上海市高行社区60岁以上居民高血压及正常高值血压患病率和危险因素分析  

Prevalence and risk factors of hypertension and prehypertension among elderly residents in Shanghai

作　　者：李娅欣 尤爱军 岳龙飞 赵侃洁 郑亮[1,2] LI Ya-xin;YOU Ai-jun;YUE Long-fei;ZHAO Kan-jie;ZHENG Liang(School of Medicine,Tongji University,Shanghai 200092,China;Shanghai Heart Failure Research Center,School of Medicine,Tongji University,Shanghai 200120,China;Dept.of General Practice,Anshun People's Hospital of Guizhou Province,Anshun 561000,Guizhou Province,China)

机构地区：[1]同济大学医学院,上海200092 [2]同济大学附属东方医院上海市心衰研究所,上海200120 [3]贵州省安顺市人民医院全科医学科,贵州安顺561000

出　　处：《同济大学学报（医学版）》2021年第4期546-553,共8页Journal of Tongji University(Medical Science)

基　　金：上海市浦东新区高峰临床学科建设项目(PWYgf2018-05);同济大学国家自然科学基金培育项目(22120180337)。

摘　　要：目的分析上海市高行社区老年人群中高血压和正常高值血压的患病率及相关的人口统计学和实验室指标,探讨相关的危险因素。方法采用单因素方差分析和χ^(2)检验比较基线数据,多因素Logistic回归分析高血压及正常高值血压危险因素,限制性立方样条函数分析血清总钙与高血压发病风险的关系。结果4422名年龄≥60岁的社区居民参与了研究,其中高血压3460人(78.2%),正常高值血压715人(16.1%)。高血压知晓率、治愈率和控制率分别为78.1%、68.5%和25.9%。多因素Logistic回归结果显示,与非高血压(正常高值血压和正常血压)相比,高血压的危险因素包括除了已经证实的年龄、性别、超重、肥胖和中心型肥胖外,本研究还发现,糖化血红蛋白(OR=1.20,95%CI:1.10~1.32,P<0.01)、血清总钙(OR=8.99,95%CI:3.48~23.27,P<0.01)与高血压呈正相关。血清总钙与高血压风险呈线性剂量-反应关系。然而,与正常血压相比,只有肥胖(OR=1.63,95%CI:1.13~2.36,P=0.01)与正常高值血压有显著相关性。结论上海市高行社区60岁以上老年人群高血压患病率高,知晓率、治疗率和控制率低。血清总钙与高血压风险呈线性剂量-反应关系,血清总钙水平升高可能是高血压的一个重要预测因子。Objective To investigate the prevalence of hypertension and prehypertension and explore its risk factors among elderly population in Shanghai.Methods Total of 4422 community residents aged≥60 years from Shanghai Gaohang community participated in the study,including 3460(78.2%)with hypertension and 715(16.1%)with prehypertension.One-way ANOVA and chi-square test were used to compare baseline data.Logistic regression was employed to analyze the risk factors of hypertension and prehypertension.The Restricted cubic splines functions were used to analyze the relationship between serum calcium(Ca^(2+))and the risk of hypertension.Results The awareness,treatment and control rates of hypertension were 78.1%,68.5%and 25.9%,respectively.Logistic regression showed that compared with non-hypertension group(prehypertension and normotension),the significant risk factors identified for hypertension were age,sex,overweight,obesity,and central obesity.HbA1c(OR=1.20,95%CI:1.10-1.32,P<0.01),Ca^(2+)(OR=8.99,95%CI:3.48-23.27,P<0.01)were positively associated with hypertension.And there was a linear dose-response relationship between Ca^(2+)and the risk of hypertension.But only obesity(OR=1.63,95%CI:1.13-2.36,P=0.01)was significantly associated with prehypertension when compared with normotension.Conclusion Our study showed that residents aged≥60 years in Shanghai have a high prevalence of hypertension and low treatment and control rates.There is a linear dose-response relationship between Ca^(2+)and the risk of hypertension.Increased Ca^(2+)levels may be a significant predictor of hypertension.

关 键 词：高血压 正常高值血压 肥胖 中心性肥胖 血清总钙 

分 类 号：R18[医药卫生—流行病学]