Kinetic epidemiological model for elucidating sexual difference of hypertension (KCIS no.20).
BACKGROUND
Woman have lower rate of hypertension than man but it is still elusive how such gender difference can be explained by kinetic epidemiological curves.


OBJECTIVE
The aim of this paper was to develop a multi-state model for delineating the kinetic epidemiology of hypertension according to the Seventh Report of the Joint National Committee (JNC 7) classification criteria by gender, and to derive gender-specific kinetic curves.


METHODS
We used data from a population-based screening programme with 42,027 participants to fit a four-state Markov model corresponding to the classification of hypertension from the JNC 7.


RESULTS
The young man had higher progression rate but lower regression rate for the movement between normal and pre-hypertension than the young woman. Such gender difference disappeared after 50 years old. The mean sojourn time of pre- and stage 1 hypertension for man and stage 1 for woman was approximately 5 years. However, the corresponding figure for pre-hypertension for woman was 25 years at age 30, 10 years at age 40 and 5 years afterwards.


CONCLUSIONS
Elucidating the kinetic epidemiological curves of hypertension explains higher prevalence rate in young man than woman. These findings fit with the role of sex hormones regulating blood pressure demonstrated in the animal model.
Yen
Amy M-F
AM
Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan.
Chen
Tony H-H
TH
D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D005260:Female; D005544:Forecasting / Q000379:methods; D006801:Humans; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012737:Sex Factors