北京社区中老年人H型高血压患病率及其危险因素分析  

Investigation of prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community

作　　者：张仲迎[1] 方向华[2] 吉训明[3] 汤哲[5] 王淳秀[2] 钱红娟[4] 关绍晨[2] 刘宏军[2] 吴晓光[2] 侯城北[2] 顾乡[6] Zhang Zhongying;Fang Xianghua;Ji Xunming;Tang Zhe;Wang Chunxiu;Qian Hongjuan;Guan Shaochen;Liu Hongjun;Wu Xiaoguang;Hou Chengbei;Gu Xiang(Evidence-Based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院综合科,北京100053 [2]首都医科大学宣武医院循证医学科,北京100053 [3]首都医科大学宣武医院神经外科,北京100053 [4]首都医科大学宣武医院营养科,北京100053 [5]首都医科大学宣武医院北京市老年病防治中心 [6]首都医科大学附属友谊医院综合科

出　　处：《中国医师进修杂志》2018年第5期443-448,共6页Chinese Journal of Postgraduates of Medicine

基　　金：北京市自然科学基金（7152068）;2014年度首都医科大学宣武医院院级课题

摘　　要：目的调查北京社区中老年人H型高血压患病率及其危险因素。方法分析“北京老龄化多维纵向研究”2009年的调查数据，纳入北京社区人群共1458人，调查人群完成调查问卷、体格检查及实验室检查。以同型半胱氨酸（Hcy）〉15μmol／L定义为高Hey血症，原发性高血压合并高同型半胱氨酸血症定义为H型高血压。采用2000年北京市人口普查的结果对数据进行权重统计H型高血压患病率。应用多因素Logistic回归模型分析H型高血压患病的独立危险因素。结果调查人群年龄（69．48±8．09）岁，Hcy中位数16．56μmol／L。经权重后，调查人群高Hey血症患病率为57．20％（834／1458），H型高血压患病率为35．32％（515／1458），占高血压患者的59．47％（515／866）。高龄、男性、血尿酸升高、估算肾小球滤过率（eGFR）下降和不经常食用鱼虾是H型高血压患病的独立危险因素（OR=2．30、1．04、1．02、0．95、0．67，95％C／1．54～3．44、1．02—1．06、1．04～1．06、0．94—0．97、0．46～0．97，P〈0．0l或〈0．05）。结论北京社区中老年人H型高血压患病率较高，控制血尿酸、保护肾功能、经常进食鱼虾类食物可能有助于H型高血压的预防。Objective To investigate the prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community. Methods A cross-sectional study by recruiting 1 458 middle-aged and elderly people from a cohort of the ＂Beijing Longitudinal Study of Aging＂ in 2009 was conducted. All participants were asked to complete a standardized questionnaire, physical examination and laboratory examinations. Hyperhomocysteinemia was defined as homocysteine （Hey） 〉 15μmol/L, and H-type hypertension was defined as having hypertension and hyperhomocysteinemia simultaneously. The prevalence of H-type hypertension was estimated by using the results of 2000 Beijing population census to weight the data. Multivariate Logistic regression analysis was preformed to estimate the associated factors of H-type hypertension. Results The age was （69.48± 8.09） years, and the distribution of Hcy was skewed with the median of 16.56 μmol/L. After weight, the prevalence of hyperhomocysteinemia was 57.20% （834/1 458）, and the prevalence of H-type hypertension was 35.32% （515/1 458）, accounting for 59.47% （515/866） in patients with hypertension. The ageing, male, hyperuricemia, estimated glomerular filtration rate （eGFR） and insufficiency of fishes/shrimps were independent risk factors of H-type hypertension （OR = 2.30, 1.04, 1.02, 0.95 and 0.67; 95% CI 1.54 - 3.44, 1.02 - 1.06, 1.04 - 1.06, 0.94 - 0.97 and 0.46 - 0.97; P〈0.01 or 〈 0.05）. Conclusions The proportion of H-type hypertension is high in the middle-aged and elderly people in Beijing community. Lowering uric acid, protection of renal function and intake sufficient fishes and shrimps might prevent and control H-type hypertension.

关 键 词：高血压 中年人 老年人 患病率 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]