BACKGROUND The prevalence of hypertension and uncontrolled hypertension may differ by age and sex. METHODS We included participants in the Atherosclerosis Risk in Communities study at seven study visits over 33 years (visit 1: 15 636 participants; mean age, 54 years; 55% women), estimating sex differences in prevalence of hypertension (systolic blood pressure ≥130 mm Hg; diastolic blood pressure ≥80 mm Hg; or self-reported antihypertension medication use) and uncontrolled hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) using unadjusted and comorbidity-adjusted models. RESULTS The prevalence of hypertension increased with age from 40% (ages, 43-46 years) to 93% (ages, 91-94 years). Within hypertensive individuals, the prevalence of uncontrolled hypertension was higher in men (33%) than women (23%) at ages 43 to 46 years but became higher in women than men starting at ages 61 to 64, with 56% of women and 40% men having uncontrolled hypertension at ages 91 to 94. This sex difference was not explained by differences in coronary heart disease, diabetes, body mass index, estimated glomerular filtration rate, number of antihypertension medications, classes of medications, or adherence to medications. In both sexes, uncontrolled hypertension was associated with a higher risk for chronic kidney disease progression (hazard ratio, 1.5 [1.2-1.9]; P=4.5×10-4), heart failure (hazard ratio, 1.6 [1.4-2.0]; P=8.1×10-7), stroke (hazard ratio, 2.1 [1.6-2.8]; P=1.8×10-8), and mortality (hazard ratio, 1.5 [1.3-1.6]; P=6.2×10-19). CONCLUSIONS Sex differences in the prevalence of hypertension and uncontrolled hypertension vary by age, with the latter having implications for health throughout the life course.

中文翻译：

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高血压的性别差异及其一生的管理。


背景 高血压和未控制的高血压的患病率可能因年龄和性别而异。方法 我们纳入了社区动脉粥样硬化风险研究的参与者，在 33 年内进行了 7 次研究访问（访问 1：15 636 名参与者;平均年龄 54 岁;55% 女性），估计高血压患病率（收缩压 ≥130 mm Hg;舒张压 ≥80 mm Hg;或自我报告的抗高血压药物使用）患病率的性别差异（收缩压 ≥140 mm Hg 或舒张压 ≥90 mm Hg）使用未调整和合并症调整模型。结果 高血压患病率随年龄增长，从 40% （年龄，43-46 岁） 增加到 93% （年龄，91-94 岁）。在高血压个体中，43 至 46 岁男性 （33%） 未控制的高血压患病率高于女性 （23%），但从 61 至 64 岁开始，女性高于男性，56% 的女性和 40% 的男性在 91 至 94 岁时患有未控制的高血压。这种性别差异不能用冠心病、糖尿病、体重指数、估计肾小球滤过率、抗高血压药物数量、药物类别或药物依从性的差异来解释。在两性中，未控制的高血压与慢性肾病进展风险较高相关（风险比，1.5 [1.2-1.9];P=4.5×10-4）、心力衰竭 （风险比，1.6 [1.4-2.0];P=8.1×10-7）、卒中 （风险比，2.1 [1.6-2.8];P = 1.8×10-8） 和死亡率 （风险比，1.5 [1.3-1.6];P=6.2×10-19）。结论 高血压患病率和未控制的高血压患病率的性别差异因年龄而异，后者对整个生命过程的健康有影响。