35~64岁自报非高血压人群首次血压测量与非同日3次血压测量结果的差异及其影响因素分析  

Differences between the First and Another 3-day Blood Pressure Levels and Associated Factors in a Self-reported Non-hypertensive Population Aged 35-64 Years

作　　者：左旭 黄招兰[2] 陆彪 ZUO Xu;HUANG Zhaolan;LU Biao(Department of General Medicine,Tianyou Hospital Affiliated to Wuhan University of Science and Technology,Wuhan 430064,China;Department of General Medicine,Wuhan University of Science and Technology Hospital,Wuhan 430065,China;Department of Cardiothoracic Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉科技大学附属天佑医院全科医学科,湖北省武汉市430064 [2]武汉科技大学医院全科医学科,湖北省武汉市430065 [3]武汉大学人民医院心胸外科,湖北省武汉市430060

出　　处：《中国全科医学》2023年第22期2771-2777,共7页Chinese General Practice

摘　　要：背景 目前已有相关研究者针对自报非高血压人群的首次血压测量结果与非同日3次血压测量结果进行对比分析,但以新型冠状病毒疫苗接种为背景开展的相关研究较少。目的 了解新型冠状病毒感染疫情常态化防控期间35~64岁的新型冠状病毒疫苗接种者的血压水平,分析经首次血压测量发现的疑似高血压患者的首次血压测量结果与非同日3次血压测量结果间的差异性,并探讨疑似高血压患者血压分级波动的影响因素,旨在为新型冠状病毒疫苗接种前血压测量工作的开展提供借鉴和指导。方法 采用随机抽样法,选取2021年9月至湖北省武汉市洪山区青菱街社区卫生服务中心接种新型冠状病毒疫苗者中35~64岁、自报无高血压病史的居民共2 814例作为高血压筛查对象,并对其血压进行测量,测量结果记为首测血压值。根据居民的首测血压值筛选出疑似高血压[收缩压≥140 mmHg和/或舒张压≥90 mmHg(1 mmHg=0.133 kPa)]人群,在疑似高血压患者未使用降压药物的情况下,非同日对其诊室血压进行3次规范化测量,基于非同日3次血压测量结果计算血压处于理想水平(收缩压<120 mmHg和舒张压<80mmHg)、正常高值水平(收缩压120~139 mmHg和/或舒张压80~89 mmHg)者,以及高血压(收缩压≥140 mmHg和/或舒张压≥90 mmHg)患者的占比。比较不同性别、年龄段、首测血压分级的疑似高血压患者的高血压确诊率,采用单因素及多因素有序多分类Logistic回归分析疑似高血压患者血压分级波动(基于非同日3次血压测量结果得出的血压分级较基于首次血压测量结果得出的血压分级的变化情况)的影响因素。结果 2 814例高血压筛查对象中,疑似高血压患者占36.67%(1 032/2 814)。经非同日3次血压测量后,1 032例疑似高血压患者中,8.82%(91/1 032)血压处于理想水平,14.34%(148/1 032)血压处于正常高值水平,76.84%(793/1 032)为高血压患者[其Background Previous studies have compared the first and another 3-day blood pressure levels in populations with no history of self-reported hypertension,but there have been few studies conducted in COVID-19 vaccine recipients.Objective To understand the blood pressure levels among 35-64-year-old COVID-19 vaccine recipients during regular COVID-19 containment,and to assess the differences between the first and another 3-day blood pressure levels and the factors affecting the fluctuation of blood pressure levels in the recipients with suspected hypertension,providing a reference and guidance for blood pressure measurement before COVID-19 vaccination.Methods In September 2021,2814 residents aged 35-64 with no history of self-reported hypertension were randomly selected for screening for hypertension before receiving COVID-19 vaccination at Qingling Community Health Service Center,Hongshan District,Wuhan City,Hubei Province.Blood pressure was measured and recorded as the first blood pressure measurement value,then based on this,those who were found with suspected hypertension〔systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg(1 mmHg=0.133 kPa)〕standardizedly measured their clinic blood pressure for another three times on different days without the use of any antihypertensive drugs.Based on the 3-day blood pressure measurement results,the proportions of those with blood pressure in the ideal range(systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg),in the high normal range(systolic blood pressure:120-139 mmHg and/or diastolic blood pressure:80-89 mmHg),and in the hypertensive range(systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg)were calculated,and the rate of hypertension diagnosis was compared between them by sex,age group,and the first blood pressure measurement level.The factors affecting the fluctuation of blood pressure levels(changes in blood pressure analyzed based on comparing the first blood pressure level and the 3-day blood press

关 键 词：高血压 筛查 诊室血压 COVID-19疫苗 接种 社区卫生服务 

分 类 号：R197.1[医药卫生—卫生事业管理] R563.12[医药卫生—公共卫生与预防医学]