天津市正常高值血压人群高血压发病危险因素的定量评价  

Quantitative assessment of risk factors for hypertension incidence in a prehypertensive population in Tianjin

作　　者：黄晶晶[1] 孙跃民[1] 高玉霞[1] 牛凯军[2] 姚薇[1] 吴宪明[1] 陈绘丽[1] 赵欢欢[1] 

机构地区：[1]天津医科大学总医院心内科 [2]天津医科大学公共卫生学院,天津300052

出　　处：《中华高血压杂志》2016年第2期163-169,共7页Chinese Journal of Hypertension

基　　金：天津市卫生局科技基金项目(11KG133)

摘　　要：目的分析天津市正常高值血压人群高血压发病的危险因素,并进行定量评价。方法 2011年7月至2012年12月,采用分层整群随机抽样法,入选天津市内六区40~70岁非高血压常住居民1059人,将调查人群中正常高值血压者[收缩压120~139mm Hg和（或）舒张压80~89 mm Hg]622人（58.7%）作为研究队列,其中男性208人,女性414人。随访2年后,除外失访者及数据缺失者,最终纳入正常高值血压者535（男173、女362）人,将发展至高血压183（男65、女118）例作为病例组,未发展至高血压者352（男108、女244）人作为对照组。采用单因素和多因素Logistic回归分析正常高值血压人群不同危险因素暴露水平与高血压发病的关系,并计算危险分数。结果多因素Logistic回归分析显示,正常高值血压男性人群,高血压发病危险因素危险性较高的前5位是微量白蛋白尿、高盐膳食、精神压抑、睡眠时间〈5h、低密度脂蛋白胆固醇（LDL-C）〉4.12 mmol/L,危险分数分别为26.228、25.094、20.201、16.845、16.447。正常高值血压女性人群,高血压发病危险因素危险性较高的前5位是吸烟、精神压抑、过量饮酒、高盐膳食、高尿酸血症,危险分数分别为10.929、4.142、3.697、3.420、3.293。结论通过定量评估方法,正常高值血压男性人群的高血压发病风险前5位：微量白蛋白尿、高盐膳食、精神压抑、睡眠时间〈5h、低密度脂蛋白胆固醇〉4.12mmol/L;女性人群前5位：吸烟、精神压抑、过量饮酒、高盐膳食、高尿酸血症。Objective To analyze and quantitatively evaluate the risk factors of hypertension in a prehypertensive population in Tianjin. Methods Between 2011 July to 2012 December,1059non-hypertensive inhabitants aged40-70 years of Tianjin were selected by stratified cluster random sampling. 622（58.7%）participants（208males and 414femals）with prehypertension [systolic blood pressure 120-139 mm Hg and（or）diastolic blood pressure80-89 mm Hg]were selected as study group. After 2years of following,participants lost to follow-up or had insufficient data were excluded and 535participants（173males and 362females）were finally enrolled. One hundred and eigthy-three participants（65males and 118females）diagnosed with hypertension during the following were selected as hypertension group,while the rest 352participants（108males and 244females）were selected as control group. The relationship between the levels of different risk factors exposure and hypertension in prehypertension population were analysed by univariate and multivariate Logistic regression. The odds ratios of risk factors for hypertension were also calculated. Results Multivariate Logistic regression showed that the 5leading risk factors for hypertension in prehypertensive male were microalbuminuria,over-intake of salt,depression,sleep less than 5hours and LDL-C〉4.12 mmol/L,with corresponding risk scores of 26.228,25.094,20.201,16.845 and 16.447,respectively. For hypertension in prehypertensive female,the 5leading risk factors were smoking,depression,excessive drinking,over-intake of salt and hyperuricemia,with corresponding risk scores of 10.929,4.142,3.697,3.420 and 3.293,respectively. Conclusions Using quantiative assessment,the 5leading risk factors for hypertension in perhypertension male were microalbuminuria,over-intake of salt,depression,sleep less than 5hours and LDL-C〉4.12mmol/L;in prehypertension female,the 5leading risk factors were smoking,depression,excessive drinking,over-intake of salt and hyperuricemia.

关 键 词：正常高值血压 危险因素 危险分数 LOGISTIC回归 

分 类 号：R544.1[医药卫生—心血管疾病]