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Global hypertension patients have increased to 1.1 billion, and the younger the risk of death, the higher the risk of death!

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Recently, a study entitled “Association of Age of onset of Hypertension with Cardiovascular Diseases and Mortality” The higher the risk of disease and the risk of mortality.

The study was included in 71,245 participants in Tangshan, Tangshan, China from July 2006 to October 2007. After layering according to age, it was followed up to December 31, 2017, with an average follow -up time of 6.5 years. During the follow -up period, 20,221 newly caught high blood pressure and 2008 deaths, of which more than 80%of the cardiovascular disease died. From the perspective of age, hypertension before the age of 45 accounted for 13.5%of all patients with hypertension, and less than one -third of patients taking antihypertensive drugs. After multiple factors, people who suffer from hypertension before the age of 45 have the highest risk of cardiovascular disease and all due to death. That is, as the age of hypertension increases, the risk of prognosis gradually weakened.

Available in the patients who are <45, 45-54, 55-64 years old, and ≥65 years old, the risk of cardiovascular disease increases by 126%, 62%, 42%, and 33%, respectively; The increase of 159%, 112%, 30%, and 29%. The younger the age when suffering from hypertension, the higher the risk of cardiovascular disease and the risk of death. Professor Xue Hao of the Corresponding Communication, Professor Xue Hao of the General Hospital of the PLA pointed out that the awareness rate, treatment rate and control rate of young Chinese patients were significantly lower than those who were senile, but their harm seemed to be greater.

Similarly, a study published by Professor Wang Jiguang and Professor Li Yan from Shanghai Ruijin Hospital, etc., confirmed that for people ≤ 60 years old, outdoor systolic blood pressure increased by 20 mmHg, all of which increased by 42 %And 70%. For> 80 -year -old elderly people, the risk of death and cardiovascular incidents only increased by 9%and 12%, respectively. Previously, studies from Qi Yan, Zhao Dong, and Liu Jing of Beijing Anzhen Hospital also found that the blood pressure of young and middle -aged people was 130 ~ 139/80 ~ 89 mmHg. These research results show that the management of young and middle -aged blood pressure is particularly important.

The “Journal of the American Cardiology Society” (JACC) commented that due to the current guidelines for hypertension treatment, there is no emphasis on the relationship between the age of onset and prognosis, nor does it pay attention to the treatment standards of young patients. In future guidelines, these higher -risk patients should be valued.

With the development of socio -economic and changing the lifestyle of residents, hypertension has become one of the major public health issues that affect the health of my country and the world’s health. According to a research report of “Lancet”, from 1975 to 2015, the number of people with high blood pressure in the world increased from 594 million to 1.1 billion, of which most people lived in developing countries, South Asia and Africa It is the area with the largest number of patients with high blood pressure.

The author of the research report said that from the global perspective, hypertension is no longer a health problem existing in the Western world or wealthy countries. In the past 40 years, the number The maximum, of which 226 million high blood pressure people live in China. If effective policies are not implemented, more people will be diagnosed with hypertension.

According to the method of layering, multi -stage, and random samples from China’s Hypertension Survey (CHS) from 2012 to 2015, 451,755 residents were drawn from 262 cities and rural areas in 31 provinces in mainland China to conduct surveys. The incidence of hypertension of people over 18 years of age is 27.9%, and the population of high blood pressure is 245 million; ≥18 -year -old adults’ awareness rate, treatment rate, and control rate of hypertension are 51.6%, 45.8%, and 16.8%, respectively.

In 2017, JAMA Magazine was based on 844 studies in 1980-2015, with a total of 8.69 million research objects. It estimates that the systolic blood pressure SBP ≥ 110-115mmHg and ≥140mmhg in 1990-2015 and related health burdens were estimated to be in 1990-2015. The number of deaths related to SBP ≥ 1110 ~ 115 MMHG increased from 7.2 million to 10.7 million years, and the number of deaths related to SBP ≥ 140 mmHg increased from 5.2 million to 7.8 million years. The disability adjustment life (DALYS) caused by SBP ≥ 1110-115mmHg has risen from 148 million years to 212 million years, and DALYS caused by SBP ≥ 140mmHg has risen from 95.9 million people to 143 million years. Due to China, India, Russia, Indonesia, and the United States, SBP ≥ 1110 ~ 115 mmHg related DALY losses have lost more than half due to large population bases. More and more evidence shows that the trend of high blood pressure is becoming more and more obvious. According to China Hypertension Survey (CHS), the prevalence of hypertension of young men under 34 is as high as 20.4%, and the disease rate of hypertension in children has continued to rise, an average annual increase of 0.16 percentage points. Although this number is far lower than that of middle -aged and elderly people, young patients have aware of the proportion of high blood pressure, the proportion of treatment and blood pressure control at the standard, and only about 50%of middle -aged and elderly patients.

In 2017, the United States AHA/ACC redefined and classified hypertension, dividing blood pressure into normal blood pressure, elevated blood pressure, level 1 hypertension, and level 2 hypertension. The diagnostic standard for hypertension will be 130/80 mmHg boundary from 140/90mmHg, and the blood pressure level is at 120-129/<80mmHg.

Researchers from the Department of Public Health Popularity of the University of Dulan and the School of Medicine of Northwestern University estimate that the blood pressure threshold of the old and new guidelines is related to the cardiovascular incident and death of the American adults. Data pointed out that in accordance with the new standards, the number of patients with high blood pressure in the United States increased by 13.7%(31.1 million). The patients with 20 to 39 rose from 6.62 million to 16.66 million, with a difference of more than 10 million.

However, the standard of high blood pressure diagnosis released by European ESC in 2018 has not followed the US standards, and it still uses the diagnostic boundary value of 140/90 mmHg. The new guide emphasizes the importance of risk factors, target organs damage evaluation, and prognosis value. At the same time, the age of antihypertensive is no longer conservative, and the age of biology is not conservative.

Although the two European and American guidelines seem to be very different, in fact, the same goal is the same. They advocate early intervention patients with high -risk and high blood pressure in the early stage, and increase the rate of blood pressure and improve the prognosis of patients.

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New definition of hypertension is of profound significance for blood pressure management today. High -blood pressure has a high prevalence but low treatment rate, reducing the threshold for diagnosis of hypertension, and helps to increase the importance of physicians and patients to high blood pressure, and can partially make up for the lack of treatment rates. Secondly, when the blood pressure exceeds 130/80 mm HG, the risk of cardiovascular risk has increased significantly. A study published by Professor Wang Jiguang and Professor Li Yan from Shanghai Ruijin Hospital, etc., confirmed that for people ≤60 years old, the diagnosis of outdoor systolic blood pressure increased by 20 mmHg, all of which increased by 42%and cardiovascular incidents by 42%and the risk of cardiovascular incidents, respectively. 70%. For> 80 -year -old elderly people, the risk of death and cardiovascular incidents only increased by 9%and 12%, respectively. Previously, studies from Qi Yan, Zhao Dong, and Liu Jing of Beijing Anzhen Hospital also found that the blood pressure of young and middle -aged people is 130 ~ 139/80 ~ 89 mmHg. Take positive measures early control. These research results show that the management of young and middle -aged blood pressure is particularly important.

Therefore, if the standard of hypertension diagnosis is moved forward, the blood pressure of more people can be managed, helping to prevent long -term complications, and reduce the long -term burden of economic hygiene. Although the new US guidelines advocate the new definition of this part of this part of the high blood pressure group to give priority to lifestyle intervention, there is a big difference in implementation and treatment in my country. At present The target value achieves long -term disease control.

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