我国中年人群高血压、超重和肥胖的发病率及其与心血管事件的关系  

The incidence of hypertension, overweight, and obesity and relationship with cardiovascular events among middle-aged Chinese: 6 years follow-up results

作　　者：陈祚[1] 李苏宁 王馨[1] 张林峰[1] 邵澜[1] 田野[1] 王增武[1] Chen Zuo;Li Suning;Wang Xin;Zhang Linfeng;Shao Lan;Tian Ye;Wang Zengwu(Division of Prevention and Community Health,National Center for Cardiovascular Disease,Fuwai Hospital,Peking Union Medical College&Chinese Academy of Medical Sciences,Beijing 102308,China)

机构地区：[1]中国医学科学院,北京协和医学院,阜外医院,国家心血管病中心社区防治部,102308

出　　处：《中华心血管病杂志》2020年第1期47-53,共7页Chinese Journal of Cardiology

基　　金：卫生行业科研专项(200902001);国家自然科学基金(81373070)。

摘　　要：目的分析我国中年人群高血压、超重和肥胖的流行趋势及其对心血管事件的影响。方法该研究为调查随访研究,研究对象来自卫生行业科研专项"心血管疾病监测、预防预警和诊治技术应用研究"。2009至2010年在12个研究地区各抽取约1000人(35~64岁),调查人群心血管疾病的危险因素;2016至2017年对上述研究对象进行随访,并记录心血管事件发生情况。最终8835人纳入该研究。比较入选人群基线和随访时的血压和体重指数(BMI),计算高血压、超重和肥胖的6年累积发病率。采用Cox回归模型分析高血压、超重、肥胖对心血管事件的影响。结果随访结果显示,研究人群BMI、收缩压和舒张压水平均较基线有所增长(P均<0.001)。高血压、超重和肥胖6年累积发病率分别为39.3%(1146/2918)、11.5%(406/3544)和4.3%(302/7025)。调整混杂因素后Cox回归模型分析结果显示,与BMI和血压均正常的中年人群比较,超重、肥胖、高血压、超重伴高血压、肥胖伴高血压的中年人群心血管事件发生风险均增加[HR分别为2.394(95%CI 1.130~5.073)、3.341(95%CI 1.454~7.674)、6.047(95%CI 2.978~12.279)、5.808(95%CI 2.924~11.539)和8.716(95%CI 4.391~17.302),P均<0.05]。结论我国中年人群超重、肥胖和高血压发病率较高,超重、肥胖、高血压或超重/肥胖伴高血压均可增加心血管事件发生风险。Objective To identify the incidence of hypertension,overweight/obesity in middle-aged population in China,and explore their impact on cardiovascular events.Methods From 2009 to 2010,12 areas were sampled in China,and about 1000 subjects aged 35-64 from each area were enrolled to collect the basic information,physical examination and blood tests were also performed.From 2016 to 2017,data from 8835 subjects,who completed the 6 years follow-up,were analyzed.Blood pressure and body mass index(BMI)at both baseline and the follow-up,as well as incidence of hypertension,overweight and obesity,were calculated.Cox proportional hazard model was used to investigate the impacts of hypertension,overweight and obesity on cardiovascular events after adjusting confounders.Results At the end of follow-up,both BMI and systolic and diastolic blood pressure increased significantly compared with the baseline levels(all P<0.001).The cumulative incidence of hypertension,overweight and obesity within 6 years was 39.3%(1146/2918),11.5%(406/3544)and 4.3%(302/7025),respectively.Compared with subjects with both normal BMI and blood pressure,people with overweight,obesity,hypertension,overweight with hypertension,and obesity with hypertension faced significantly increased risk of cardiovascular disease(HRs(95%CIs)were 2.394(1.130-5.073),3.341(1.454-7.674),6.047(2.978-12.279),5.808(2.924-11.539)and 8.716(4.391-17.302),respectively,all P<0.05),after adjusting for other confounders.Conclusions The incidence of overweight,obesity,and hypertension is high in middle-aged people in China.Overweight,obesity and hypertension are associated with significantly increased risk of cardiovascular events during the 6 years follow up.

关 键 词：心血管疾病 高血压 超重 肥胖 

分 类 号：R544[医药卫生—心血管疾病] R589[医药卫生—内科学]