmental noise exposure (including road traffic, railway, and aircraft noises) and the development of hypertension and cardiovascular diseases. Thus, the study by Wang et al. emphasizes the importance of environmental control in the prevention of cardiovascular diseases, not only in the workplace but also outside it.     

Hypertension and stress

This study explores the relationship of chronic stress to hypertension. The study included 127 hospitalized and 134 outpatients of a stress treatment program and 129 "normal" persons in the general population. All subjects were matched for age, sex, and race. After three days of hospitalization, there was a 17.3% incidence of hypertension in the hospitalized patients when hypertension was defined as blood pressure levels greater than 140/90 mmHg. These data compare with a 5% and 13% incidence of hypertension in the outpatient stress and "normal" groups, respectively. The National Health Survey of 1962 indicated that 18% of the population were hypertensive. Our data indicate that the incidence of hypertension was no greater in a diagnostically established group of hospitalized stress patients than in the less stressed outpatient or an otherwise "normal" group. The frequently expressed notion that tension and chronic stress predispose a population to essential hypertension is not confirmed by this analysis.     

A review of the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

Hypertension is a major modifiable risk factor for cardiovascular diseases. After decades of improvement, population surveys demonstrate disturbing downward trends in the rates of awareness, treatment, and control of this disorder in recent years. Over this same time period, there has been a slight increase in the incidence of strokes, and a steady rise in the incidence of end-stage renal disease and the prevalence of congestive heart failure, conditions in which hypertension plays a prominent role. Results of recent studies support the possibility that lifestyle modifications may be effective for prevention of hypertension. Treatment of established hypertension involves lifestyle modifications and drug therapies designed to control blood pressure and reduce overall cardiovascular risk. Both threshold blood pressure levels for initiating drug therapy and goal blood pressure levels with treatment are individually determined based on the presence or absence of additional cardiovascular risk factors and hypertension target organ injury or clinical cardiovascular disease. Recent clinical trials support the value of lower goal blood pressures for patients with diabetes, heart failure, and renal disease. The presence or absence of comorbid conditions often determines specific drug choices. Diuretics and beta-blockers remain the drugs of choice in uncomplicated hypertension. Additional studies confirm the benefits of treating isolated systolic hypertension in the elderly. The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure provides a practical, evidence-based resource to help health care providers meet the public health challenges of preventing and controlling hypertension.     

高血压社区综合干预研究

目的　探讨以社区为基础的高血压综合防治模式。方法　选择嘉兴、绍兴、丽水三地区作为农村、城市、城镇社区 ,分别设立干预区和对照区。在干预区内对一般人群进行健康促进 ,对高危人群进行强化干预 ,对患病人群进行系统管理。结果　通过社区综合干预 1)提高了人群高血压知晓率、服药率 (44 6 5 % )和血压控制率 (11 78% ) ;2 )多种高血压危险因素得到进一步控制 ;3)高血压患者平均收缩压下降 2 6 9mmHg ,舒张压下降 3 2 2mmHg ;4 )心血管急性事件的发生率和死亡率逐年降低。结论　以社区为基础的高血压综合干预措施对减少人群的高血压危险因素水平、增加高血压患者的治疗率和血压控制率 ,降低心血管急性事件的发生率和死亡率不仅有效 ,而且是切实可行的。     

Carryover effects after cessation of drug treatment: trophies or dreams?

BACKGROUND: In randomized trials of primary prevention, there has been interest in the persistence of a beneficial effect of therapy after treatment has been stopped. We investigated the impact of measurement error in the outcome on results of the trial of preventing hypertension (TROPHY), a trial of candesartan vs. placebo for preventing hypertension in prehypertensive subjects. METHODS: We simulated the TROPHY study design, assuming that candesartan reduced blood pressure by 8/6 mm Hg during treatment, but had no carryover effect after treatment stopped. We simulated individual true blood pressures in the TROPHY-eligible range of 130-140 mm Hg for systolic blood pressure and 80-90 mm Hg for diastolic blood pressure, and added individual measurement variability. As in TROPHY, incident hypertension was defined as any three occurrences of systolic blood pressure 140 mm Hg or diastolic blood pressure 90 mm Hg. RESULTS: In the absence of any carryover effect, typical incidence curves for time to hypertension were similar to those from TROPHY. A significant difference in cumulative incidence 2 years after stopping treatment was detected in 80% simulated studies, giving a Type I error rate of 80%. CONCLUSIONS: The published data from TROPHY are consistent with a lack of carryover effect of candesartan.     

Hypertension and kidney disease: A deadly connection

Kidney disease may be the cause or a consequence of hypertension. Hypertension affects 25% of the adult population in the United States. Similarly, chronic kidney disease (CKD) and end-stage renal disease (ESRD) have been steadily increasing in incidence because of the increasing age of the US population and rise in the incidence of risk factors, including hypertension. Substantial evidence supports the notion that elevated blood pressure is the most significant risk factor for developing CKD. Microalbuminuria has been shown to be the early marker of hypertensive renal disease. Furthermore, therapy to reduce microalbuminuria was associated with delayed progression of renal disease. Black Americans are at higher risk for developing hypertensive nephrosclerosis than whites. Hypertension is a major risk factor for cardiovascular events in patients with CKD and ESRD and those who have undergone renal transplantation. Studies have documented that elevated serum creatinine and CKD are risk factors for a cardiovascular event. Tight blood pressure control has been shown to reduce microalbuminuria and proteinuria and to delay progression of renal disease. Tailoring antihypertensive medication to the clinical setting to achieve a blood pressure goal is critical in reducing complications from this deadly connection.     

Blood Pressure,Sodium Intake,and Hypertension Control: Lessons From the North Karelia Project

From the very beginning of the North Karelia Project, prevention, detection, and control of hypertension were included as key aims in the project. An intensive hypertension prevention and control program was established in North Karelia in 1972 that included community-based activities to reduce blood pressure levels in the entire population, detect people with hypertension, improve their treatment, establish standard diagnostic and therapeutic methods, and to monitor blood pressure levels, control of hypertension, and the performance of the health care. After the first 5 years of the project, most of these activities were also implemented on the national level. In late 1970s, work to reduce the salt intake was started, and substantial reductions have taken place in salt intake in the Finnish population. Remarkable improvements have been seen both in blood pressure levels and in treatment and control of hypertension in North Karelia and in the whole of Finland. Between 1972 and 2012 in North Karelia, the mean systolic blood pressure among 30- to 59-year-old men has decreased from 149 mm Hg to 135 mm Hg and among women from 153 mm Hg to 129 mm Hg. The decreases in mean diastolic blood pressure have been from 92 mm Hg to 84 mm Hg among men and from 92 mm Hg to 79 mm Hg among women.     

Does socioeconomic status affect blood pressure goal achievement?

Hypertension is a major cause of disease burden in all racial, ethnic, and socioeconomic groups in developing and developed regions and countries. Differences in blood pressure likely begin early in life and reflect a complex relationship of biologic, genetic, social, and environmental interactions. The relationship between socioeconomic status and hypertension is complex and difficult to measure. Instituting lifestyle changes for the primary prevention and treatment of hypertension among the general population would decrease prevalence, improve blood pressure control, and be effective in eliminating many socioeconomic differences in risk factors for cardiovascular disease. Health care providers can potentially impact blood pressure control by incorporating knowledge of socioeconomic factors and mechanisms in care delivery. This review highlights socioeconomic status in the prevalence and incidence of hypertension and identifies contributing factors associated with blood pressure control.     

Dietary salt reduction in hypertension—What is the evidence and why is it still controversial?

The link between sodium intake and hypertension remains controversial because of inconsistency between early epidemiologic studies, which showed a strong positive relationship between salt intake and blood pressure/incidence of hypertension, and more recent studies, which showed only modest decreases in blood pressure with sodium reduction, particularly in the normotensive population. In addition, there is clinical evidence that sodium is related to target organ damage such as left ventricular hypertrophy and renal disease. Although the evidence available linking sodium intake and blood pressure in the general population is weak, sodium reduction has been shown to be useful in hypertensive patients, particularly salt-sensitive patients. Whether dietary sodium reduction should be recommended for the general population remains questionable because of marginal benefit and the suggestion of possible deleterious effects on cardiovascular outcomes independent of blood pressure. This paper will review the definition and methods used in determining salt sensitivity, the evidence linking sodium intake and target organ damage, and modern studies of salt and blood pressure.