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CARDIOLOGY

The mortality rate associated with hypertension in the United States has soared, and China is “following the pace”!

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As we all know, hypertension is the most common chronic disease and one of the main risk factors for cardiovascular disease.Hypertension can not be effectively controlled for a long time, and it can often promote the occurrence of coronary heart disease and stroke. According to the report of Lancet in 2019, these two diseases are the top two causes of death for our residents.
Hypertension-related cardiovascular death (hereinafter referred to as: hypertension-related death) has been receiving much attention. This is not, it was released at the annual scientific conference jointly held by the American College of Cardiology (ACC) and the World Heart Congress (WCC)A clinical study counted the changes in hypertension-related deaths in the United States in the past decade. The relevant results were published simultaneously in the “JACC” magazine. Let’s take a look together.The study analyzed the proportion of hypertension-related deaths among 1050 individual deaths counted by the US Centers for Disease Control and Prevention from 2007 to 2017, and was conducted based on age, gender, degree of urbanization (urban and rural), and geographic location.Subgroup analysis.The southern and rural areas of the United States are “severely hit areas”. It was found that during this decade, hypertension-related mortality has increased year by year, and it has shown age, urbanization, and regional differences: the age-standardized death rate of urban population has increased by 20%The rural area in the southern United States has the highest mortality rate, which is 2.5 times higher than other regions. Among all age groups, the mortality rate of the oldest group (65-74 years old) has also been the highest.In addition, the study also showed that the overall mortality rate of hypertension among men was higher than that of women (25.7% vs 20.3%).The study analysis pointed out that since 2011, the overall mortality rate of cardiovascular disease in the United States has gradually slowed, while the deaths related to hypertension have shown the opposite trend, indicating that controlling hypertension in the population is imminent, and the need to implement the new version of ACC / AHA highBlood pressure guidelines.In the southern rural population, the reason for the rapid increase in hypertension-related deaths may be related to obesity, diabetes, and poor health care.The prevalence of hypertension in China continues to increase. The situation in the United States is so severe, so what is the situation in China?According to the 2012-2015 national survey, the prevalence of hypertension in the Chinese population also showed an upward trend and increased significantly with age. The prevalence of hypertension among residents over 18 years of age reached 23.2%, and 41.3% was in the pre-hypertension stagestatus.Among hypertensive patients, males are higher than females, the phenomenon of high in the north and low in the south still exists, but the difference is changing, showing the characteristics of high prevalence of hypertension in large and medium-sized cities, such as hypertension in Beijing, Tianjin and Shanghai residentsThe prevalence rates are 35.9%, 34.5% and 29.1%, which may be related to the relatively high living pressure in these areas.Surprisingly, the prevalence of hypertension in rural areas is growing faster than in cities. In this national survey, the prevalence of rural areas (23.4%) exceeded that of cities (23.1%) for the first time. This may beAlthough living conditions in rural areas have improved significantly in recent years, it is caused by a relatively lack of health awareness. Therefore, it is still necessary to carry out in-depth hypertension health education.In addition, compared among different ethnic groups, the prevalence of hypertension among Tibetans, Manchus and Mongolians is higher than that of the Han population, while the prevalence of hypertension among the Hui, Miao, Zhuang and Buyi ethnic groups is lower than that of the Han population.The awareness rate and control rate of hypertension in China are still low. In recent years, with the popularization of health education and the improvement of people’s health awareness, the awareness rate, treatment rate and control rate of hypertension in China have improved significantly, but the overallThe low level reached 46.9%, 40.7% and 15.3% respectively.By comparing different demographic characteristics, it is found that the awareness rate, treatment rate and control rate of women are higher than men, and the treatment rate of urban hypertension is significantly higher than that of rural areas; compared with northern areas, the awareness rate of residents with hypertension in southern areasThe treatment rate and control rate are higher; compared with different ethnic groups, the treatment and control rate of hypertension among ethnic minority residents is lower than that of the Han nationality.In the treatment of hypertension, calcium antagonists are the most commonly used single-agent drugs (46.5%), and 31.7% of patients are treated with two or more antihypertensive drugs.Previous studies have shown that the vast majority of patients require combined drug treatment, especially in the case of comorbidities, but 70% of patients use monotherapy.Judging from the current rate of hypertension control, drug combination therapy may be more helpful in controlling hypertension in the population.Where to go for hypertension treatment ▎Lifestyle intervention is to increase sodium and low potassium diets. Overweight and obesity are the most important risk factors for hypertension in our country. In addition, excessive drinking, long-term mental stress, and lack of physical work can also affect blood pressure levels; ageAnd family history are influential factors that cannot be changed.Therefore, to control blood pressure, we must first start from improving poor lifestyles, such as reducing sodium intake, the daily salt intake per person gradually reduced to <6 g, increasing potassium intake; balanced diet; weight control, so that BMI <24. Men's waist circumference <90 cm, women's waist circumference <85 cm; quit smoking; do not drink or limit alcohol consumption; increase exercise, exercise 4-7 times a week with moderate intensity, each time lasting 30-60 min.▎Adhering to taking medicine is the key. On the basis of improving lifestyle, patients whose blood pressure is still ≥140 / 90 mmHg and / or higher than the target blood pressure should receive long-term drug treatment. Generally, patients with hypertension should be reduced to <140/90 mmHgTolerants and some high-risk patients can be further reduced to <130/80 mmHg.Hypertension drug treatment follows the following principles: Initial dose: general patients use conventional doses; the initial treatment of elderly patients should use a smaller effective therapeutic dose, and gradually increase the dosage as needed; priority use of long-acting antihypertensive drugs for effective control24-hour blood pressure to prevent cardiovascular and cerebrovascular complications; high-risk patients with blood pressure ≥160 / 100 mmHg, 20/10 mmHg higher than the target blood pressure, or patients who do not meet the standard of single drug treatment should be combined with antihypertensive therapy; Pay attention to individualized treatment; hypertension is a lifelong treatment, and cost / benefit needs to be considered.The above content is only authorized for exclusive use by 39Health.com, please do not reprint without the authorization of the copyright party.

ouyangshaoxia

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