湖州市血压控制未达标高血压患者慢性病共病及影响因素分析  

Prevalence and influencing factors of comorbidity of chronic diseases among hypertensive patients with uncontrolled blood pressure in Huzhou City

作　　者：沈益妹[1] 章奇 朱新凤[1] 丁晶莹[1] 俞梅华[1] SHEN Yimei;ZHANG Qi;ZHU Xinfeng;DING Jingying;YU Meihua(Department of Chronic Disease Control and Prevention,Huzhou Center for Disease Control and Prevention,Huzhou,Zhejiang 313000,China)

机构地区：[1]湖州市疾病预防控制中心慢性病防制科,浙江湖州313000

出　　处：《预防医学》2023年第6期541-545,550,共6页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：2021年湖州市科技局公益性应用研究医卫一般项目(2021GYB67)。

摘　　要：目的了解浙江省湖州市社区血压控制未达标高血压患者慢性病共病情况,并分析影响因素,为社区高血压防治提供依据。方法采用整群随机抽样方法,抽取湖州市5个县(区)35~74岁血压控制未达标的高血压患者为调查对象;采用问卷收集基本信息、生活行为和慢性病患病情况;测量身高、体重、腰围和血压,检测血糖、血脂等生化指标;描述性分析慢性病共病数量及组合方式,并采用多因素有序logistic回归模型分析共病的影响因素。结果调查1215例,年龄为(60.83±7.76)岁;其中男性652例,占53.66%;女性563例,占46.34%。血脂异常、糖尿病、高尿酸血症和心脑血管疾病患病率分别为45.10%、30.95%、23.05%和5.10%。慢性病共病发生率为69.22%,其中共病1种497例,占40.91%;共病2种272例,占22.39%;共病≥3种72例,占5.93%;共病组合以高血压+血脂异常(20.74%),高血压+糖尿病+血脂异常(9.96%),高血压+糖尿病+血脂异常+高尿酸血症(4.36%)为主。多因素有序logistic回归结果显示:超重(OR=1.782,95%CI:1.390~2.286)、肥胖(OR=2.411,95%CI:1.802~3.222)、高血压2级(OR=1.438,95%CI:1.077~1.919)患者共病数量多的风险分别高于体质指数正常、血压控制患者;女性(OR=0.563,95%CI:0.456~0.696)共病数量多的风险低于男性。结论湖州市社区血压控制未达标高血压患者共病发生率为69.22%,共存慢性病主要为血脂异常和糖尿病;男性、超重、肥胖、高血压2级患者存在较高的共病风险。Objective To investigate the prevalence and influencing factors of comorbidity of chronic diseases among hypertensive patients with uncontrolled blood pressure in Huzhou City,so as to provide insights into community hypertension control.Methods Hypertensive patients with uncontrolled blood pressure at ages of 35 to 74 years were sampled using a cluster random sampling method from 5 districts(counties)of Huzhou City.Participants'demographics,living behaviors,and development of chronic diseases were collected using questionnaires,and the height,body weight,waist circumference and blood pressure were measured.Blood glucose,blood lipid and other biochemical parameters were detected,and the number and combination of comorbidity of chronic diseases were descriptively analyzed.Factors affecting the comorbidity of chronic diseases were identified using a multivariable ordinal logistic regression model.Results A total of 1215 respondents were included,with a mean age of(60.83±7.76)years,and including 652 men(53.66%)and 563 women(46.34%).The prevalence of dyslipidemia,diabetes,hyperuricemia and cardiac encephalopathy was 45.10%,30.95%,23.05%and 5.10%,respectively.The prevalence of comorbidity of chronic diseases was 69.22% among respondents,and there were 497 respondents with one comorbidity(40.91%),272 with two comorbidities(22.39%)and 72 with three and more comorbidities(5.93%).Hypertension+dyslipidemia(20.74%),hypertension+diabetes+dyslipidemia(9.96%)and hypertension+diabetes+dyslipidemia+hyperuricemia(4.36%)were predominant comorbid combinations.Multivariable ordinal logistic regression analysis showed that participants with overweight(OR=1.782,95%CI:1.390-2.286),obesity(OR=2.411,95%CI:1.802-3.222),grade 2 hypertension(OR=1.438,95%CI:1.077-1.919)had a higher risk of multiple comorbidities than those with normal body mass index and controlled blood pressure,and women(OR=0.563,95%CI:0.456-0.696)had a lower risk of multiple comorbidities than men.Conclusions The prevalence of comorbidity of chronic diseases was 69.22% am

关 键 词：高血压 血压控制 慢性病共病 社区 

分 类 号：R544.1[医药卫生—心血管疾病]