中国藏族人群高血压患病率的系统回顾和荟萃分析

Prevalence of hypertension in Tibetans,China:a systematic review and meta-analysis

目的系统评价中国藏族人群高血压的患病率,为卫生资源配置及卫生政策制定提供依据。方法在中国知网(CNKI)、维普(VIP)、万方数据库和PubMed数据库、Cochrane图书馆、EMBASE数据库收集建库至2019年2月28日国内外公开发表的有关我国藏族人群高血压患病率的相关文献,辅以手工检索。由两位研究者按照纳入、排除标准独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 12.0软件进行荟萃分析。结果共纳入17篇文献,包括研究对象64481人,其中研究对象年龄范围为≥18岁的文献有12篇,共计55718人。荟萃分析结果显示,中国藏族年龄≥18岁人群的高血压患病率为36%(95%CI 26%~46%)。按年龄分层,18~<36、36~<60和≥60岁人群高血压患病率分别为14%(6%~22%)、40%(32%~47%)和58%(46%~71%);按性别分层,男性和女性高血压的患病率分别为39%(31%~47%)和34%(26%~43%);按居住区域分层,城市、农村和牧区高血压的患病率分别为36%(28%~44%)、33%(20%~46%)和36%(32%~40%);按调查年份分层,2002-2012年、2013-2015年和2016年之后高血压患病率分别为38%(32%~43%)、32%(22%~41%)和34%(29%~39%);按海拔高度分层,居住在1.5~3.0、>3.0~4.0和>4.0 km人群的高血压患病率分别为16%(12%~21%)、33%(25%~42%)和47%(37%~57%)。总体高血压知晓率、治疗率和控制率分别45%(32%~58%)、30%(22%~38%)和7%(4%~10%)。结论中国藏族人群高血压呈"三低一高"现象,即知晓率、治疗率、控制率低以及患病率高。

Objective To systematically review the prevalence of hypertension in Tibetans,China and provide evidence basis for resource allocation in healthcare decision making and health policy.Methods The PubMed,EMBASE,the Cochrane Library,China National Knowledge Infrastructure(CNKI),WanFang and VIP databases were reviewed to identify potentially eligible articles that provided data on the prevalence of hypertension in Tibetans,China before February 28,2019.Two investigators independently assessed articles according to eligibility criteria,extracted data and assessed the risk of bias.Statistical analysis was completed using Stata software version 12.0.Results A total of 17 articles with 64481 subjects were eligible,and thereof 12 articles included 55718 subjects aged≥18 years.Overall prevalence of hypertension in Tibetans aged≥18 years was 36%(95%confidence interval:26%to 46%,similarly hereinafter).Upon stratification by age,the prevalence of hypertension was 14%(6%to 22%),40%(32%to 47%)and 58%(46%to 71%)in Tibetans aged 18-<36,36-<60 and≥60 years,respectively.By gender,hypertension was found in 39%(31%to 47%)males and 34%(26%to 43%)females.By region,the prevalence of hypertension was 36%(28%to 44%)in urban areas,33%(20%to 46%)in rural areas and 36%(32%to 40%)in pastoral areas.By survey year,the prevalence of hypertension was 38%(32%to 43%),32%(22%to 41%)and 34%(29%to 39%)in 2002-2012,2013-2015 and after 2016,respectively.By the geographic altitude,the prevalence of hypertension was 16%(12%to 21%)between 1.5-3.0 km,33%(25%to 42%)between>3.0-4.0 km and 47%(37%to 57%)above 4.0 km,respectively.The rates of awareness,treatment and control of hypertension were 45%(32%to 58%),30%(22%to 38%)and 7%(4%to 10%),respectively.Conclusion The prevalence of hypertension in Tibetans,China is high,while the awareness,treatment and control rates are relatively low.