18～30岁人群体质量指数与高血压发病的关系  

The relationship between body mass index and incidence of hypertension in young adults aged 18-30 years old

作　　者：赵楚敏[1] 王希柱[2] 宋巧凤[2] 吴寿岭[3] 张彩凤[4] 郑香[5] 陈朔华[3] 

机构地区：[1]河北联合大学附属骨科医院(唐山市第二医院)综合内科,河北唐山063000 [2]河北联合大学附属唐山市人民医院心内科 [3]河北联合大学附属开滦总医院心内科 [4]河北联合大学附属医院神经内科一病区 [5]唐山市人民医院功能科

出　　处：《中华高血压杂志》2015年第4期343-348,共6页Chinese Journal of Hypertension

摘　　要：目的探讨18-30岁人群体质量指数与高血压发病的关系。方法采用前瞻性队列研究,以参加2006年7月至2007年10月开滦集团健康体检的18-30岁人群为研究对象,排除既往高血压病史、妊娠者及资料不全,排除2008-2009,2010-2011或2012-2013年均未参加查体者,最终纳入统计分析的4765人,观察不同体质量指数分组人群高血压发病情况,并分析进展至不同亚型高血压的情况。采用寿命表法计算高血压累积发病率,Cox比例风险回归模型分析体质量指数与高血压发病的关系。结果中位随访5.8年,期间共发生高血压999例,其中单纯收缩期高血压（ISH）占14%,单纯舒张期高血压（IDH）占62%,收缩舒张期高血压（SDH）占24%。低体质量组、正常体质量组、超重组和肥胖组累积高血压发病率分别为9.90%、18.28%、34.97%和61.13%,发病密度分别为12.19人/千人年、24.86人/千人年、51.14人/千人年、103.75人/千人年,组间比较差异有统计学意义（P〈0.05）。校正年龄、性别、吸烟、饮酒、体育锻炼、教育程度、基线收缩压、低密度脂蛋白胆固醇及高血压家族史等混杂因素后,超重组和肥胖组发生高血压的风险分别为体质量正常组的1.60（95%CI 1.36-1.87）和2.88（2.44-3.39）倍。结论在18-30岁人群中,高血压发病以IDH为主。随体质量指数增加,高血压发病率及发病风险增加。超重和肥胖对青年人群IDH和SDH发病的影响更大。Objective To investigate the relationship between body mass index （BMI） and incidence of hypertension in young aduhs. Methods A prospective population-based cohort study was conducted to survey the employees of Kailuan Corporation who underwent health examinations from July 2006 to October 2007. Data from 4765 participants aged 18--30 years old, free of hypertension and with complete information was used to estimate the incidence of hypertension. Cumulative incidence of hypertension was calculated using life table method, and Cox proportional hazards regression model was used to calculate hazard ratios for different BMI groups. Results During the median follow-up of 5.8 years, 999 subjects developed hypertension,in which isolated systolic hypertension（ISH） accounted for 14 %, isolated diastolic hypertension （IDH） accounted for 62 % and systolic-diastolic hypertension（SDH ） accounted for 24%/oo. The cumulative incidence of hypertension was 9.90%, 18.28%, 34.97% and 61.13% and the incidence density was 12.19/1000 person-years, 24.86/1000 person-years, 51.14/1000 person-years and 103.75/1000 person-years in participants with BMI % 18.5 kg/m2 （lower BMI group）, 18.5 - 24.0 kg/m2 （normal group） ; 24.0--28.0 kg/m^2 （overweight group） and 228.0 kg/m2 （obese group）, respectively（P〈0.05）. After adjustment for age, family history of hypertension, education, baseline systolic blood pressure, low density lipoprotein chetosterol, Cox proportional hazards model showed that compared to participants in normal group, the hazard ratios for hypertension were 1.60（95%CI 1.36-1.87） and 2.88（2.44-3.39） for those in overweight group and obese group, respectively. Conclusion The incidence of IDH is higher than that of ISH and SDH, and the risk of hypertension is increased with the increase of BMI among young adults.

关 键 词：青年 体质量指数 高血压 发病率 

分 类 号：R544.1[医药卫生—心血管疾病]