单日和3日血压测量对人群高血压患病率的影响  

The difference of hypertension prevalence based on blood pressure measured on one day or on 3 different days in community populations

作　　者：胡世云[1] 俞蔚[1] 丁芳[1] 关方霞[2] 吴兴利 杨新春 俞柳燕 宣诚 范敏华 刘庆敏[8] 徐小玲[1] 杨丽[1] 严静[1] HU Shi-yun;YU Wei;DING Fang;GUAN Fang-xia;WU Xing-li;YANG Xin-chun;YU Liu-yan;XUAN Cheng;FAN Min-hua;LIU Qing-min;XU Xiao-ling;YANG Li;YAN Jing(Zhejiang Hospital and The Center for The Prevention and Control of Cardio-cerebro-vascular Diseases of Zhejiang Province,Hangzhou Zhejiang 310013,China)

机构地区：[1]浙江医院,浙江省心脑血管病防治研究中心,浙江杭州310013 [2]郑州大学 [3]中国人民解放军医院 [4]首都医科大学附属北京朝阳医院心脏中心 [5]诸暨市疾病预防控制中心 [6]诸暨市第二人民医院 [7]杭州市江干区闸弄口社区卫生服务中心 [8]杭州市疾病预防控制中心

出　　处：《中华高血压杂志》2018年第11期1030-1034,共5页Chinese Journal of Hypertension

基　　金：国家十二五科技支撑计划项目(2014BAI08B01);浙江省重大科技专项重点社会发展项目(2014C03045-1);浙江省医药卫生科技计划项目(2010KYB010)

摘　　要：目的社区人群中比较单日血压和3日血压测量对高血压患病率的影响。方法于2015年4-9月在北京、浙江和河南3省市对常住居民47 955人进行高血压筛查,年龄35~75(54.2±15.3)岁。每次血压测量3遍,间隔1min,取平均值为最终血压值。既往无高血压病史、当日收缩压和(或)舒张压高于高血压诊断切点者定为可疑高血压。对可疑高血压患者,在随后1个月内,再进行非同日2次血压测定。3日的收缩压均≥140和(或)舒张压≥90mm Hg时确诊为高血压。比较单日血压和3日血压测量对人群高血压诊断的影响。结果在筛查的47 955人中,明确高血压患者7344例,可疑高血压人群3221例,依据单日血压判断的高血压患病率为22.0%。在3221例可疑高血压人群中,仅425例(13.2%)符合临床高血压诊断标准,3日血压临床高血压确诊率为16.2%,较单日血压诊断低5.8个百分点。通过3日血压测量确诊的高血压组和非高血压组比较,年龄、大量饮酒率和首日收缩压差异有统计学意义(P<0.01)。多因素Logistic回归分析显示,在可疑高血压患者中,调整其他因素后,老年和收缩压舒张压均升高者更可能被确诊为高血压患者,OR(95%CI)分别为4.470(1.451~13.722)(年龄65~74岁),5.358(1.577~18.203)(年龄≥75岁),3.766(2.018~7.027)。高盐膳食者诊断相对风险较低[OR(95%CI)=0.331(0.161~0.679)]。结论依据单日血压测量评估的高血压患病率高于非同日3次血压测量方法的结果。Objective To evaluate the difference of hypertension prevalence based on blood pressure(BP)measured on one day or on 3 different days in community populations. Methods A total of 47 955 residences aged 35-75(54.2±15.3)years in provinces of Zhejiang,Henan and city of Beijing were enrolled. BP was measured three times at one-minute interval and averages were used as final values. Suspected hypertension was defined as systolic BP(SBP)≥140 mm Hg and/or diastolic BP(DBP)≥90 mm Hg without history of hypertension. Patients with suspected hypertension received BP measurements on other two days within one month. Clinical hypertension was defined as that all three BP readings in different days fulfill the above-mentioned standard.The prevalence of hypertension diagnosed by BP measured on one day or on 3 different days were compared. Results There were 7344 diagnosed hypertension patients and 3221 suspected hypertension patients.Hypertension prevalence was 22.0% by BP measurement on one day. Among 3221 patients with suspected hypertension,only 425(13.2%)were diagnosed as clinical hypertension base on BP measurements on 3 different days. Thus,the prevalence of clinical hypertension was 16.2%,5.8 percentages lower than that by measured on one day. There was significant difference in age,heavy drinking and SBP measured during the first visit between hypertension and non-hypertension in 3221 suspected hypertension patients.Logistic regression analysis showed 65-<75 years(OR=4.470),and≥75 years old(OR=5.358)had increased risk of hypertension diagnosed by 3-day measurements,whereas high salt diet(OR=0.331)decreased the risk. Conclusion Hypertension prevalence would be overestimated by BP measured on one day compared with on 3 different days.

关 键 词：高血压 患病率 流行病学 测量 诊断 

分 类 号：R544.1[医药卫生—心血管疾病]