Prevalence of isolated systolic and isolated diastolic hypertension subtypes in China

BACKGROUND: Isolated systolic hypertension (ISH), more so than any other hypertension subtype, increases the risk for stroke and coronary heart disease. The prevalence of ISH versus other hypertension subtypes in the general Chinese adult population is not known. METHODS: The prevalence of isolated systolic and isolated diastolic hypertension (IDH) was examined in a representative national sample of 15,540 Chinese adults aged 35 to 74 years. Three seated blood pressure (BP) measurements taken after 5 min of rest were averaged and hypertension subtypes were defined among individuals not receiving antihypertensive therapy as follows: ISH as systolic BP >/=140 mm Hg and diastolic BP <90 mm Hg; IDH as systolic BP <140 mm Hg and diastolic BP >/=90 mm Hg; and combined systolic/diastolic hypertension (SDH) as a systolic BP >/=140 mm Hg and diastolic BP >/=90 mm Hg. RESULTS: Overall, 7.6% of the Chinese adult population had ISH, 7.4% had SDH, and 4.4% had IDH. The prevalence of ISH increased with age and was more common in older women than in older men. Stage 1 hypertension was much more prevalent than stage 2 hypertension among all hypertension subtypes. The prevalence of SDH, IDH, and ISH (women, only) were higher in northern China than southern. The prevalence of ISH and SDH (women, only) were higher among rural residents versus urban residents. CONCLUSIONS: These data document high rates of ISH in China. Given the risk of cardiovascular disease associated with ISH, our findings underscore the critical need for enhanced hypertension screening and treatment programs in China.     

社区人群高血压类型与脑卒中发病关系研究

目的了解不同高血压类型与脑卒中发病之间的关系。方法收集年龄≥35岁社区人群的数据资料,对36836例基线调查时测得的血压与随访3 a监测的脑卒中发病情况进行相关分析,将新发脑卒中作为研究终点。结果高血压患病率约为23.9%;其中单纯收缩期高血压（ISH）患病率为11.1%,单纯舒张期高血压（IDH）为2.3%,混合型高血压（SDH）为10.5%。随访114339人年,共发生脑卒中事件356例,其中缺血性卒中240例,出血性卒中97例,未分类卒中19例,总脑卒中的发病率为311.4/10万人年。SDH组发生脑卒中的危险比其他组高,其发生总的脑卒中、缺血性卒中和出血性卒中的相对危险度及95%CI分别为3.03（2.20-4.15）、2.66（1.81-3.90）、3.09（1.67-5.69）。SDH组男性发生脑卒中的危险比女性高。结论ISH的患病率比IDH高,二者均会增加发生脑卒中的危险。SDH患者发生脑卒中的危险性最高,应该及时积极治疗。     

Trends in the prevalence of hypertension according to severity and phenotype in Chinese adults over two decades (1991‐2015)

Until recently, few studies have reported the secular trend and associated factors of hypertension severities and phenotypes in China. In this study, the authors aimed to assess the trend in the prevalence of hypertension according to severity and phenotype in Chinese adults from 1991 to 2015 and to explore potential cardiometabolic factors. From the China Health and Nutrition Survey (CHNS), the authors included 164 682 records of adults (≥18 years). The prevalence of hypertension by severity (stage 1 and stage 2 hypertension) and by phenotype (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], and systolic‐diastolic hypertension [SDH]), during 1991‐2015 was explored. The potential effects of demographic, socioeconomic, geographic, and cardiometabolic factors on hypertension severities and phenotypes were assessed by multivariable logistic regression. During 1991‐2015, the overall prevalence of hypertension increased dramatically from 15.7% to 23.3%. For stage 1 and stage 2 hypertension, the age‐standardized prevalence increased from 10.1% to 15.6% and from 5.5% to 7.4%, respectively. For ISH and SDH, the age‐standardized prevalence rates rose from 3.6% to 6.4% and from 6.9% to 10.4%, respectively. Advanced age and medium/high urbanization were positively associated factors, whereas females, higher educational attainments, and residing in Southern China were negatively associated factors. Additionally, general obesity, central obesity, diabetes, and elevated triglyceride levels were linked to ISH, IDH, and SDH. The present study documents an increasing trend in the prevalence of hypertension, including different severities and phenotypes, among Chinese adults over more than two decades. Efforts for the prevention and management of hypertension are in urgent need in China.     

Alcohol intake and hypertension subtypes in Chinese men

OBJECTIVE: To examine the associations between alcohol intake and isolated systolic hypertension (ISH), systolic-diastolic hypertension (SDH), and isolated diastolic hypertension (IDH). DESIGN: Cross-sectional study of Chinese adults. METHODS: We analyzed data from 5317 Chinese males who were not on antihypertensive medications from a nationally representative sample of Chinese adults aged 35-74 years. ISH was defined as a mean systolic blood pressure (SBP) >/=140 mmHg and a mean diastolic blood pressure (DBP) < 90 mmHg, SDH as a SBP >/= 140 mmHg and DBP >/= 90 mmHg, and IDH as SBP < 140 mmHg and DBP >/= 90 mmHg. Alcohol intake was determined using an interviewer-administered questionnaire and participants were categorized either as non-drinkers (<12 drinks in the prior year) or by tertile of alcohol intake. RESULTS: The odds ratios of all three hypertension subtypes were higher at higher levels of alcohol intake, with those in the highest alcohol intake category (>/=30 drinks/week) 2.0 (95% confidence interval: 1.3, 3.0), 2.2 (1.6, 3.1), and 2.1 (1.4, 3.1) times more likely to have ISH, SDH, or IDH, respectively, than non-drinkers. The population attributable risk percentage due to heavy drinking (>/=30 drinks/week) was 13.9% for ISH, 13.4% for SDH, and 12.0% for IDH. Liquor drinking, specifically, was associated with a higher odds ratio of ISH, while SDH and IDH associations did not differ by type of alcoholic beverage. CONCLUSIONS: In Chinese males, higher intake of alcohol is associated with higher risk of ISH, SDH, and IDH. Efforts to reduce hypertension in China should include a strong focus on decreasing heavy alcohol consumption.     

An assessment of platelet parameters in different ethnic groups with hypertension subtypes and associated risk factors in Xinjiang,China

The goal of this study was to investigate platelet parameters in populations with hypertension subtypes among the Han, Uygur, and Kazakh ethnic groups and their associated risk factors in Xinjiang, northwestern China. In total, 9816 adult participants were recruited from a multiethnic, cross-sectional cardiovascular risk survey. Our results indicated that the platelet counts in Han, Uygur, and Kazakh participants with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic diastolic hypertension (SDH) varied significantly (P < 0.001). Additionally, the mean platelet volume (MPV) in Han, Uygur, and Kazakh participants with ISH was significantly different (P < 0.05). Furthermore, the individual platelet parameters had different associated risk factors. For example, the risk factors for platelet counts were Uygur ethnicity, Kazakh ethnicity, drinking, ISH, diabetes, and high triglycerides (TGs). The risk factors for MPV were Uygur ethnicity, smoking, overweight, obesity, ISH, IDH, diabetes, and high TGs. Gender was a risk factor for abnormal plateletcrit (PCT) values. Only a low high-density lipoprotein cholesterol level was found to be a risk factor for platelet distribution width (PDW). We suggest that more attention should be paid to platelet parameters and the associated risk factors to reinforce the effect of antiplatelet therapy and to provide a clinical basis for preventing the occurrence of thrombosis complications and cerebro- and cardiovascular diseases effectively.     

Hypertension subtypes and risk of cardiovascular diseases in a Mongolian population,inner Mongolia,China

Background: There have been no reports about the effects of hypertension subtypes on the future cardiovascular events among Mongolian people, China. Methods and results: From June 2003 to July 2012, we conducted a prospective study to assess the association of hypertension subtypes with future risk of cardiovascular events including stroke and coronary heart disease among a Mongolian cohort of 2589 adults in China. According to the baseline blood pressure levels, the subjects were divided into those with normal blood pressure, prehypertension, isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and combined systolic and diastolic hypertension (SDH). Cox proportional hazards models were used to evaluate the association between blood pressure subtypes and risk of cardiovascular diseases. After adjustment for age and gender, hazard ratios (95% confidence intervals) of cardiovascular diseases were 1.75(0.92–3.33), 2.11(0.95–4.70), 2.14(1.01–4.56) and 5.31(2.86–9.77) for pre-hypertension, ISH, IDH and SDH, respectively, compared with normal blood pressure. Furthermore, after adding other cardiovascular risk factors to adjustment, hazard ratios(95% confidence intervals) of cardiovascular diseases were 1.74(0.92–3.31), 2.00(0.88–4.54), 2.20(1.02–4.74) and 4.92(2.62–9.26) for pre-hypertension, ISH, IDH and SDH, respectively, compared with the normal blood pressure group. Conclusions: IDH and SDH were significantly associated with the increased risk of cardiovascular diseases; this study suggests that carefully monitoring and actively treating the subjects with IDH should be an important strategy for CVD prevention among Mongolian population.     

The prevalence and risk factors associated with isolated untreated systolic hypertension in Korea: the Korean National Health and Nutrition Survey 2001

Although isolated systolic hypertension (ISH) increases the risk of coronary heart disease and stroke, more than any other hypertension subtype, the prevalence and risk factors associated with ISH in the Korean population are not known. The 2001 Korean National Health and Nutrition Survey was a cross-sectional and nationally representative survey conducted in 2001. The prevalence of ISH by age and body mass index (BMI) was examined in 6601 Korean adults over 20 years of age. After adjusting for age, 4.32+/-0.32% of Korean adults had ISH, 5.28+/-0.37% had isolated diastolic hypertension and 5.82+/-0.36% had systolic/diastolic hypertension. The overall prevalence of ISH was found to increase directly with advancing age and increasing BMI. Although the ISH was found to be more common in men overall (4.81+/-0.50% in men, 4.12+/-0.37% in women), it was more common in women over 70 years of age. Independent variables associated with risk for ISH included advanced age, BMI, triglyceride (TG) levels, monthly income and alcohol intake. However, gender, fasting blood glucose, total cholesterol and high-density lipoprotein cholesterol levels, residential area, education level and smoking were found not to be significantly associated with ISH risk. The findings of the present study demonstrate that the prevalence of untreated ISH in Korea was lower than in Western countries. Age, BMI, TG levels, monthly income and alcohol intake were associated with ISH.     

The contribution of the systolic and diastolic components for the diagnosis of arterial hypertension under the 2017 ACC/AHA Guideline and metabolic heterogeneity among individuals with Stage 1 hypertension

Little is known about the impact of the 2017 ACC/AHA hypertension guideline on the distribution pattern of hypertension modalities (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], and systolic‐diastolic hypertension [SDH]). This cross‐sectional study had the following objectives: to compare the prevalence of hypertension, ISH, IDH, and SDH, according to the definitions of the JNC 7 or the 2017 guideline; to determine the relative contribution of the systolic and the diastolic components for the diagnosis of hypertension; and to compare the metabolic profile of ISH, IDH, or SDH among new hypertensive individuals by the 2017 guideline. The authors retrospectively evaluated 33 594 patients (42 ± 10 years, 67% male) who underwent a routine health evaluation. Hypertensive patients not using antihypertensive medication were classified into ISH, IDH, or SDH using guideline‐defined thresholds. The prevalence of hypertension increased from 21.1% by the JNC 7 definition to 54.7% using the 2017 criteria (2.6‐fold increase). More profound increases were seen in the prevalence of IDH (8.7‐fold) and SDH (3.3‐fold), whereas the prevalence of ISH reduced from 1.1% (JNC 7) to 0.5% (2017 definition). Among patients with Stage 1 hypertension by the 2017 document, 85% had IDH and fewer metabolic abnormalities compared to those with SDH or ISH. The authors concluded that the 2017 guideline inflates the role of the diastolic component and diminishes the contribution of the systolic component for the diagnosis of hypertension. Individuals with Stage 1 hypertension by the 2017 guideline are metabolically heterogeneous and may have different long‐term prognoses.     

单纯舒张期高血压预后的前瞻性研究

目的 :探讨单纯舒张期高血压 (IDH)对心血管事件 (CVD)发生的危险性。方法 :采用前瞻队列研究方法 ,对北京市自然人群 (40岁以上 )共 7333人于 1991年基线危险因素调查后 ,分别于 1996年、1999年二次进行随访。对在随访期间发生的心血管事件和死亡进行登记。并根据基线调查时收缩压及舒张压水平 ,将队列人群分成以下 4组 :正常血压组 ,单纯舒张期高血压组 ,单纯收缩期高血压组 ,收缩压合并舒张压升高组。不同血压组与CVD事件发生率之间的关系分别进行单因素分析 (Gehan检验 )及多因素分析 (Cox回归 )。结果 :1 单纯舒张期高血压组平均年龄最小 (5 2 1± 8 7岁 ) ,其在中年人中占较大的比例 (82 8% ) ,而单纯收缩期高血压组平均年龄最大 (6 4 3± 9 8岁 ) ,其在老年人中占较大构成比 (6 5 9% )。 2 与正常血压组相比 ,单纯舒张期高血压组发生心血管事件的危险性无显著性差异(RR =1 0 9,95 %CI:0 5 6～ 2 .13) ,而单纯收缩期高血压组及收缩压合并舒张压升高组的危险性显著升高 ,RR分别为 :2 0 3(95 %CI:1 6 3～ 2 .5 2 )、3 38(95 %CI:2 73～ 4 .17)。结论 :1 单纯舒张期高血压预后良好 ,而单纯收缩期高血压及收缩压合并舒张压升高者有较大的发生CVD事件的危险性。 2 对高血压患者 ,应着重对升高     

Physical activity and sedentary behavior thresholds for identifying childhood hypertension and its phenotypes: The Healthy Growth Study

Hypertension phenotypes may represent differential pathophysiologic mechanisms and clinical impact, yet they have been poorly investigated. The study aimed to examine the associations of physical activity and sedentary behavior with hypertension phenotypes in a large group of Greek children and to identify thresholds regarding risk of hypertension. This was a cross-sectional study with a regionally representative sample of 2473 schoolchildren aged 9–13 years, with full data on physical activity and sedentary behavior indices, as well as arterial blood pressure measurements, physical examination, and anthropometry. Hypertensive children of both sexes had lower levels of physical activity (steps/d). Hypertensive girls had lower moderate-to-vigorous physical activity (MVPA), whereas hypertensive boys with isolated systolic hypertension (ISH) had more screen time than their normotensive counterparts. Increased levels of physical activity was associated with 33%–54% lower risk of all hypertension phenotypes in both sexes, whereas increased MVPA was associated with 41%–65% lower risk of all phenotypes in girls and with ISH and systolic and diastolic hypertension (SDH) in boys. In boys, higher sedentary time was associated with 11%–13% higher risk for SDH and ISH. Cutoff points of 12,378 steps/d, 47.3 min/d of MVPA, and 2.9 h/d of sedentary behavior were determined for identifying children at increased risk of hypertension. Physical activity is inversely associated with all hypertension phenotypes, whereas sedentary behavior is positively associated with ISH and SDH in boys. More studies should confirm the hypertension-specific cutoff values identified to be used in future prevention programs for childhood hypertension.     

Stroke risk in systolic and combined systolic and diastolic hypertension determined using ambulatory blood pressure. The Ohasama study

BACKGROUND: To investigate the risk of stroke in subjects with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and combined systolic and diastolic hypertension (SDH) in a Japanese general population, we used 24-h ambulatory blood pressure (ABP) and casual-screening blood-pressure (CBP) readings. METHODS: Subtypes of hypertension were defined based on systolic blood pressure (SBP) >135 mm Hg or diastolic blood pressure (DBP) >80 mm Hg for 24-h ABP, and SBP >140 mm Hg or DBP >90 mm Hg for CBP. We obtained 24-h ABP and CBP data for 1271 (40% male) subjects aged > or =40 years (mean age, 61 years) without a history of symptomatic stroke; their stroke-free survival was then determined. The prognostic significance of each subtype of hypertension was determined by Cox proportional hazard analysis. RESULTS: There were 113 symptomatic strokes during follow-up (mean time, 11 years). Compared with normotension, among the hypertension subtypes determined by 24-h ABP, the adjusted relative hazards (RHs) of stroke were 2.24 for ISH (P = .002) and 2.39 for SDH (P = .0004). The association was less marked among subtypes determined by CBP (RH = 1.40 and P = .13 for ISH; RH = 2.07 and P = .017 for SDH). The IDH group was excluded from the Cox analysis because both the prevalence and the number of events were low in this group. CONCLUSIONS: Isolated systolic hypertension, as determined by 24-h ABP measurements, was associated with a high risk of stroke, similar to that found in SDH subjects; this suggests that the prognosis of hypertensive patients would be improved by focusing treatment on 24-h systolic ABP.     

���������ڸ�Ѫѹ�ص㼰����

高血压是心血管疾病的独立危险因素。单纯舒张期高血压(IDH),是指在标准状态下测量的收缩压<140 mmHg,同时舒张压≥90 mmHg。高血压分为三种亚型:单纯收缩期高血压(ISH)、单纯舒张期高血压(IDH)、收缩期合并舒张期高血压(SDH)。单纯舒张期高血压是一种发生率相对较低的高血压类型。然而近年来一些大型临床研究发现IDH与ISH、SDH一样已经成为心血管事件发生的独立危险因素。因此IDH越来越受到重视,了解掌握IDH的特点及治疗措施已经成为降压治疗及预防心血管疾病的重要组成部分。     

澳门地区老年单纯性收缩期高血压患病率及其与脑卒中的关系

目的 调查澳门地区老年人单纯性收缩期高血压（ＩＳＨ）的患病情况,并了解其与脑卒中的关系。方法 按统一标准,以家庭为单位对５１７７人进行问卷调查,测量血压,并进行脑血管病的检诊。结果 确诊ＩＳＨ患病率为４．１７％,临界ＩＳＨ患病率为４．９％,女性患病率高于男性;确诊ＩＳＨ和临界ＩＳＨ的患病率老年组较非老年组明显增高,且女性患病率的增高更剧;随年龄增长,随卒中的危险性也增加。多因素分析显示,脑卒中与年     

Blood pressure categories, hypertensive subtypes, and the metabolic syndrome

BACKGROUND: Elevated blood pressure (BP) is one element of metabolic syndrome (MetS); however, the relation of various BP categories and hypertension subtypes to the likelihood of having MetS is not well defined. METHODS: We determined the odds of MetS, defined by the National Cholesterol Education Program, in various BP categories from a cross-sectional study of 5968 individuals aged at least 18 years and untreated for hypertension (weighted to 124.7 million) in the National Health and Nutrition Examination Survey, 1999-2002. Nonhypertensive BP categories were optimal, normal, and high-normal BP, according to JNC-VI classification. Hypertension consisted of three subtypes: isolated diastolic hypertension (IDH), systolic-diastolic hypertension (SDH), and isolated systolic hypertension (ISH). RESULTS: Among those with hypertension and MetS, 25.3% had IDH, 20.2% had SDH, and 54.5% had ISH. The MetS prevalence in nontreated persons was 5.8% for optimal BP, 9.1% for normal BP, 38.2% for high-normal BP, 45.9% for IDH, 44.3% for SDH, and 43.9% for ISH. Risk factor odds ratios (95% confidence intervals; reference group, optimal BP), adjusted for age, sex, total cholesterol, and smoking, were 1.6 (1.2-2.2) for normal BP, 9.4 (6.9-12.7) for high-normal BP, 14.7 (8.9-24.0) for IDH, 12.2 (7.2-20.8) for SDH, and 10.2 (7.0-14.9) for ISH (all P < 0.01); odds ratios were higher for women in all categories. CONCLUSIONS: Despite having the lowest mean age, IDH subtype is associated with greatest likelihood of MetS. The high frequency of ISH in the hypertensive population, however, makes ISH the most common hypertensive subtype in persons with MetS.     

Prevalence and risk factors of the rural adult people prehypertension status in Liaoning Province of China.

BACKGROUND: Prehypertension is a new category of blood pressure (BP) classification according to the Seventh Report of The Joint National Committee. Little is known about the epidemiology of prehypertension in rural China. The purpose of the present study is to determine the prevalence of prehypertension and associated risk factors in rural adult people of China. METHODS AND RESULTS: Through cluster multistage and random sampling method, a resident group of 29,970 people aged > or =35 years old in Liaoning Province was selected from 2004 to 2005. The survey on BP and associated risk factors was carried out. Prehypertension was defined as systolic BP between 120 and 139 mmHg or diastolic BP 80 and 89 mmHg. Overall, the prevalence of prehypertension was 47.0%, males 51.2% and females 42.6%, respectively. The prevalence of hypertension was 36.2%. Multivariable logistic regression showed overweightness, obesity and drinking were risk factors of prehypertension. Female and greater than high school education status were shown as protective factors. CONCLUSIONS: The prevalence of prehypertension of rural adult people in China is dramatically high and it was associated with many risk factors. Comprehensive lifestyle modifications are needed to be taken to decrease the incidence of prehypertension and to prevent prehypertension people from hypertension and cardiovascular disease.     

Association of body mass index and alcohol intake with hypertension subtypes among HAN Chinese

Obesity and excessive drinking are major risk factors for development of hypertension. We aimed to explore association of body mass index (BMI) and alcohol intake with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and combined systolic/diastolic hypertension (SDH) among Shandong Shengli Oil field workers. A total of 26,681 subjects were cross-sectionally analyzed. Statistical calculations included polytomous logistic regression and interaction analysis. After assigning normotensives as a reference, the odds of being ISH decreased by 4% for moderate drinkers, whereas that of being IDH and SDH increased significantly by 1.50 and 1.15 folds (P < 0.001). The odds for heavy drinkers of being ISH, IDH, and SDH increased by 1.38, 2.41, and 2.25 folds, respectively (P < 0.001). For BMI, the odds of being ISH, IDH, and SDH increased in a dose-response manner (P < 0.001). For patients with BMI of [23, 25), [25, 27), [27, 30) and ≥ 30 kg/m(2), the odds (95% confidence interval (CI)) of being SDH increased significantly by 2.28 (2.07-2.50), 3.22 (2.93-3.55), 5.44 (4.93-6.01), and 8.45 (7.31-9.77) folds, respectively. Interaction analysis indicated that BMI and alcohol intake were interactively associated with ISH (P ≤ 0.045) rather than IDH (P ≥ 0.161). Our results demonstrated that BMI and alcohol intake interactively influenced systolic hypertension, especially for overweight and obese patients.     

Association of Body Mass Index and Alcohol Intake with Hypertension Subtypes Among HAN Chinese

Obesity and excessive drinking are major risk factors for development of hypertension. We aimed to explore association of body mass index (BMI) and alcohol intake with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and combined systolic/diastolic hypertension (SDH) among Shandong Shengli Oil field workers. A total of 26,681 subjects were cross-sectionally analyzed. Statistical calculations included polytomous logistic regression and interaction analysis. After assigning normotensives as a reference, the odds of being ISH decreased by 4% for moderate drinkers, whereas that of being IDH and SDH increased significantly by 1.50 and 1.15 folds (P < 0.001). The odds for heavy drinkers of being ISH, IDH, and SDH increased by 1.38, 2.41, and 2.25 folds, respectively (P < 0.001). For BMI, the odds of being ISH, IDH, and SDH increased in a dose-response manner (P < 0.001). For patients with BMI of [23, 25), [25, 27), [27, 30) and ≥ 30 kg/m², the odds (95% confidence interval (CI)) of being SDH increased significantly by 2.28 (2.07–2.50), 3.22 (2.93–3.55), 5.44 (4.93–6.01), and 8.45 (7.31–9.77) folds, respectively. Interaction analysis indicated that BMI and alcohol intake were interactively associated with ISH (P ≤ 0.045) rather than IDH (P ≥ 0.161). Our results demonstrated that BMI and alcohol intake interactively influenced systolic hypertension, especially for overweight and obese patients.     

佛山市普君街道办事处老年高血压患病率调查

目的　探讨广东佛山市普君街道办事处老年高血压患病率情况。方法　按统一方法对佛山市禅城区普君街道办事处 6 0岁以上常住居民 3382人进行现场问卷调查 ,同时测量人体基本参数如血压、身高、体重等 ,并进行餐后 2小时血糖测定 ,以及空腹血糖、血脂常规、血尿酸等测定。结果　高血压粗患病率 4 0 0 % ,标化率为 4 0 0 % ,较佛山 1993年 (5 1 5 % )明显下降。单纯收缩期高血压 (ISH)粗患病率 2 1 3% ,标化率为 2 2 1%。女性患病率高于男性。新检出高血压患者占高血压病患者总数的 4 0 1% ,ISH占高血压病患者总数的 5 3 9% ,随年龄增长高血压患病率增高。老年人群平均收缩压 (SBP)为 12 6± 17mmHg、舒张压 (DBP)为 77± 8mmHg、脉压 (PP)为 4 9± 11mmHg。高血压组的年龄、血压、体重、体重指数、餐后 2小时血糖、空腹血糖、尿酸及血脂 (总胆固醇、甘油三酯 )与非高血压组比较有差异 ,(P <0 0 1～ 0 0 5 )。结论　高血压与多种危险因素有密切相关 ,佛山市老年人高血压患病率高 ,应当重视开展高血压的社区防治。     

Prothrombotic factors, endothelial function and left ventricular hypertrophy in isolated systolic hypertension compared with systolic-diastolic hypertension.

BACKGROUND: Individuals with systolic-diastolic hypertension (SDH, systolic blood pressure (SBP) >160 mm Hg and diastolic blood pressure (DBP) >90 mm Hg) are at increased risk of thrombotic complications, such as stroke and heart attacks, which may be related to a hypercoagulable state. Individuals with only isolated systolic hypertension (ISH; i.e. SBP >160 mm Hg but DBP <90 mm Hg) are also at significant cardiovascular risk. We hypothesized that patients with ISH would exhibit a prothrombotic state similar to that seen in SDH. A secondary hypothesis was that individuals with ISH had similar echocardiographic parameters to those seen in SDH. METHODS: We measured indices of haemorheology, endothelial dysfunction, thrombogenesis and platelet activation in 23 individuals with ISH (mean blood pressure 193/82 mm Hg), who were compared with 51 matched patients with SDH (mean blood pressure 198/112 mm Hg) and 34 age- and sex- matched normotensive healthy control individuals (mean blood pressure 130/78 mm Hg). Echocardiographic parameters in patients with ISH were compared to those from patients with SDH. RESULTS: Mean plasma viscosity (an index of blood rheology, ANOVA, P = 0.001), von Willebrand factor (an index of endothelial damage, P = 0.013), plasminogen activator inhibitor-1 and lipoprotein (a) (both markers of thrombogenesis; Kruskal-Wallis test, both P<0.001) were all significantly raised in ISH and SDH relative to controls. Individuals with SDH also had high mean plasma fibrinogen (P = 0.018) and haematocrit (P = 0.010) levels compared with control individuals. There were no significant differences in levels of fibrin D-dimer or the platelet activation marker soluble P-selectin in the hypertensive patients (i.e. ISH and SDH) compared with control individuals. Patients with ISH had similar M-mode and Doppler echocardiographic parameters compared to patients with SDH. CONCLUSIONS: We conclude that individuals with ISH have abnormalities in plasma prothrombotic factors and markers of endothelial dysfunction, and echocardiographic parameters, broadly similar to that seen in SDH. This is consistent with the increased risk of thrombotic events (strokes and heart attacks) in patients with ISH.     

Systolic and diastolic hypertension: no relationship with lipid and inflammatory markers in Haute-Garonne,France

BACKGROUND: Isolated systolic hypertension (ISH) is a major cardiovascular risk factor. The prevalence of ISH, isolated diastolic (IDH), and mixed hypertension (MH) and their association with lipid, inflammatory, and endothelial cell markers were assessed. METHODS: A population sample from Haute-Garonne, France, was chosen. RESULTS: Prevalence of ISH, IDH, and MH was 16%, 5%, and 16%, respectively, in men, and 13%, 2%, and 9% in women. No difference was found between ISH, IDH, or MH subjects in comparison to normotensive individuals for all biologic markers studied. CONCLUSIONS: Isolated systolic hypertension and MH are relatively common in Haute-Garonne and are not associated with lipid, inflammatory, or endothelial cell markers.