Chinese people's hypertension is "different": Folic acid reducing the stroke

Wen ｜ Huo Yong

"China Cardiovascular Health and Disease Report 2021" pointed out that there are currently 330 million patients with cardiovascular disease in my country, of which about 245 million patients with hypertension. The incidence of emergencies remains high, which has also brought huge challenges to our country's chronic disease prevention and control system.

my country's high blood pressure disease is significant "three highs and three lows" characteristics: the "three highs" means that the prevalence is high, the growth trend is high, and the harmfulness is high;

Looking at the world, although the prevalence of high blood pressure in many European and American countries is higher than that of my country, the incidence of hypertension and stroke is much lower than that of my country. Is this because my country's hypertension prevention and control level is backward, or is the hypertension of the people in my country different from the high blood pressure of European and American populations? With such doubts, we have opened for more than 20 years.

For the first time, "H -type hypertension"

Since 1995, our research team has started to establish an epidemiological queue covering 39,000 people and tracking the follow -up of 6.2 years. We found through a lot of data analysis that the overall folic acid level of the crowd in my country is low, and the level of blood same cysteine ​​(HCY) is high. The combination of blood pressure is an important reason for the high incidence of strokes in my country.

In 2008, for the first time, we proposed the concept of "H -type hypertension", namely "hypertension with a high blood pressure with bloody camvascopic acid." This concept is of great significance to the prevention and control of cardiovascular and chronic diseases.

In the same year, we started the study of my country's stroke first -level prevention (CSPPT) research on the characteristics of Hypertex high -incidence of H -type hypertension in China. Research.

CSPPT research lasted nearly 5 years, and was included in 20702 patients with a history of Chinese hypertension with a history of brain -free and myocardial infarction. According to the layer of the genotype of the Anecartia tetrahydrofolate C677T, we divide the patients randomly and double -blindness into two groups, and take a single tablet fixed compound preparation of Malay acid Yinaninic acid tablets daily. Estimation of 0.8mg folic acid) and simply Yisinubi (10mg), the main observation end is the first stroke, the secondary end point is the first ischemic stroke, the first hematopoietic stroke, myocardial infarction, all cause of death, and including death, and include including Cardiovascular death, cardiovascular infarction, and cardiovascular incidents, including cardiovascular death, myocardial infarction, and stroke.

The results of the CSPPT study confirmed that compared with the control group of Yisanubi, the test group of Malay acid Yinanic acid tablets was reduced by 21%of the first stroke risk when the blood pressure control was the same. The research was published in the "American Medical Association Magazine" in 2015.

The "Rongcheng Mode" effect is highlighted

CSPPT studies have important significance and benefits of results transformation. After the release of related research results, research in many countries and regions has further confirmed that supplementing folic acid can reduce the risk of stroke of the stroke, which has further confirmed that the research results of CSPPT are repeated.

For the public, there are three main information transmitted by CSPPT.

First, the hypertension of the people in my country is different from the European and American people. Studies have found that most of the people with folic acid in the Chinese population and low -level folk acid are mostly one of the main reasons for the prevention and control of high blood pressure cardiovascular and cerebrovascular disease risk prevention and control in my country.

Second, supplementing folic acid can effectively reduce the occurrence of stroke. For patients with hypertension, especially patients with H -type hypertension, effective evidence given by CSPPT research has increased effective measures to prevent stroke.

Third, clear folic acid supplementary doses. Studies are carried out under the premise of regular medication and specific doses. Therefore, long -term adherence to folic acid (0.8 mg daily) can effectively reduce the risk of stroke.

In response to the characteristics of the high blood pressure of Chinese people, we have formulated guidelines such as "Hypertext Hypertension Diagnosis and Treatment Expert Consensus". At the same time, with Shandong Rongcheng as a pilot, we launched the "H -type hypertension and stroke of stroke to prevent and control the people's project. ", Based on the screening of H high blood pressure and precision signing prevention and control as the starting point, build a comprehensive prevention and treatment system for adult residents in the city.

Data show that compared with 2013, during the 3 years (2015-2017) launched by the project, the incidence of stroke in the Rongcheng area decreased by 13%, 15%, and 22%in order. Rongcheng Mode. The exploration of H high blood pressure in H -type H -type is an extension and expansion of my country's chronic disease prevention and control model, and it is an important step in the prevention and control of hypertension in my country.

It turns out that the prevention and control strategy of H -type hypertension can be used for reference and replication. In the future, we should promote the implementation of this prevention and control system to the country to lead the comprehensive prevention and control of chronic diseases across the country.

(Author Unit: First Hospital of Peking University, this article is interviewed by Zhang Siwei, a reporter from the China Science News)

"China Science News" (2022-07-06 The 3rd Edition)

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