2019年8月24日出版的《柳叶刀》杂志公布了一个国际研究协作小组NCD-RisC的最新成果，他们分析了12个高收入国家高血压意识、治疗和控制的长期和近期趋势。

研究人员收集了12个高收入国家（包括澳大利亚、加拿大、芬兰、德国、爱尔兰、意大利、日本、新西兰、韩国、西班牙、英国和美国）从1976年到2017年进行的123次全国健康体检调查的40-79岁人群的数据。

高血压定义为收缩压超过140毫米汞柱，舒张压超过90毫米汞柱，或正在接受高血压药物治疗。高血压控制定义为血压低于140/90毫米汞柱。该研究采集了526336名参与者的数据，在最近的调查中，加拿大、韩国、澳大利亚和英国的高血压患病率最低，芬兰最高。

20世纪80年代至90年代初，大多数国家、年龄和性别群体的高血压治疗率最高为40%，控制率低于25%。90年代至2000年代早中期，12个国家的高血压意识和治疗水平都有所提高，控制率也有所增长，其中韩国和德国的改善幅度最大，此后多数国家进入了停滞期。

调查发现，加拿大、德国、韩国和美国的高血压意识、治疗和控制水平最高，而芬兰、爱尔兰、日本和西班牙最低。即使在表现最好的国家，治疗覆盖率也最多为80%，控制率不超过70%。

综上，自上世纪8、90年代以来，高收入国家的高血压意识、治疗和控制水平有了显著提高。然而，控制率在过去10年已趋于稳定，但仍低于高质量高血压规划的水平。各国在高血压意识、治疗和控制方面仍存在显著差异。

附：英文原文

Title: Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys

Author: NCD Risk Factor Collaboration (NCD-RisC)

Issue&Volume: VOLUME 394, ISSUE 10199, P663-671, AUGUST 24, 2019

Summary:

Background

Antihypertensive medicines are effective in reducing adverse cardiovascular events. Our aim was to compare hypertension awareness, treatment, and control, and how they have changed over time, in high-income countries.

Methods

We used data from people aged 40–79 years who participated in 123 national health examination surveys from 1976 to 2017 in 12 high-income countries: Australia, Canada, Finland, Germany, Ireland, Italy, Japan, New Zealand, South Korea, Spain, the UK, and the USA. We calculated the proportion of participants with hypertension, which was defined as systolic blood pressure of 140 mm Hg or more, or diastolic blood pressure of 90 mm Hg or more, or being on pharmacological treatment for hypertension, who were aware of their condition, who were treated, and whose hypertension was controlled (ie, lower than 140/90 mm Hg).

Findings

Data from 526?336 participants were used in these analyses. In their most recent surveys, Canada, South Korea, Australia, and the UK had the lowest prevalence of hypertension, and Finland the highest. In the 1980s and early 1990s, treatment rates were at most 40% and control rates were less than 25% in most countries and age and sex groups. Over the time period assessed, hypertension awareness and treatment increased and control rate improved in all 12 countries, with South Korea and Germany experiencing the largest improvements. Most of the observed increase occurred in the 1990s and early-mid 2000s, having plateaued since in most countries. In their most recent surveys, Canada, Germany, South Korea, and the USA had the highest rates of awareness, treatment, and control, whereas Finland, Ireland, Japan, and Spain had the lowest. Even in the best performing countries, treatment coverage was at most 80% and control rates were less than 70%.

Interpretation

Hypertension awareness, treatment, and control have improved substantially in high-income countries since the 1980s and 1990s. However, control rates have plateaued in the past decade, at levels lower than those in high-quality hypertension programmes. There is substantial variation across countries in the rates of hypertension awareness, treatment, and control.

DOI: https://doi.org/10.1016/S0140-6736(19)31145-6

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31145-6/fulltext#