中国中老年人抑郁症状与高血压发病风险关联的前瞻性队列研究  

Association of depressive symptoms and incident hypertension in Chinese middle-aged and elderly people:a prospective cohort study

作　　者：徐正兴 肖成汉[1] 姜侠 姚于勤 张本[1] 廖加强[1] XU Zheng-xing;XIAO Cheng-han;JIANG Xia;YAO Yu-qin;ZHANG Ben;LIAO Jia-qiang(West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院,四川成都610041

出　　处：《现代预防医学》2022年第23期4225-4229,4245,共6页Modern Preventive Medicine

基　　金：国家自然科学基金面上项目(81874283,81673255)。

摘　　要：目的探讨中国中老年人抑郁症状对高血压发病的影响。方法基于中国健康与养老追踪调查(CHARLS)2015年和2018年的数据,选取11281例基线没有高血压且有完善抑郁量表评估问卷的中老年人(年龄≥45岁)作为研究对象,进行随访调查。抑郁情况采用流调中心抑郁量表(CES-D)简表进行测量。采用Cox比例风险回归模型探讨抑郁症状及其严重程度与高血压发病风险的关联。结果在平均时长为2.85年的随访中,1045名研究对象发生高血压。多因素Cox回归分析结果显示,抑郁症状评分每增加1分,高血压的发生风险增加2%(HR=1.02,95%CI:1.01~1.03)。与无抑郁症状的研究对象相比,有抑郁症状的研究对象高血压发病风险增加22%(HR=1.22,95%CI:1.07~1.39)。进一步分析抑郁症状严重程度与高血压发病风险的结果显示,与无抑郁症状的研究对象相比,轻度抑郁症状的研究对象高血压发病风险增加17%(HR=1.17,95%CI:1.01~1.34),重度抑郁症状的研究对象高血压发病风险增加53%(HR=1.53,95%CI:1.19~1.97)。结论中国中老年人群中抑郁症状与高血压发病风险增加显著相关,且抑郁症状越严重,高血压发病风险越高。Objective To investigate the association between depressive symptoms and incident hypertension of Chinese middle-aged and elderly people.Methods The study was conducted based on data from the China Health and Retirement Longitudinal Survey(CHARLS)2015 and 2018.A total of 11281 middle-aged and older adults(age≥45 years)without hypertension at baseline and with a completed depression scale assessment questionnaire were selected for the follow-up study.Depression was measured using the Center for Epidemiologic Studies Depression Scale(CES-D)short form.Cox proportional hazard regression models were used to explore the association of depressive symptoms and their severity with the risk of the onset of hypertension.Results During a mean follow-up of 2.85 years,a total of 1045 study participants developed incident hypertension.The results of multivariate Cox regression showed that an average increase of 1 point in depressive symptom score was associated with a 2%increase in the risk of hypertension(HR=1.02,95%CI:1.01-1.03).The risk of developing hypertension was increased by 22%(HR=1.22,95%CI:1.07-1.39)in participants with depressive symptoms compared to those without depressive symptoms.Further analysis of the severity of depressive symptoms and the risk of incident hypertension,the results showed a 17%increased risk of developing hypertension with mild depressive symptoms(HR=1.17,95%CI:1.01-1.34)and a 53%increased risk of incident hypertension with major depressive symptoms(HR=1.53,95%CI:1.19-1.97)compared with no depressive symptoms.Conclusion Depressive symptoms are associated with an increased risk of hypertension in the Chinese middle-aged and elderly population,and the more severe the depressive symptoms,the higher the risk of developing hypertension.

关 键 词：中老年人 抑郁症状 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]