《柳叶刀》：过去 30 年全球高血压患者数量翻倍，达 12 亿人

邓文龙

《柳叶刀》：过去 30 年全球高血压患者数量翻倍，达 12 亿人

科研圈

2021/08/27

论文
论文标题：Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants
作者：NCD Risk Factor Collaboration (NCD-RisC)
期刊：The Lancet
发表时间：2021/08/24
数字识别码：10.1016/S0140-6736(21)01330-1
摘要：BackgroundHypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories.MethodsWe used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.FindingsThe number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran.InterpretationImprovements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.FundingWHO.

所属学科：
流行病学
公共卫生


图片来源：Pixabay



21-8 月 23 日，全球慢性非传染性疾病风险因素研究联盟（NCD-RisC）在《柳叶刀》（The Lancet）发表了一篇回顾性研究，对过去 30 年中 184 个国家的高血压的流行、诊断和治疗进行全面分析，发现 2019年全球高血压患者数量与 30年前相比翻倍，其中半数未接受治疗。



平静状态下血压超过 140/90 mmHg 被定义为高血压，过去 30 年间，在全球 30-79 岁人群中，男性高血压患者数从 3.17 亿升至 6.52 亿，女性高血压患者数从 3.31 亿升至 6.26 亿。其中，51% 的男性患者和 41% 的女性患者并不知道自己患病；62% 的男性患者和 53% 的女性患者没有获得治疗。每 4 位女性患者、每 5 位男性患者中，只有 1 人血压控制在正常范围。高收入国家如加拿大、瑞士、英国和西班牙等，报告的患病率处于历史最低水平；中低收入国家如巴拉圭、匈牙利、波兰和克罗地亚等，高血压患病率仍处在高水平。包括加拿大、韩国、冰岛、美国、哥斯达黎加和德国在内的高收入和一些中等收入国家在高血压的治疗和控制方面取得了令人瞩目的进步。但对位于撒哈拉沙漠以南和大洋洲的低收入国家，情况几乎没有变化。



研究作者呼吁将哥斯达黎加、巴西、土耳其、哈萨克斯坦和南非等国家在检测、治疗和控制方面的经验推广到低收入和中等收入国家，从而降低高血压带来的全球心血管疾病负担。（The Lancet）

https://www.thelancet.com/journa ... 21)01330-1/fulltext

https://www.linkresearcher.com/t ... 2-8552-6aac13049742



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