高血压患者体力活动时长、睡眠质量及体重控制对患者报告结局的影响  

The Effects of Physical Activity Duration,Sleep Quality,and Weight Control on Patient-Reported Outcomes in Hypertensive Patients

作　　者：张茹 赵雅静 张雯 唐顺定 王涵 张晓磬 ZHANG Ru;ZHAO Yajing;ZHANG Wen;TANG Shunding;WANG Han;ZHANG Xiaoqing(School of Public Health,Kunming Medical University,Kunming Yunnan 650500;Hypertension Department,Fuwai Yunnan Cardiovascular Disease Hospital,Kunming Yunnan 65003;ICU,Fuwai Yunnan Cardiovascular Disease Hospital,Kunming Yunnan 650032;Tuberculosis Control Institute,Yunnan Centre for Disease Control and Prevention,Kunming Yunnan 650506,China)

机构地区：[1]昆明医科大学公共卫生学院,云南昆明650500 [2]云南省阜外心血管病医院高血压病区,云南昆明650032 [3]云南省阜外心血管病医院ICU,云南昆明650032 [4]云南省疾病预防控制中心结核病防治所,云南昆明650506

出　　处：《昆明医科大学学报》2025年第2期80-87,共8页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项面上项目(202401AY070001-067);云南省科技厅基础研究计划(202101AY070001-221);云南省科技厅基础研究计划(202101AY070001-222);昆明医科大学硕士研究生创新基金(2024S169)。

摘　　要：目的探讨高血压患者体力活动时长、睡眠质量、体重控制与患者报告结局(patient-reported outcomes,PRO)之间的关系,为高血压患者PRO的提高提供有效信息。方法2020年4—6月自云南省4个县中随机抽取625例高血压患者参加现场调查。问卷内容包括患者基本情况、生活方式、健康状况及高血压患者报告结局量表-PROISCD-HY(V1.0)。t检验、方差分析及多元线性回归用于分析体力活动时长、睡眠质量、体重控制与PRO之间的关系,并用Bootstrap法检验中介效应。结果调整潜在协变量后,多元线性回归模型显示体力活动时长≥2 h与PRO显著相关[B=6.551,95%CI(2.611,10.491)],分层后发现关联仅在男性、女性及中青年中存在,在老年人中不存在。睡眠质量好与PRO之间均存在显著相关性[B=1.870,95%CI(0.449,3.291)],关联在各人群中均存在。通过运动+饮食控制的患者PRO得分升高[B=1.904,95%CI(0.383,3.424)],饮食及其他方式控制体重的患者PRO得分降低[B=-4.873,95%CI(-7.860,-1.887);B=-7.105,95%CI(-12.211,-1.999)],各人群关联情况不同。Bootstrap法发现体力活动时长对PRO存在直接和间接影响,睡眠质量在体力活动时长与PRO间起部分中介作用。结论体力活动时长≥2 h,睡眠质量好,控制体重能提高高血压患者的PRO。Objective To investigate the correlation between physical activity duration,sleep quality,weight control,and PRO(patient-reported outcomes)in individuals with hypertension,providing effective information for enhancing patient-reported outcomes in this population.Methods A total of 625 hypertensive patients were randomly selected from four counties in Yunnan Province from April to June 2020 to participate in a field survey.The questionnaire included patients'basic information,lifestyle,health status and the PRO Scale for Hypertension-PROISCD-HY(V1.0).Statistical analyses including t-tests,one-way ANOVA,and multivariate linear regression were conducted to investigate the relationships between physical activity duration,sleep quality,weight control,and PRO,with the Bootstrap method used to examine potential mediating effects.Results After adjusting for potential covariates,the multiple linear regression model indicated a significant association between a physical activity duration of≥2 hours with PRO[B=6.551,95%CI(2.611,10.491)].Stratified analysis showed that this association was only present among males,females,and younger adults,but not in older adults.Additionally,a positive correlation was found between good sleep quality and PRO[B=1.870,95%CI(0.449,3.291)],with this association being consistent across all populations after stratification.Patients who managed their condition through exercise and diet had higher PRO scores[B=1.904,95%CI(0.383,3.424)],while those controlling weight through diet and other methods exhibited a decrease in PRO scores[B=-4.873,95%CI(-7.860,-1.887);B=-7.105,95%CI(-12.211,-1.999)],with variations among different groups.The bootstrap method revealed that physical activity duration had both direct and indirect effects on PRO,with sleep quality acting as a partial mediator between physical activity duration and PRO.Conclusion A Physical activity duration of at least 2 hours,good sleep quality,and weight control have been shown to improve PRO in individuals with hypertension.

关 键 词：高血压 患者报告结局 多元线性回归 BOOTSTRAP 

分 类 号：R544.1[医药卫生—心血管疾病]