我国部分地区成年人高血压患者的控制率已达45%｜ACC 2019热点研究提前看

高血压是导致心血管病发生和死亡的重要危险因素。既往调查数据显示，我国18岁以上成年人的高血压患病率为23.2%，知晓率为46.9%，治疗率为40.7%，但控制率只有15.3%。根据ACC 2019年会即将发布的一项研究结果，我国部分地区的高血压控制率达到了45%，但不同人群的控制率仍存在较大差异。

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清华大学网络科学与网络空间研究院王颖（音译）等，对中国县级市三河市所有基层卫生服务中心2016年至2017年的544,892份电子健康记录（EHR）进行了统计分析。

在这项研究中，共纳入85,170名年龄＞35岁的高血压患者。高血压控制定义为收缩压（SBP）＜140 mmHg，且舒张压（DBP）＜90 mmHg。

患者的年龄较大（平均年龄63岁），在全部患者中男性占45.05%，农民占77.29%。超重或肥胖的患病率为66.12%。

结果显示，总的控制率为44.70%。西药治疗组患者的控制率更高，中西医结合治疗组患者的控制率最低（41.9% vs. 21.4%）。

年龄在35~44岁、体重指数（BMI）＜24 kg/m²的患者控制率最高（54.2%），年龄＞75岁、BMI＞28 kg/m²的患者控制率最低（38.2%）。年龄＞45岁的患者，控制率随BMI水平增加而降低（如图所示）。

虽然该地区的高血压控制率达到了45%，但不同年龄组和不同BMI水平人群的高血压控制率仍然存在差异。

Background: To describe the control rate for patients with essential hypertension in Chinese adults based on electronic health records(EHRs) from the primary health sites in a region that executed the standards to manage hypertension patients.

Methods: The EHRs included 544,892 records from all primary health sites centers from 2016 to 2017 in Sanhe, a county-level city in China. In this study, 85,170 hypertension patients older than 35 were included. Hypertension control was defined as SBP less than 140 mm Hg and DBP less than 90 mm Hg.

Results: Men accounted for 45.05%, the patients were older with mean age 63, 77.29% were farmers. The prevalence of overweight or obesity was 66.12%. Totally, the control rate achieved 44.70%. The control rate was much higher for patients treated by western medicine only and lowest for those treated by combination of western and traditional Chinese medicine (41.9% VS. 21.4%). The patients aged 35 to 44 years old and BMI less than 24 kg/m2 had highest control rate(54.2%), and those aged older than 75 years old and BMI more than 28 kg/m2 had lowest control rate(38.2%). The control rate was decreasing with the increasing of BMI levels for the patients aged more than 45 years old(as figure shown).

Conclusion: Although the control rate achieved 45% for hypertension patients in this district, the variation still existed in different age groups and BMI levels.