高血压患者吸烟状况与心血管危险分层的关系  

The relationship between smoking status and cardiovascular risk stratification in hypertensive patients

作　　者：贾贡献[1] 余金明[1] 林凡礼[1] 宫霄欢[1] 石常宏[1] 孔群钰[1] 胡大一[2] 

机构地区：[1]复旦大学公共卫生学院,公共卫生安全教育部重点实验室,上海200032 [2]北京大学人民医院心脏中心

出　　处：《中华高血压杂志》2013年第4期340-345,共6页Chinese Journal of Hypertension

摘　　要：目的探讨高血压患者吸烟状况与心血管危险分层的关系。方法 2011-03-05,在全国29个城市129家二级及以上医院进行横断面临床流行病学调查。共收集18岁及以上高血压患者4057例,年龄18.5～105.0(61.1±14.0)岁。记录其人口学特征、血压控制情况及心血管危险分层情况。校正人口学因素、危险因素及伴发疾病后,拟合心血管危险分层与吸烟状况(以无吸烟史患者为参考)的非条件有序Logistic回归模型。结果在同样心血管危险分层条件下,吸烟人群发生心血管危险是不吸烟人群的1.40倍(OR=1.40,95%CI1.17～1.67,P<0.01),已戒烟人群是不吸烟人群的1.23倍(OR=1.23,95%CI0.94～1.60,P=0.13),吸烟人群是已戒烟人群的1.14倍(OR=1.14,95%CI0.86～1.51,P=0.36)。对吸烟人群进行非条件有序Logistic回归分析,同样心血管分层条件下,吸烟严重者发生心血管危险是吸烟轻微者的1.88倍(OR=1.88,95%CI1.38～2.55,P<0.01)。结论吸烟可增加高血压患者的心血管总体危险,戒烟后近期内仍存在心血管风险。Objective To explore the relationship between smoking status and cardiovascular risk stratification in hypertensive patients. Methods Between March and May in 2011, a cross-sectional clinical epidemiological survey was carried out in 129 tertiary or secondary hospitals from 29 cities across China. A total of 4057 hypertensive out- patients aged from 18.5 to 105.0 years old[mean age （61. 1±14.0）] were recruited. Their demographic characteristics, blood pressure control and cardiovascular risk stratification were recorded. After adjusting demographic fac- tors, risk factors and concomitant diseases, unconditional ordered logistic regression model was used to analyze the relationship between cardiovascular risk stratification and smoking status （used non-smoker for reference ）. Results At the same risk stratification, the cardiovascular risk for smokers was 1.40 times （OR= 1.40, 95 % CI 1.17-1.67, P〈0.01） as much as that for non-smoker, and the cardiovascular risk of smokers was 1.23 times （OR=1. 23, 95% CI 0. 94-1.60, P=0.13） as much as that for non-smokers, and the cardiovascular risk for smokers＇ was 1.14 times （ OR = 1.14, 95 % CI 0.86- 1.51, P = 0.36 ） as much as that for smoking cessation population. Unconditional ordered Logistic regression analysis for smokers showed that, at the same risk stratification, the cardiovascular risk for heavy smokers was 1.88 times （OR=I. 88, 95% CI 1.38-2.55, P〈0.01） as much as that for light smokers. Conclusion Smoking increases overall cardiovascular risk for hypertensive patients. And the cardiovascular risk still exists after smoking cessation in the short term.

关 键 词：高血压 吸烟 心血管危险分层 

分 类 号：R544.1[医药卫生—心血管疾病]