Hypertension treatment and control in five European Countries, Canada, and the United States

被引:821
作者
Wolf-Maier, K
Cooper, RS
Kramer, H
Banegas, JR
Giampaoli, S
Joffres, MR
Poulter, N
Primatesta, P
Stegmayr, B
Thamm, M
机构
[1] Loyola Univ, Stritch Sch Med, Dept Epidemiol & Prevent Med, Maywood, IL 60153 USA
[2] Univ Autonoma Madrid, Fac Med, Dept Med Prevent & Salud Publ, Madrid, Spain
[3] Inst Super Sanita, Epidemiol & Biostat Lab, Rome, Italy
[4] Dalhousie Univ, Fac Med, Dept Epidemiol & Community Hlth, Halifax, NS, Canada
[5] Univ London Imperial Coll Sci Technol & Med, Cardiovasc Studies Unit, London, England
[6] UCL, Sch Med, Dept Epidemiol & Publ Hlth, London W1N 8AA, England
[7] Univ Umea Hosp, Dept Med, S-90185 Umea, Sweden
[8] Robert Koch Inst, D-1000 Berlin, Germany
关键词
hypertension; detection and control; antihypertensive therapy; blood pressure monitoring; models; statistical; cross-sectional studies;
D O I
10.1161/01.HYP.0000103630.72812.10
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Levels of hypertension treatment and control have been noted to vary between Europe and North America, although direct comparisons with similar methods have not been undertaken. In this study, we sought to estimate the relative impact of hypertension treatment strategies in Germany, Sweden, England, Spain, Italy, Canada, and the United States by using sample surveys conducted in the 1990s. Hypertension was defined as a blood pressure of 160/95 mm Hg or 140/90 mm Hg, plus persons taking antihypertensive medication. "Controlled hypertension" was defined as a blood pressure less than threshold among persons taking antihypertensive medications. Among persons 35 to 64 years, 66% of hypertensives in the United States had their blood pressure controlled at 160/95 mm Hg, compared with 49% in Canada and 23% to 38% in Europe. Similar discrepancies were apparent at the 140/90 mm Hg threshold, at which 29% of hypertensives in the United States, 17% in Canada, and less than or equal to10% in European countries had their blood pressure controlled. At the 140/90 mm Hg cutpoint, two thirds to three quarters of the hypertensives in Canada and Europe were untreated compared with slightly less than half in the United States. Although guidelines vary among countries, resulting in different case definitions, this does not account entirely for the varying success of different national control efforts. Low treatment and control rates in Europe, combined with a higher prevalence of hypertension, could contribute to a higher burden of cardiovascular disease risk attributable to elevated blood pressure compared with that in North America.
引用
收藏
页码:10 / 17
页数:8
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