{"title":"患有常见并发症的加拿大成年人的高血压患病率、患者意识、治疗和控制情况","authors":"","doi":"10.1016/j.cjco.2024.05.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Whether certain medical conditions are associated with blood pressure (BP) treatment and control is unclear.</p></div><div><h3>Methods</h3><p>Using the Canadian Health Measures Survey (2007-2019), BP was assessed according to the presence of selected comorbidities, including prior heart attack or stroke, dyslipidemia, chronic kidney disease, diabetes mellitus, obstructive sleep apnea, and overweight or obesity.</p></div><div><h3>Results</h3><p>A total of 5,841,453 people, representing 23.0% (95% confidence interval [CI] 21.7%-24.2%) of Canadian adults, were hypertensive. The adjusted odds ratio (aOR) of having hypertension treated and controlled was higher in people with the following conditions, as compared to people without these conditions: a prior heart attack or stroke (aOR 3.15; 95% CI 2.31-4.31); dyslipidemia (aOR 2.51; 95% CI 1.96-3.21); obstructive sleep apnea (aOR 1.95; 95% CI 1.19-3.21); overweight or obesity (aOR 1.51; 95% CI 1.18-1.94); chronic kidney disease (aOR 1.49; 95% CI 1.13-1.95); and diabetes (aOR 1.44; 95% CI 1.12-1.86). Individuals without any of these comorbidities were less likely to have BP that is treated and controlled (aOR 0.34; 95% CI 0.25-0.48). Moreover, the prevalence of BP treatment and control was low among many people without prior heart attack or stroke, even those with a moderate (aOR 0.25; 95% CI 0.17-0.37) or high (aOR 0.10; 95% CI 0.06-0.16) Framingham risk.</p></div><div><h3>Conclusions</h3><p>Large differences in levels of BP control exist across comorbidity profiles, and the greatest gaps are seen in individuals without recognized comorbidities, even those who have a moderate-to-high Framingham risk. Efforts to optimize BP control and narrow care gaps, especially in individuals without recognized comorbidities, are necessary to reduce the burden of cardiovascular disease and premature death in Canada.</p></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589790X24002245/pdfft?md5=411839c062bc84c37a80300dfaa9cec9&pid=1-s2.0-S2589790X24002245-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Prevalence, Patient Awareness, Treatment, and Control of Hypertension in Canadian Adults With Common Comorbidities\",\"authors\":\"\",\"doi\":\"10.1016/j.cjco.2024.05.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Whether certain medical conditions are associated with blood pressure (BP) treatment and control is unclear.</p></div><div><h3>Methods</h3><p>Using the Canadian Health Measures Survey (2007-2019), BP was assessed according to the presence of selected comorbidities, including prior heart attack or stroke, dyslipidemia, chronic kidney disease, diabetes mellitus, obstructive sleep apnea, and overweight or obesity.</p></div><div><h3>Results</h3><p>A total of 5,841,453 people, representing 23.0% (95% confidence interval [CI] 21.7%-24.2%) of Canadian adults, were hypertensive. The adjusted odds ratio (aOR) of having hypertension treated and controlled was higher in people with the following conditions, as compared to people without these conditions: a prior heart attack or stroke (aOR 3.15; 95% CI 2.31-4.31); dyslipidemia (aOR 2.51; 95% CI 1.96-3.21); obstructive sleep apnea (aOR 1.95; 95% CI 1.19-3.21); overweight or obesity (aOR 1.51; 95% CI 1.18-1.94); chronic kidney disease (aOR 1.49; 95% CI 1.13-1.95); and diabetes (aOR 1.44; 95% CI 1.12-1.86). Individuals without any of these comorbidities were less likely to have BP that is treated and controlled (aOR 0.34; 95% CI 0.25-0.48). Moreover, the prevalence of BP treatment and control was low among many people without prior heart attack or stroke, even those with a moderate (aOR 0.25; 95% CI 0.17-0.37) or high (aOR 0.10; 95% CI 0.06-0.16) Framingham risk.</p></div><div><h3>Conclusions</h3><p>Large differences in levels of BP control exist across comorbidity profiles, and the greatest gaps are seen in individuals without recognized comorbidities, even those who have a moderate-to-high Framingham risk. Efforts to optimize BP control and narrow care gaps, especially in individuals without recognized comorbidities, are necessary to reduce the burden of cardiovascular disease and premature death in Canada.</p></div>\",\"PeriodicalId\":36924,\"journal\":{\"name\":\"CJC Open\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2589790X24002245/pdfft?md5=411839c062bc84c37a80300dfaa9cec9&pid=1-s2.0-S2589790X24002245-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CJC Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589790X24002245\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CJC Open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589790X24002245","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景某些疾病是否与血压(BP)的治疗和控制有关尚不清楚。方法利用加拿大健康措施调查(2007-2019 年),根据是否存在某些合并症(包括既往心脏病发作或中风、血脂异常、慢性肾病、糖尿病、阻塞性睡眠呼吸暂停、超重或肥胖)来评估血压。结果共有 5,841,453 人患有高血压,占加拿大成年人的 23.0%(95% 置信区间 [CI] 21.7%-24.2%)。与不存在以下情况的人相比,存在以下情况的人接受治疗并控制高血压的调整赔率(aOR)较高:曾患心脏病或中风(aOR 3.15;95% CI 2.31-4.31);血脂异常(aOR 3.15;95% CI 2.31-4.31)。31)、血脂异常(aOR 2.51;95% CI 1.96-3.21)、阻塞性睡眠呼吸暂停(aOR 1.95;95% CI 1.19-3.21)、超重或肥胖(aOR 1.51;95% CI 1.18-1.94)、慢性肾病(aOR 1.49;95% CI 1.13-1.95)和糖尿病(aOR 1.44;95% CI 1.12-1.86)。没有上述任何一种合并症的人,其血压得到治疗和控制的可能性较低(aOR 0.34;95% CI 0.25-0.48)。此外,在许多既往没有心脏病发作或中风的人群中,即使是那些具有中度(aOR 0.25;95% CI 0.17-0.37)或高度(aOR 0.10;95% CI 0.06-0.16)弗明翰风险的人群,血压治疗和控制的普及率也很低。要减轻加拿大心血管疾病和过早死亡的负担,就必须努力优化血压控制并缩小护理差距,尤其是在没有公认合并症的人群中。
Prevalence, Patient Awareness, Treatment, and Control of Hypertension in Canadian Adults With Common Comorbidities
Background
Whether certain medical conditions are associated with blood pressure (BP) treatment and control is unclear.
Methods
Using the Canadian Health Measures Survey (2007-2019), BP was assessed according to the presence of selected comorbidities, including prior heart attack or stroke, dyslipidemia, chronic kidney disease, diabetes mellitus, obstructive sleep apnea, and overweight or obesity.
Results
A total of 5,841,453 people, representing 23.0% (95% confidence interval [CI] 21.7%-24.2%) of Canadian adults, were hypertensive. The adjusted odds ratio (aOR) of having hypertension treated and controlled was higher in people with the following conditions, as compared to people without these conditions: a prior heart attack or stroke (aOR 3.15; 95% CI 2.31-4.31); dyslipidemia (aOR 2.51; 95% CI 1.96-3.21); obstructive sleep apnea (aOR 1.95; 95% CI 1.19-3.21); overweight or obesity (aOR 1.51; 95% CI 1.18-1.94); chronic kidney disease (aOR 1.49; 95% CI 1.13-1.95); and diabetes (aOR 1.44; 95% CI 1.12-1.86). Individuals without any of these comorbidities were less likely to have BP that is treated and controlled (aOR 0.34; 95% CI 0.25-0.48). Moreover, the prevalence of BP treatment and control was low among many people without prior heart attack or stroke, even those with a moderate (aOR 0.25; 95% CI 0.17-0.37) or high (aOR 0.10; 95% CI 0.06-0.16) Framingham risk.
Conclusions
Large differences in levels of BP control exist across comorbidity profiles, and the greatest gaps are seen in individuals without recognized comorbidities, even those who have a moderate-to-high Framingham risk. Efforts to optimize BP control and narrow care gaps, especially in individuals without recognized comorbidities, are necessary to reduce the burden of cardiovascular disease and premature death in Canada.