关键词: 2017 ACC/AHA ACC/AHA, American College of Cardiology/American Heart Association BP, Blood pressure Blood pressure Blood pressure control CI, Confidence interval CKD, Chronic kidney disease CVD, Cardiovascular disease DBP, Diastolic blood pressure Hypertension Hypertension treatment JNC, Joint National Committee NHANES NHANES, National Health and Nutrition Examination Survey Race Racial/ethnic disparities SBP, Systolic blood pressure SE, Standard error US

来  源:   DOI:10.1016/j.pmedr.2019.100850   PDF(Sci-hub)   PDF(Pubmed)

Abstract:
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults recommends reduced systolic/diastolic blood pressure (SBP/DBP) cutoffs to define hypertension (i.e., by changing these from ≥140/90 to ≥130/80 mmHg), including new recommendations about indications and goals of antihypertensive treatment. This study reported the differences in age-adjusted prevalence and treatment status of hypertension according to race among US adults per the 2017 ACC/AHA guideline. The National Health and Nutrition Examination Survey 2011-16 data was analyzed. The main outcomes were age-adjusted prevalence and treatment status of hypertension among adults aged ≥20 years. After prevalence estimation, other proportions were obtained. The analysis included 16,103 adults (mean age: 47.6 years, 51.8% women). The age-adjusted proportions of adults with hypertension (59.0%, 95% confidence interval [CI]: 57.4%-60.6%), treatment-eligible for hypertension (49.3%, 95% CI: 47.7%-50.8%), and unmet treatment goals (63.8%, 95% CI: 60.0%-67.5%) among the treated were highest among non-Hispanic blacks. A large proportion of Mexican-Americans (46.5%, 95% CI: 42.0%-51.0%) and people of other races/ethnicities (49.3%, 95% CI: 45.5%-53.0%) were not receiving treatment despite having indication. Non-Hispanic blacks also had the highest prevalence of stage 2 hypertension. Among all races, prevalence, treatment-eligibility, and unmet treatment goals were higher among people with older age, male gender, diabetes, higher body weight, and higher cardiovascular disease risk while the majority of younger, lower/normal body weight, or non-diabetic people were untreated despite being eligible for treatment. The prevalence, treatment-eligibility, and unmet goals were substantially higher among non-Hispanic blacks. Moreover, disparities exist in treatment where Mexican-Americans and people of \'other races/ethnicities\' were largely untreated despite having indication.
摘要:
2017年美国心脏病学会/美国心脏协会(ACC/AHA)预防指南,检测,评价,和成人高血压的管理建议降低收缩压/舒张压(SBP/DBP)来定义高血压(即,通过将这些从≥140/90更改为≥130/80mmHg),包括关于抗高血压治疗的适应症和目标的新建议。这项研究报告了根据2017年ACC/AHA指南,根据美国成年人的种族,年龄调整后的高血压患病率和治疗状态的差异。对2011-16年度全国健康和营养检查调查数据进行了分析。主要结果是年龄调整后的患病率和年龄≥20岁成人高血压的治疗状况。在患病率估计之后,获得其他比例。分析包括16,103名成年人(平均年龄:47.6岁,51.8%妇女)。成人高血压患者的年龄调整比例(59.0%,95%置信区间[CI]:57.4%-60.6%),符合高血压治疗条件(49.3%,95%CI:47.7%-50.8%),和未达到的治疗目标(63.8%,95%CI:60.0%-67.5%)在接受治疗的人中,非西班牙裔黑人中最高。很大一部分墨西哥裔美国人(46.5%,95%CI:42.0%-51.0%)和其他种族/族裔的人(49.3%,95%CI:45.5%-53.0%)尽管有适应症,但未接受治疗。非西班牙裔黑人的2期高血压患病率最高。在所有种族中,患病率,治疗资格,未达到的治疗目标在老年人中更高,男性,糖尿病,体重较高,和更高的心血管疾病风险,而大多数年轻人,较低/正常体重,尽管有资格接受治疗,但非糖尿病患者仍未接受治疗.患病率,治疗资格,在非西班牙裔黑人中,未达到的目标明显较高。此外,尽管有适应症,但墨西哥裔美国人和“其他种族/种族”的人在治疗上存在差异。
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