影响杭州市社区老年高血压控制的因素  

The factors correlated with the blood pressure control among the elderly hypertension in Hangzhou

作　　者：刘仕俊[1] 刘庆敏[1] 丁华[1] 罗军[1] 裘欣[1] LIU Shi-jun;LIU Qing-min;DING Hua;LUO Jun;QIU Xin(Hangzhou Center for Disease Control and Prevention,Hangzhou,Zhejiang 310021,China)

机构地区：[1]杭州市疾病预防控制中心,浙江杭州310021

出　　处：《中华高血压杂志》2021年第3期251-256,共6页Chinese Journal of Hypertension

摘　　要：目的评价纳入国家基本公共卫生服务的老年高血压患者的社区健康管理效果,描述其血压控制状况及其影响因素。方法采用现况研究方法,以杭州市纳入基本公共卫生服务社区健康管理的老年高血压患者(年龄≥60岁)为对象,利用2017年健康体检数据描述患者的生活方式、肥胖、血脂、空腹血糖和血压水平等流行病学特征,采用收缩压≥140和/或舒张压≥90 mm Hg标准计算血压控制率并分析影响血压控制的危险因素。结果本文共纳入研究对象209768人,平均年龄(70.7±7.1)岁,血压控制率48.39%,收缩压(141.4±16.9)、舒张压(80.2±10.0)mm Hg。研究对象心血管病危险因素分布:不良生活方式有86.27%、肥胖和/或中心性肥胖有38.20%、血脂异常有58.16%和空腹血糖异常有14.72%。各心血管病危险因素对血压控制状况的影响分别为不良生活方式的OR=1.18(95%CI 1.15~1.21)、肥胖OR=1.23(95%CI 1.21~1.25)、血脂异常OR=1.10(95%CI 1.09~1.11),空腹血糖异常OR=1.44(95%CI 1.40~1.48)。患者合并心血管病危险因素越多,血压控制难度越大,合并4项时OR值最大,达1.96(95%CI 1.83~2.09)。所有对象中单纯收缩期高血压占34.87%,且年龄越大比例越高。结论杭州市纳入国家基本公共卫生服务社区健康管理的老年高血压患者血压控制率为48.39%,肥胖、不良生活方式、空腹血糖异常和血脂异常均为血压控制的危险因素并呈现累积效应。Objective To evaluate the effectiveness of community health management of elderly hypertension,and to describe the status and related risk factors of blood pressure control.Methods The cross-sectional study was used in the present study.Hypertensive patients aged 60 years and above who take part in community health management in Hangzhou were selected.Physical examination data in 2017 including lifestyle,obesity,blood lipid,fasting plasma glucose(FPG)and blood pressure was used to describe the characteristics of subjects.Systolic blood pressure≥140 and/or diastolic blood pressure≥90 mm Hg standard was used to calculate the blood pressure control rate.Results There were 209768 subjects with mean age(70.7±7.1)years in the present study.The mean value of systolic blood pressure and diastolic blood pressure were(141.4±16.9)and(80.2±10.0)mm Hg,respectively.The blood pressure control rate was 48.39%.The rate of the subjects with unhealthy lifestyles,obesity(or central obesity),dyslipidemia and abnormal FPG were 86.27%,38.20%,58.16%and 14.72%,respectively.Cardiovascular risk factors including unhealthy lifestyle,obesity,abnormal fast plasma glucose and dyslipidemia,had significant impart on blood pressure control rate,with an OR(95%CI)of 1.18(1.15-1.21),1.23(1.21-1.25),1.44(1.40-1.48)and 1.10(1.09-1.11).The more risk factors,the more difficult to control,with the highest OR(95%CI)of 1.96(95%CI 1.83-2.09),when combinationed with 4 risk factors.In all,the percentage of isolated systolic hypertension was 34.87%and increased with age improving.Conclusions The blood pressure control rate of the elderly hypertension patients included in the community health management by national essential public health service was 48.39%.Obesity,unhealthy lifestyle,abnormal fasting blood glucose and dyslipidemia are risk factors of blood pressure control and have cumulative effectiveness.

关 键 词：国家基本公共卫生服务 高血压 老年人 社区健康管理 流行病学 

分 类 号：R544.1[医药卫生—心血管疾病]