我国35～59岁人群血压的自然转归  

The Natural Variances of Blood Pressure Category Among Aged 35-59 People

作　　者：胡继宏[1,2] 赵连成[1] 周北凡[1] 武阳丰[1,3] 

机构地区：[1]中国医学科学院阜外心血管病医院流行病学研究室,北京100037 [2]宁夏医学院公共卫生学系流行病研究室 [3]北京大学公共卫生学院

出　　处：《中华高血压杂志》2009年第1期19-23,共5页Chinese Journal of Hypertension

基　　金：国家"九五"(96-906-02-01);"十五"(2004BA703B01)科技攻关资助

摘　　要：目的探讨我国中年人群血压状态的自然转归和进展，为确定高血压的防治策略提供依据。方法利用国家“九五”（1998年）和“十五”（2004年）期间年龄35～59岁的10组人群资料（n=6129），剔除任何一次调查服药者864人，对剩余两次调查中均未服药5265人进行分析。2次调查血压水平分类均根据中国高血压防治指南2005年修订版标准。结果6年后，约85％（3834／4525）的非高血压停留在血压正常和正常高值状态；大约78％（457／587）的轻度高血压维持原状或转为非高血压；仅有不到1／4（37／153）的中、重度高血压转为非高血压。多元回归分析结果显示，与中、重度高血压患者相比，轻度高血压患者有2倍的机会转为非高血压（OR=0．5，95％CI：o．3～O．7）；与血压正常者相比，正常高值有4倍的几率进展为高血压（OR=4．3，95％CI：3．6～5．1）。体质量变化显著影响了血压的进展和转归，饮酒仅显著影响了血压的进展。结论中、重度高血压应该加强药物治疗，轻度高血压适当给予药物治疗。正常高值应先密切监测血压，同时建议非药物措施（改善生活方式）。Objective To study the natural changes course of blood pressure in a cohort of middle-aged Chinese population. Methods The study comprised two cross-sectional surveys conducted in 1998 and 2004. A total of 6 129 participants aged 35--59 were enrolled. After excluding 864 persons in treatment, 5265 people were classified as normal BP （n=2621）, normal-high BP（n=1 904）, mild hypertension （n=587） and were moderate heavy hypertension （n= 153） according to Chinese guideline for prevention and treatment of hypertension （revised edition 2005 ）. The participarts were followed up for 6 years. Results After 6 years without antihypertensive treatment, the majority （85%, 3834/4525） of normotensives remained as normal or high normal; 78%（457/587） mild hypertensives persisted, only 25 % moderate or heavy hypertension regressed to non-hypertension. Multi-variable logistic regression showed that high-normal had 4 times more likely to progress to hypertension compared with normal blood pressure （OR=4.3, 95% CI：3. 6-5.1） , while the mild hypertension patients who had a 2-fold greater chance regress to normotensive compared with moderate or heavy hypertension （OR = 0. 5 95% CI： 0.3- 0. 7 ）. Weight change significantly influenced BP progression and regression. Heavy alcohol drinking affected progression significantly. Conclusion Data from this study support the strategy of intensively treatment moderate or severe hypertension and aggressively treatment mild hypertension. Persons with high-normal BP should be monitored and lifestyle modification should be implicated.

关 键 词：血压 自然变化 高血压 治疗 干预 

分 类 号：R544.1[医药卫生—心血管疾病]