昆明市城乡老年人高血压患病现状及其影响因素对比分析
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摘要
目的对比云南省昆明市城市和农村地区老年人高血压患病现状及其影响因素,为有针对性地制定城乡两地老年人高血压的防控措施提供参考依据。方法于2016年7月—2017年10月采用多阶段分层随机抽样方法在昆明市官渡区和宜良县抽取3 225名≥60岁城乡老年人进行问卷调查和体格检查。结果昆明市3 225名≥60岁城乡老年人中,城市老年人1 624人,农村老年人1 601人;城市和农村老年人高血压患病率分别为40.9%和43.5%,标化患病率分别为41.3%和43.2%,昆明市城乡老年人高血压患病率差异无统计学意义(P> 0.05);多因素非条件logistic回归分析结果显示,饮酒和超重/肥胖是昆明市城市老年人高血压患病的危险因素;年龄≥75岁、缺乏体力活动、超重/肥胖和中心性肥胖是昆明市农村老年人高血压患病的危险因素,吸烟是昆明市农村老年人高血压患病的保护因素。结论昆明市城市和农村老年人高血压患病率差异不大,但影响因素存在着明显的城乡差异,应根据城乡老年人高血压的不同影响因素,制定有针对性的高血压预防控制措施。
Objective To compare the prevalence and influencing factors of hypertension among the elderly in urban and rural areas of Kunming municipality, Yunnan province and to provide references for developing hypertension prevention and control measures for the two groups of population. Methods We selected 3 225 residents at ages of 60 years and above in 6 communities of an urban district and 6 rural villages in a county of Kunming municipality of Yunnan province using stratified multistage random sampling; then a face-to-face questionnaire survey and physical examination were conducted among the elderly from July 2016 to October 2017. Results The prevalence of hypertension among the 1 624 urban and the1 601 rural elderly were 40.9% and 43.5%, and the standardized hypertension prevalence for the two groups were 41.3% and43.2%, respectively, with no significant difference in the hypertension prevalence between the urban and rural elderly(P >0.05). The results of multivariate unconditional logistic regression analysis demonstrated that alcohol drinking and overweight/obesity were risk factors of hypertension among the urban elderly; whereas, among the rural elderly, aged over 75 years, lack of physical activity, overweight/obesity, and central obesity were risk factors of hypertension and smoking was a protective factor against hypertension. Conclusion Hypertension prevalence is not significantly different but the distribution for the influencing factors of hypertension is significantly different between the elderly in urban and rural region of Kunming city. The results suggest that targeted prevention and control measures for hypertension should be developed according to characteristics of the urban and rural elderly population.
Objective To compare the prevalence and influencing factors of hypertension among the elderly in urban and rural areas of Kunming municipality, Yunnan province and to provide references for developing hypertension prevention and control measures for the two groups of population. Methods We selected 3 225 residents at ages of 60 years and above in 6 communities of an urban district and 6 rural villages in a county of Kunming municipality of Yunnan province using stratified multistage random sampling; then a face-to-face questionnaire survey and physical examination were conducted among the elderly from July 2016 to October 2017. Results The prevalence of hypertension among the 1 624 urban and the1 601 rural elderly were 40.9% and 43.5%, and the standardized hypertension prevalence for the two groups were 41.3% and43.2%, respectively, with no significant difference in the hypertension prevalence between the urban and rural elderly(P >0.05). The results of multivariate unconditional logistic regression analysis demonstrated that alcohol drinking and overweight/obesity were risk factors of hypertension among the urban elderly; whereas, among the rural elderly, aged over 75 years, lack of physical activity, overweight/obesity, and central obesity were risk factors of hypertension and smoking was a protective factor against hypertension. Conclusion Hypertension prevalence is not significantly different but the distribution for the influencing factors of hypertension is significantly different between the elderly in urban and rural region of Kunming city. The results suggest that targeted prevention and control measures for hypertension should be developed according to characteristics of the urban and rural elderly population.
引文
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[18]Alomari MA,Al-Sheyab NA.Cigarette smoking lowers blood pressure in adolescents:the Irbid-TRY[J].Inhal Toxicol,2016,28(3):140-144.
[19]胡文斌,张婷,史建国,等.男性吸烟与高血压病的剂量-反应关系[J].中华心血管病杂志,2014,42(9):773-777.
[20]赖斌,魏玉杰,刘惠亮.吸烟、内皮细胞功能紊乱和动脉粥样硬化[J].心脏杂志,2015,27(4):483-485.
[2]中华医学会老年医学分会,中国医师协会高血压专业委员会.老年人高血压特点与临床诊治流程专家建议[J].中华老年医学杂志,2014,33(7):689-701.
[3]苏蓉,蔡乐,董峻,等.云南4个少数民族糖尿病危险因素及相关知识的对比分析[J].重庆医学,2016,45(29):4103-4105,4109.
[4]曹丰,蔡乐,崔文龙,等.云南省玉龙县纳西族心血管疾病危险因素聚集性的社会经济影响研究[J].昆明医科大学学报,2015,36(2):36-39.
[5]葛均波,徐永健,王辰.内科学[M].9版.北京:人民卫生出版社,2019:2.
[6]昆明市人民政府网.2017年昆明市国民经济和社会发展统计公报[EB/OL].[2018-05-10].http://www.km.gov.cn/c/2018-05-10/2571823.shtml.
[7]宋惠明.通州区郎府地区60岁以上老年人高血压患病情况分析[J].大家健康:中旬版,2016,10(9):23-24.
[8]周泉,王培席,吴冰源,等.佛山市南海区社区老年人群高血压患病率及危险因素[J].中国老年学杂志,2015,35(14):4012-4014.
[9]辜滟翔,郝习君,陈长香,等.河北省城乡居家老年人慢性病患病现状及其影响因素[J].中国公共卫生,2015,31(2):132-136.
[10]王改玲,陈还珍.山西省忻州市城区老年人群高血压流行病学调查分析[J].中西医结合心脑血管病杂志,2016,14(9):997-1000.
[11]何倩.安徽省农村地区老年人高血压与超重、肥胖的关联研究[D].合肥:安徽医科大学,2017.
[12]刘淼.京郊农村老年人群肥胖和高血压的流行情况及影响因素[C]//中国老年学学会老年医学委员会.中国老年健康论坛2015暨首届中国老年健康服务大会论文集,成都,2015.北京:中国老年学学会老年医学委员会,2015:56-60.
[13]刘国琴,饶文博,刘志军,等.贵州省15岁及以上人群高血压患病率及分布调查[J].中华流行病学杂志,2018,39(5):614-618.
[14]吴兰,张玉花,叶涛.甘肃地区老年人慢性疾病发病率及其危险因素调查分析[J].中国初级卫生保健,2015,29(4):62-64.
[15]郑文秋,郝春艳.锦州市社区老年高血压患病现状及影响因素[J].解放军预防医学杂志,2016,34(4):513-515.
[16]楚洁,王临虹,徐爱强,等.山东省成年人高血压与高血压前期流行情况及影响因素分析[J].中华预防医学杂志,2014,48(1):12-17.
[17]Kim BJ,Han JM,Kang JG,et al.Association between cotinineverified smoking status and hypertension in 167,868 Korean adults[J].Blood Pressure,2017,26(5):303-310.
[18]Alomari MA,Al-Sheyab NA.Cigarette smoking lowers blood pressure in adolescents:the Irbid-TRY[J].Inhal Toxicol,2016,28(3):140-144.
[19]胡文斌,张婷,史建国,等.男性吸烟与高血压病的剂量-反应关系[J].中华心血管病杂志,2014,42(9):773-777.
[20]赖斌,魏玉杰,刘惠亮.吸烟、内皮细胞功能紊乱和动脉粥样硬化[J].心脏杂志,2015,27(4):483-485.