社区老年人正常高值血压与高血压的区分因素
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摘要
目的分析社区老年人正常高值血压与高血压的区分因素及各因素间的相互作用。方法抽取安徽省六安市城乡社区60岁及以上居民1 080人,将其中高血压和正常高值血压共967人纳入分析。采用logistic逐步回归筛选区分正常高值血压与高血压2组老年人的相关因素,并对筛选出的因素进行一阶交互作用分析。结果相比正常高值血压,患高血压老年人下列因素分布比例更高:高年龄组(80～94岁组与60～70岁组)、男性、有高血压家族史、慢性病共病数量(≥2组与0组)、肥胖、LDL-C高、TG高和尿蛋白异常。有统计学意义的交互作用项如下:性别(男/女)×年龄(低、中、高),性别(男/女)×高血压家族史(有/无)和BMI(正常、超重、肥胖)×高血压家族史(有/无)。结论高龄、男性、高血压家族史、慢性病、肥胖及其相关因素与高血压存在关联。高龄只在男性中与高血压有关联;高血压家族史与高血压的关联强度在男性中高于女性;肥胖只在有高血压家族史老年人中与高血压有关联。
Objective To explore the factors between high normal blood pressure and hypertension in elderly community, and to examine the interaction of influencing factors. Methods From July to September in 2016, a total of 1 080 residents aged60 years or over from communities in an urban and a rural area of Lu'an City of Anhui Province were invited to participate in the survey. A sub-sample including 967 participants with hypertension or prehypertension was used in this study. Stepwise Logistic regression was used to select the correlative factors distinguishing prehypertension from hypertension, and the first order interaction analysis was conducted for the selected factors. Results Stepwise logistic regression analyses showed that the proportions of the following factors were higher in the elderly with hypertension than with the prehypertension: high age group(80-94 group vs 60-70), males, family history of hypertension, comorbid chronic diseases( ≥2 vs 0), obesity, high level of low-density lipoprotein cholesterol, high level of triglyceride and proteinuria. Three interaction terms were statistically significant: gender(males/females) × age(low, medium and high), gender(males/females) × family history of hypertension(with/without) and BMI(normal, overweight, obesity) × family history of hypertension(with/without). Conclusion Advanced age, gender, a family history of hypertension, obesity and its related factors are significantly associated with hypertension among community-dwelling elderly. The significant association between advanced age and hypertension was found only in male. The association of a family history of hypertension and hypertension was stronger in males than females. The relationship of obesity and hypertension were significant in the elderly with family history of hypertension rather than those without.
Objective To explore the factors between high normal blood pressure and hypertension in elderly community, and to examine the interaction of influencing factors. Methods From July to September in 2016, a total of 1 080 residents aged60 years or over from communities in an urban and a rural area of Lu'an City of Anhui Province were invited to participate in the survey. A sub-sample including 967 participants with hypertension or prehypertension was used in this study. Stepwise Logistic regression was used to select the correlative factors distinguishing prehypertension from hypertension, and the first order interaction analysis was conducted for the selected factors. Results Stepwise logistic regression analyses showed that the proportions of the following factors were higher in the elderly with hypertension than with the prehypertension: high age group(80-94 group vs 60-70), males, family history of hypertension, comorbid chronic diseases( ≥2 vs 0), obesity, high level of low-density lipoprotein cholesterol, high level of triglyceride and proteinuria. Three interaction terms were statistically significant: gender(males/females) × age(low, medium and high), gender(males/females) × family history of hypertension(with/without) and BMI(normal, overweight, obesity) × family history of hypertension(with/without). Conclusion Advanced age, gender, a family history of hypertension, obesity and its related factors are significantly associated with hypertension among community-dwelling elderly. The significant association between advanced age and hypertension was found only in male. The association of a family history of hypertension and hypertension was stronger in males than females. The relationship of obesity and hypertension were significant in the elderly with family history of hypertension rather than those without.
引文
[1] Lu JP, Lu Y, Wang XC, et al. Prevalence, awareness, treatment, andcontrol of hypertension in China:data from 1.7 million adults in apopulation-based screening study(China PEACE Million PersonsProject)[J]. Lancet, 2017, 390(1112):2549-2558.
[2] Chobanian AV, Bakris GL, Black HR, et al. Seventh report of thejoint National committee on prevention, detection, evaluation, andtreatment of high blood pressure[J]. Hypertension, 2003, 42(6):1206-1252.
[3] Ferguson TS, Younger N, Tulloch-Reid MK, et al. Progression fromprehypertension to hypertension in a Jamaican cohort:incident hy-pertension and its predictors[J]. West Indian Medical Journal, 2010,59(5):486-493.
[4]黄晶晶,孙跃民,高玉霞,等.天津市正常高值血压人群高血压发病危险因素的定量评价[J].中华高血压杂志,2016,24(2):163-169.
[5]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中国医学前沿杂志(电子版),2011,3(5):42-93.
[6] Pitsavos C, Chrysohoou C, Panagiotakos DB, et al. Abdominal obesityand inflammation predicts hypertension among prehypertensive menand women:the ATTICA Study[J]. Heart and Vessels, 2008, 23(2):96-103.
[7] Selassie A, Wagner CS, Laken ML, et al. Progression is acceleratedfrom prehypertension to hypertension in blacks[J]. Hypertension,2011, 58(4):579-587.
[8] Zheng L, Sun Z, Zhang X, et al. Predictors of progression fromprehypertension to hypertension among rural Chinese adults:resultsfrom Liaoning Province[J]. European Journal of Cardiovascular Pre-vention and Rehabilitation:Official Journal of the European Societyof Cardiology, Working Groups on Epidemiology&Prevention andCardiac Rehabilitation and Exercise Physiology, 2010, 17(2):217-222.
[9]黄喆,吴寿岭,高竞生,等.正常高值血压人群血压进展及影响因素[J].中华高血压杂志,2011,(7):630-635.
[10] Kuwabara M, Hisatome I, Niwa K, et al. Uric acid is a strong riskmarker for developing hypertension from prehypertension:a 5-YearJapanese cohort study[J]. Hypertension, 2018, 71(1):78-86.
[11]尚红,王毓三,申子瑜.全国临床检验操作规程[M].4版.北京:人民卫生出版社,2015.
[12]马晨,吴炳义,董惠玲,等.山东省成人高血压患病现状及危险因素分析[J].现代预防医学,2017,44(21):3927-3930.
[13]孙晓华.尿蛋白在高血压患者中的临床检验效果观察[J].中国医药指南,2017,15(21):165-166.
[2] Chobanian AV, Bakris GL, Black HR, et al. Seventh report of thejoint National committee on prevention, detection, evaluation, andtreatment of high blood pressure[J]. Hypertension, 2003, 42(6):1206-1252.
[3] Ferguson TS, Younger N, Tulloch-Reid MK, et al. Progression fromprehypertension to hypertension in a Jamaican cohort:incident hy-pertension and its predictors[J]. West Indian Medical Journal, 2010,59(5):486-493.
[4]黄晶晶,孙跃民,高玉霞,等.天津市正常高值血压人群高血压发病危险因素的定量评价[J].中华高血压杂志,2016,24(2):163-169.
[5]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中国医学前沿杂志(电子版),2011,3(5):42-93.
[6] Pitsavos C, Chrysohoou C, Panagiotakos DB, et al. Abdominal obesityand inflammation predicts hypertension among prehypertensive menand women:the ATTICA Study[J]. Heart and Vessels, 2008, 23(2):96-103.
[7] Selassie A, Wagner CS, Laken ML, et al. Progression is acceleratedfrom prehypertension to hypertension in blacks[J]. Hypertension,2011, 58(4):579-587.
[8] Zheng L, Sun Z, Zhang X, et al. Predictors of progression fromprehypertension to hypertension among rural Chinese adults:resultsfrom Liaoning Province[J]. European Journal of Cardiovascular Pre-vention and Rehabilitation:Official Journal of the European Societyof Cardiology, Working Groups on Epidemiology&Prevention andCardiac Rehabilitation and Exercise Physiology, 2010, 17(2):217-222.
[9]黄喆,吴寿岭,高竞生,等.正常高值血压人群血压进展及影响因素[J].中华高血压杂志,2011,(7):630-635.
[10] Kuwabara M, Hisatome I, Niwa K, et al. Uric acid is a strong riskmarker for developing hypertension from prehypertension:a 5-YearJapanese cohort study[J]. Hypertension, 2018, 71(1):78-86.
[11]尚红,王毓三,申子瑜.全国临床检验操作规程[M].4版.北京:人民卫生出版社,2015.
[12]马晨,吴炳义,董惠玲,等.山东省成人高血压患病现状及危险因素分析[J].现代预防医学,2017,44(21):3927-3930.
[13]孙晓华.尿蛋白在高血压患者中的临床检验效果观察[J].中国医药指南,2017,15(21):165-166.