生命历程视角下老年人口高血压患病的年龄-时期-队列效应分析
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摘要
在生命历程理论框架下,探讨我国老年人群高血压患病的年龄、时期和队列效应,对于慢性非传染疾病发生、发展规律,制定现代社会条件下全人群、全生命周期的防控策略具有重要意义。数据来源为中国老年健康影响因素跟踪调查(CLHLS)1998年、2000年、2002年、2005年、2008年、2011年和2014年,共7期调查。在描述性分析基础上,运用分层随机效应模型,探讨我国老年人群高血压患病的年龄、时期和队列效应。结果表明,个体层面上的性别、城乡、教育程度和生活来源均显著影响老年人群的高血压患病率;年龄效应上,老年人群高血压患病风险随年龄增加而增大;1998-2002、2002-2005和2008-2014三个历史时期,高血压患病率随年代总体呈上升趋势;与备受关注的时期效应相比,我国老年人群高血压患病率的队列效应不显著。可见,我国老年人群高血压患病风险的时期效应占主导地位,生活环境、行为生活方式、饮食习惯和心理状况等因素,可能是形成时期效应的重要因子。
Under the framework of life course theory,this paper discusses the age,period and cohort effect of hypertension in the elderly population in China,summarizes the occurrence and development of chronic non-communicable diseases,and formulates the whole population under the conditions of modern society.The prevention and control strategy of the whole life cycle is significant.The data were collected from 1998,2000,2002,2005,2008,2011 and 2014.On the basis of descriptive analysis,stratified random effect model was used to study the age,period and cohort effect of hypertension in the elderly population.The results showed that sex,urbanand rural areas,education level and source of living significantly affected the prevalence of hypertension in the elderly. Age effect,the risk of hypertension in the elderly increased with the growth; The prevalence rate of hypertension in the three historical periods from 1998-2002 to2002-2005 and 2008-2014 showed an overall upward trend( P < 0. 05). Compared with the period effect,the cohort effect of hypertension prevalence in the elderly population was not significant( p = 0. 0549). It can be seen that the period effect of hypertension risk is dominant in the elderly population in China. The changes of factors such as living environment,behavior lifestyle,diet habits and psychological status may be the important factors to form the period effect.
Under the framework of life course theory,this paper discusses the age,period and cohort effect of hypertension in the elderly population in China,summarizes the occurrence and development of chronic non-communicable diseases,and formulates the whole population under the conditions of modern society.The prevention and control strategy of the whole life cycle is significant.The data were collected from 1998,2000,2002,2005,2008,2011 and 2014.On the basis of descriptive analysis,stratified random effect model was used to study the age,period and cohort effect of hypertension in the elderly population.The results showed that sex,urbanand rural areas,education level and source of living significantly affected the prevalence of hypertension in the elderly. Age effect,the risk of hypertension in the elderly increased with the growth; The prevalence rate of hypertension in the three historical periods from 1998-2002 to2002-2005 and 2008-2014 showed an overall upward trend( P < 0. 05). Compared with the period effect,the cohort effect of hypertension prevalence in the elderly population was not significant( p = 0. 0549). It can be seen that the period effect of hypertension risk is dominant in the elderly population in China. The changes of factors such as living environment,behavior lifestyle,diet habits and psychological status may be the important factors to form the period effect.
引文
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[26]Kuwabara M,Hisatome I,Niwa K,et al. Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension:A 5-Year Japanese Cohort Study.[J]. Hypertension,2018,71(1):78.
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[2]王媛.天津市市区成人高血压患病率及其影响因素的结构方程模型分析[D].天津:天津医科大学,2011.
[3]李晓露.山东省农村居民慢病现状及行为危险因素研究[D].山东:山东大学,2015.
[4]Ben-Shlomo Y,Mishra G,Kuh D. Life Course Epidemiology[M]. Springer New York,2014.
[5]杨慧霞.健康与疾病的发育起源[M].北京:人民卫生出版社,2013.
[6]张宁.原发性高血压的流行病学与防治现状[J].中国健康教育,2010,26(4):310-311.
[7]Wu Y,Huxley R,Li L. et al. Prevalence,awareness,treatment and control of hypertension in China:data from the China National Nutrition and Heath Survey 2002[J]. Circulation,2008. 118(25):79-86.
[8]沈鹏宇.重庆市青年人群高血压患病率及影响因素研究[D].重庆医科大学,2017.
[9]张晨,葛杰,邱永强.齐齐哈尔市社区高血压患病现状及相关行为危险因素分析[J].卫生研究,2015,44(4):595-599.
[10]刘春霞,祖香雨,许靓等.秦皇岛市海港区18岁以上流动人群高血压病流行病学调查[J].中国健康教育,2015,31(6):564-566.
[11]闫志民.社会排斥的年龄差异及其影响因素[D].西南大学,2015.
[12]石琼光.婚姻关系中两性地位的变异及发展趋势——从恩格斯《家庭、私有制和国家的起源》中得到的启示[J].池州学院学报,2012,26(2):42-44.
[13]Martins N P F,Tavares D M D S,Martins N P F,et al. Health behaviors and anthropometric variables among older adults with and without hypertension[J]. Texto EContex to Enfermagem,2015,24(1):47-54.
[14]Demarco VG,Aroor AR,Sowers JR. The pathophysiology of hypertension in patients with obesity.[J]. Nature Reviews Endocrinology,2014,10(6):364-376.
[15]李红霞,李永进,吕金昌,等.北京市某区成人高血压及影响因素分析[J].中国公共卫生管理,2016,5(5):649-651.
[16]郭艺芳.我国高血压防控现状的最新数据与启示[J].中华高血压杂志,2016,6(6):504-504.
[17]Cascella N G,Kryszak D,Bhatti B,et al. Prevalence of celiac disease and gluten sensitivity in the United States clinical antipsychotic trials of intervention effectiveness study population.[J]. Schizophr Bull,2011,37(1):94-100.
[18]李婷.哪一代人更幸福?——年龄、时期和队列分析视角下中国居民主观幸福感的变迁[J].人口与经济,2018,1(1):90-102.
[19]张健,张兰.原发性高血压遗传度的研究[J].中华高血压杂志,1995,6(2):161-163.
[20]Callens M. Long Term Trends in Life Satisfaction,1973-2012:Flanders in Europe[J]. Social Indicators Research,2017,130(1):1-21.
[21]Nef T,Ganea R L,Müri R M,et al. Social networking sites and older users-a systematic review.[J]. International Psychogeriatrics,2013,25(7):1041-1053.
[22]Davidian M. Hierarchical Linear Models:Applications and Data Analysis Methods[J]. Publications of the American Statistical Association,2003,98(463):2-8.
[23]Venhorst V,Dijk J V,Wissen L V. An Analysis of Trends in Spatial Mobility of Dutch Graduates[J]. Spatial Economic Analysis,2011,6(1):57-82.
[24]刘晓迪.中国中老年人群高血压患病影响因素分析[J],中国公共卫生,2018,1(11):1-3.
[25]梁伟.甘肃省中老年人群高血压流行病学调查及治疗现状研究[D].兰州大学,2016.
[26]Kuwabara M,Hisatome I,Niwa K,et al. Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension:A 5-Year Japanese Cohort Study.[J]. Hypertension,2018,71(1):78.
[27]鲁晓迪,周郁秋,王月枫,等.高血压急症相关危险因素[J].中华高血压杂志,2018,1(1):25-28.
[28]任洁,赵冬.重视生活方式和心理因素对心血管疾病的影响[J].中华心血管病杂志,2010,38(8):691-692.