据估计,在世界范围内,有十亿人患有高血压,每年有 710 万例左右的死亡病例与高血压有关。[8]Geleijinse JM, Kork FJ, Grobbee DE. Blood pressure response to changes in sodium and potassium intake: a meta-regression analysis of randomized trials. J Hum Hypertens. 2003 Jul;17(7):471-80.http://www.ncbi.nlm.nih.gov/pubmed/12821954?tool=bestpractice.com 随着寿命延长、肥胖、活动减少和不健康饮食等相关因素的流行,高血压越来越常见。[9]Singh RB, Suh IL, Singh VP, et al. Hypertension and stroke in Asia: prevalence, control and strategies in developing countries for prevention. J Hum Hypertens. 2000 Oct-Nov;14(10-11):749-63.http://www.nature.com/jhh/journal/v14/n10/pdf/1001057a.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/11095165?tool=bestpractice.com[10]Yusuf S, Reddy S, Ounpuu S, et al. Global burden of cardiovascular diseases. Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001 Dec 4;104(23):2855-64.http://circ.ahajournals.org/content/104/22/2746.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11733407?tool=bestpractice.com 在许多发展中国家,特别是城市区域,高血压患病率已经与发达国家一样高。[11]Khor GL. Cardiovascular epidemiology in the Asia-Pacific region. Asia Pac J Clin Nutr. 2001;10(2):76-80.http://www.ncbi.nlm.nih.gov/pubmed/11710361?tool=bestpractice.com
目前美国患原发性高血压人数从1990年的5000万人增加至约7000万人。[12]Fields LE, Burt VL, Cutler JA, et al. The burden of adult hypertension in the United States 1990-2000. A rising tide. Hypertension. 2004 Oct;44(4):398-404.http://hyper.ahajournals.org/content/44/4/398.fullhttp://www.ncbi.nlm.nih.gov/pubmed/15326093?tool=bestpractice.com[13]Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the US: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief. 2013 Oct;(133):1-8.https://www.cdc.gov/nchs/data/databriefs/db133.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/24171916?tool=bestpractice.com 根据美国全国健康和营养检查调查 (National Health and Nutrition Examination Surveys, NHANES) 的数据,患病率最高为黑人妇女,并且她们发生高血压年龄低于其他种族群体。[14]Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003 Jul 9;290(2):199-206.http://jama.jamanetwork.com/article.aspx?articleid=196894http://www.ncbi.nlm.nih.gov/pubmed/12851274?tool=bestpractice.com[15]Mozaffarian D, Benjamin EJ, Go AS, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2016 update: a report from the American Heart Association. Circulation. 2015 Jan 27;131(4):e29-322.http://circ.ahajournals.org/content/133/4/e38.longhttp://www.ncbi.nlm.nih.gov/pubmed/25520374?tool=bestpractice.com 美国白人发病率高于墨西哥裔美国人。[15]Mozaffarian D, Benjamin EJ, Go AS, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2016 update: a report from the American Heart Association. Circulation. 2015 Jan 27;131(4):e29-322.http://circ.ahajournals.org/content/133/4/e38.longhttp://www.ncbi.nlm.nih.gov/pubmed/25520374?tool=bestpractice.com[16]Lorenzo C, Serrano-Rios M, Martinez-Larrad MT, et al. Prevalence of hypertension in Hispanic and non-Hispanic white populations. Hypertension. 2002 Feb;39(2):203-8.http://hyper.ahajournals.org/content/39/2/203.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11847184?tool=bestpractice.com 所有人种和性别的发病率均随年龄增加而增加。45 岁以下男性的患病率高于女性,45 至 64 岁之间不同性别患病率相同,65 岁以上的人群中女性患病率高于男性。[15]Mozaffarian D, Benjamin EJ, Go AS, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2016 update: a report from the American Heart Association. Circulation. 2015 Jan 27;131(4):e29-322.http://circ.ahajournals.org/content/133/4/e38.longhttp://www.ncbi.nlm.nih.gov/pubmed/25520374?tool=bestpractice.com 男性和女性在年龄>55 岁至存活至 80 岁之间发生高血压的风险为 90%。[17]Vasan RS, Beiser A, Seshadri S, et al. Residual lifetime risk for developing hypertension in middle aged women and men: the Framingham Heart Study. JAMA. 2002 Feb 27;287(8):1003-10.http://jama.jamanetwork.com/article.aspx?articleid=194679http://www.ncbi.nlm.nih.gov/pubmed/11866648?tool=bestpractice.com
根据美国心脏病学会/美国心脏协会 (ACC/AHA) 对高血压的定义,美国高血压的患病率从 32% 升至 46%,目前约有 1.03 亿人罹患高血压。[5]Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-248.https://www.sciencedirect.com/science/article/pii/S0735109717415191?via%3Dihubhttp://www.ncbi.nlm.nih.gov/pubmed/29146535?tool=bestpractice.com高血压的患病率在 20-44 岁的男性人群中约为之前的 3 倍(从 11%升高至 30%),在 45 岁以下的女性人群中约为之前的 2 倍(从 10%升高至 19%)。非洲裔美国人的患病率高于白人、亚裔和墨西哥裔美国人。[5]Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15;71(19):e127-248.https://www.sciencedirect.com/science/article/pii/S0735109717415191?via%3Dihubhttp://www.ncbi.nlm.nih.gov/pubmed/29146535?tool=bestpractice.comAHA Centers for Health Metrics and Evaluation: 2017 hypertension guidelines visualisation