中国高血压人群中H型高血压的比率和特征及与美国人群的比较  

Rate and characteristics of H-type hypertension in Chinese hypertensive population and comparison with American population

作　　者：梁喆 范芳芳[1] 张岩[1] 秦献辉[2] 李建平[1] 霍勇[1] LIANG Zhe;FAN Fang-fang;ZHANG Yan;QIN Xian-hui;LI Jian-ping;HUO Yong(Department of Cardiology,Peking University First Hospital,Institute of Cardiovascular Disease,Peking University First Hospital,Beijing 100034,China;Division of Nephrology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]北京大学第一医院心血管内科,北京大学第一医院心血管疾病临床研究所,北京100034 [2]南方医科大学南方医院肾内科,广州510515

出　　处：《北京大学学报（医学版）》2022年第5期1028-1037,共10页Journal of Peking University:Health Sciences

基　　金：国家重点研发计划(2021YFC2500500、2021YFC2500501);分子心血管学教育部重点实验室(北京大学)和国家卫生健康委员会心血管分子生物学与调节肽重点实验室(北京大学)项目。

摘　　要：目的:研究中国高血压人群中H型高血压的比率和特征,并与美国的相关人群数据进行比较。方法:在中英文多个数据库(PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方数据知识服务平台和中国生物医学文献数据库)中检索发表于2022年4月30日前的关于中国人群H型高血压患病率的观察性研究,进行文献筛选、资料提取和质量评价。采用随机效应模型估计H型高血压在高血压患者中的比率以及总体患病率,采用分层分析探索中国H型高血压的分布特点,采用meta回归分析寻找异质性的来源。在美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库1999—2006年的人群中,根据数据发布时间将其分为4个阶段,从数据库获取参与者的基本信息,分析H型高血压的患病率。结果:本研究最终纳入33项研究,包括78470名高血压患者,其中59842名H型高血压患者。中国H型高血压在高血压人群中的比率为73.1%(95%CI:69.3%~76.9%,I^(2)=99.4%,P<0.001),普通人群的总体患病率为26.9%(95%CI:21.1%~32.8%,I^(2)=99.8%,P<0.001)。分层分析中,H型高血压的比率在≥65岁的老年人、男性、少数民族、内陆、西部、北部和农村地区较高。2011—2020的10年间,中国H型高血压比率缓慢下降(2011—2013年79.2%vs.2014—2016年70.4%vs.2017—2020年66.6%,P<0.001)。Meta回归显示地域为异质性的来源。美国H型高血压比率随着时间的增长,在2003—2004年达到高值,随后在2005—2006年出现下降。美国H型高血压在高血压人群中的比率和总体患病率均低于中国。结论:中国高血压患者中H型高血压的比率虽有下降趋势,但仍远超美国,特别是在老年人、男性、少数民族、内陆、西部、北部和农村地区中,了解H型高血压的流行病学可为进一步预防心脑血管疾病提供科学的循证医学证据。Objective:To study the rate and characteristics of H-type hypertension in Chinese hypertensive population,and to compare them with the relevant data from the United States.Methods:Observational studies on the prevalence of H-type hypertension in Chinese population published before April 30,2022 were searched in several Chinese and English databases(PubMed,Embase,Web of Science,Cochrane Library,Chinese National Knowledge Infrastructure,Wanfang Databases,and Chinese Biome-dical Literature Database).Study selection,date extraction and quality evaluation were conducted.Random effect model was used to estimate the rate of H-type hypertension in hypertensive patients and the pooled prevalence of H-type hypertension.Stratified analysis was used to explore the distribution characteristics of H-type hypertension in China.We made meta-regression to search the source of heterogeneity.The National Health and Nutrition Examination Survey(NHANES)population from 1999 to 2006 in the United States was divided into four stages according to the time of data collection.Basic information of the participants was acquired from the database and the rate and prevalence of H-type hypertension analyzed.Results:This study was finally comprised of 33 studies,involving 78470 patients with hypertension,among whom 59842 patients were with H-type hypertension.The rate of H-type hypertension in hypertensive population in China was 73.1%(95%CI:69.3%-76.9%,I^(2)=99.4%,P<0.001),and the prevalence of H-type hypertension in general population was 26.9%(95%CI:21.1%-32.8%,I^(2)=99.8%,P<0.001).In the stratified analysis,the rate of H-type hypertension was higher among the elderly over 65 years,males,ethnic minorities,and residents in the inland,western,northern,and rural areas.During the decade from 2011 to 2020,the rate of H-type hypertension in China declined slowly(2011-2013:79.2%vs.2014-2016:70.4%vs.2017-2020:66.6%,P<0.001).Meta-regression showed that area was the source of heterogeneity.The rate of H-type hypertension in the United States increased

关 键 词：H型高血压 特征 中国 风险评估 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]