辽宁省≥40岁居民高血压、糖尿病和血脂异常共病流行现况及其与心血管病死亡风险的关联  

Prevalence of comorbidity of hypertension,diabetes and dyslipidemia and the association between comorbidity and cardiovascular mortality in population aged 40 years and over in Liaoning Province

作　　者：井丽 田园梦 阎涵[1] 孙群[2] 李树宝 崔士民 孙继绪 石雷 马尉瑶[5] 李光校[6] 刘爽[7] 邢立莹[1] Jing Li;Tian Yuanmeng;Yan Han;Sun Qun;Li Shubao;Cui Shimin;Sun Jixu;Shi Lei;Ma Yuyao;Li Guangxiao;Liu Shuang;Xing Liying(Liaoning Provincial Center for Disease Control and Prevention,Shenyang 110172,China;Liaoning Chaoyang Center for Disease Control and Prevention,Chaoyang 122099,China;Liaoning Dandong Center for Disease Control and Prevention,Dandong 118002,China;Liaoning Liaoyang Health Commission,Liaoyang 111018,China;Liaoning Liaoyang Center for Disease Control and Prevention,Liaoyang 111018,China;Department of Medical Record Management Center,the First Hospital of China Medical University,Shenyang 110001,China;Department of Ultrasound,the Fourth Affiliated Hospital of China Medical University,Shenyang 110032,China)

机构地区：[1]辽宁省疾病预防控制中心,沈阳110172 [2]朝阳市疾病预防控制中心,朝阳122099 [3]丹东市疾病预防控制中心,丹东118002 [4]辽阳市卫生健康委员会,辽阳111018 [5]辽阳市疾病预防控制中心,辽阳111018 [6]中国医科大学附属第一医院病案管理中心,沈阳110001 [7]中国医科大学附属第四医院超声科,沈阳110032

出　　处：《中华心血管病杂志》2024年第11期1311-1316,共6页Chinese Journal of Cardiology

基　　金：2019年辽宁省重点研发计划项目(2019JH2/10300001)。

摘　　要：目的了解辽宁省≥40岁居民高血压、糖尿病和血脂异常共病(三高)的现况,探讨三高与心血管病死亡风险的关联。方法本次调查为前瞻性队列研究,于2017年2月—2019年3月,采用多阶段分层整群随机抽样的方法对辽宁省≥40岁常住居民开展基线调查,收集人口学信息及高血压、糖尿病和血脂异常病史等,并每年进行随访,死亡信息主要通过人口死亡信息登记管理系统获取。采用Cox比例风险回归模型分析三高与心血管病死亡风险之间的关联。结果共纳入辽宁省≥40岁城乡居民18758人,年龄(60.3±9.9)岁,男性7325人(39.1%)。三高患病率为6.7%(1256/18758),标化患病率为5.4%,随着年龄的增长呈上升趋势,女性高于男性,城市高于农村(P均<0.001)。三高者在糖尿病患者、血脂异常患者和高血压患者中分别占39.3%(1256/3198)、18.7%(1256/6710)和11.8%(1256/10653)。随访(4.3±0.6)年,共463例心血管病死亡,三高患者心血管病死亡率为8.74/1000人年。经多因素调整后,Cox比例风险回归模型分析结果显示,与正常者相比,三高患者心血管病死亡的HR=2.55(95%CI:1.63~3.99)。结论辽宁省≥40岁居民三高患病率较高,且三高患者心血管病死亡风险增加。Objective To investigate the comorbidity status of hypertension,diabetes,and dyslipidemia(the"three diseases")among residents aged≥40 in Liaoning Province,and to explore the correlation between the comorbidity and cardiovascular disease mortality.Methods This investigation was a prospective cohort study.From February 2017 to March 2019,a multi-stage stratified cluster random sampling method was used to carry out a baseline survey of 18758 permanent residents aged≥40 years in Liaoning Province.Demographic information and history of hypertension,diabetes,and dyslipidemia were collected and followed up every year.Death was mainly identified by linkage to the Population Death Information Registration Management System.Cox proportional hazard regression model was used to analyze the association between the comorbidity of the"three diseases"and cardiovascular disease mortality risk.Results A total of 18758 residents aged≥40 in Liaoning Province were included,with an age of(60.3±9.9)years and 7325 males(39.1%).The comorbidity rate of hypertension,diabetes,and dyslipidemia was 6.7%(1256/18758),and the standardized prevalence rate was 5.4%.The comorbidity rate increased with age(P<0.001),which was higher in women than in men,and more significant in urban areas than in rural areas(all P<0.001).The comorbidity of"three diseases"accounted for 39.3%(1256/3198),18.7%(1256/6710),and 11.8%(1256/10653)in patients with diabetes,dyslipidemia,and hypertension,respectively.With a follow-up of(4.3±0.6)years,463 people died of cardiovascular disease.The mortality rate of cardiovascular disease in the comorbidity of hypertension,diabetes,and dyslipidemia was 8.74/1000 person-years.After adjusting potential confounders,Cox proportional hazard regression model analysis showed that compared with normal individuals,the hazard ratio of cardiovascular disease mortality in patients with the"three diseases"was 2.55(95%CI:1.63-3.99).Conclusion The prevalence of comorbidity of hypertension,diabetes,and dyslipidemia among residents aged≥

关 键 词：高血压 糖尿病 血脂异常 死亡风险 前瞻性研究 

分 类 号：R544.1[医药卫生—心血管疾病] R587.2[医药卫生—内科学] R589.2[医药卫生—临床医学]