基于健康促进理论高血压患者影响因素效应分析  

Influencing factors of hypertension among adult residents in Shandong province: a survey based on health promotion theory

作　　者：董惠玲[1] 吴炳义[1] 郭晓宇 于奇 李娟丽 DONG Hui-ling;WU Bing-yi;GUO Xiao-yu(School of Public Health and Management,Weifang Medical University,Weifang,Shandong Province 261053,China;不详)

机构地区：[1]潍坊医学院公共卫生与管理学院,山东潍坊261053 [2]潍坊市荣复军人医院

出　　处：《中国公共卫生》2021年第9期1365-1370,共6页Chinese Journal of Public Health

基　　金：山东省医药卫生科技发展计划项目(2017WS851);山东省社会科学规划项目(18CRKJ01);潍坊市软科学研究计划项目(2017RKX135)。

摘　　要：目的量化影响高血压的社会人口经济学因素、行为危险因素及卫生保健行为因素之间的关系及其对高血压的影响效应,为科学开展高血压防控相关工作提供参考依据。方法以2016年3月在山东省采取分阶段分层整群抽样方法在19个监测点抽取的3800名≥18岁常住居民作为研究对象,通过问卷调查收集数据,应用AMOS 17.0软件进行结构方程模型分析。结果城乡、性别、年龄、文化程度、婚姻状况和家庭年收入与高血压患病率差异有统计学意义(P<0.05);其中,农村人口患高血压所占比例(28.2%)明显高于城镇(4.2%);男性(29.6%)稍高于女性(26.3%);55~69岁年龄段人口患高血压所占比例最高(51.5%);小学及以下人口患高血压所占比例最高(38.8%)。是否吸烟、饮食咸淡、休闲活动锻炼、体检情况、体质指数BMI、腰臀比WHR在高血压患病率上的差异有统计学意义(P<0.05)。其中,吸烟者患高血压的比例(27.8%)高于非吸烟者(25.1%);饮食偏咸者患高血压比例最高(31.5%);无按时体检人群所占比例(30.6%)高于体检人群(24%);体质指数≥24的人群患高血压比例最高(36.9%)。潜变量年龄和不良生活行为对潜变量高血压病兼具直接效应和间接效应,其总效应值分别为0.198和0.017;体型是各个变量影响高血压的中间变量,可对高血压病产生直接效应,效应值为0.107;潜变量社会经济学特征和良好生活行为可通过体型对潜变量高血压病产生间接效应;年龄和文化程度之间存在着交互作用(-0.15),身高和体重之间存在着交互效应(0.30)。结论体型是高血压患病人群的重要表征,其他变量多通过它对高血压病产生影响;不良生活行为是高血压患病的重要风险因子;高血压的防控策略和措施必须重视体型和不良生活行为因素的影响,以健康促进的相关理论为指导,促使居民改变不健康习惯、形成健康的生活行为,提高健康素养。Objective To quantitatively assess interactive influences of socio-economic, behavioral risk, and health care behavioral factors on hypertension among adults and to provide evidences for prevention and control of hypertension.Methods We conducted a face-to-face questionnaire survey and physical examination among 4 000 permanent urban and rural adult residents( ≥ 18 years old) recruited at 19 disease surveillance settings in Shandong province with stratified random cluster sampling in March 2016. AMOS 17.0 software was adopted in data analyses using structural equation model.Results Among the 3 800 participants with valid responses, the hypertension prevalence rate differed significantly by permanent residence(urban or rural region), sex, age, education, marital status and annual family income(all P < 0.05).Compared to that among the urban and female participants, the hypertension prevalence rate was significantly higher among the urban(28.2% vs. 4.2%) and the male(29.6% vs. 26.3%) participants(both P < 0.05). For the groups of participants at various ages and with different education, the highest prevalence rate of hypertension was observed among the group aged55 - 66 years(51.5%) and the group with the education of primary school or lower(38.8%). The hypertension prevalence rate also differed significantly by smoking, preference for salty diet, leisure exercise, physical examination, body mass index(BMI), and waist-hip ratio(WHR)(all P < 0.05). In comparison with that among the nonsmokers and those not having salty diet, having periodic physical examination, the hypertension prevalence rate was higher among smokers(27.8% vs. 25.1%)and those having salty diet(31.5%), not having periodic physical examination(30.6% vs. 24.0%). Age and unhealthy living behavior as the two exogenous latent variables showed both direct and indirect effect on the latent variable hypertension, with the total effect values of 0.198 and 0.017. As an intermediate variable affecting other impact factors, somatotype had direct effect on hy

关 键 词：高血压 影响因素 健康促进 结构方程模型 

分 类 号：R544.1[医药卫生—心血管疾病]