甘肃汉族人群高血压家族史与高血压关联的研究
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摘要
目的了解甘肃省20~80岁汉族人群高血压患病现状,探讨高血压家族史(family history,FH)与高血压之间的关系。方法本研究为横断面研究,采用多阶段分层整群抽样方法,选择甘肃省4个调查地区的汉族人群,进行面对面问卷调查、体格检查和血生化检测。结果共调查4 247名20~80岁汉族常住居民,问卷应答率为97.4%,合格率为98.7%。其中男性有1 777人(41.8%),女性有2 470人(58.2%),高血压粗患病率为28.2%。多因素Logistic回归分析显示,有FH者患高血压的风险比无FH高(OR=3.36,95%CI:2.58~4.41,P<0.001),当患病亲属从1代增加到2代和3代时,高血压的患病风险从2.33倍(OR=2.33,95%CI:1.77~3.09,P<0.001)增加到5.97倍(OR=5.97,95%CI:4.42~8.13,P<0.001)和14.64倍(OR=14.64,95%CI:8.30~26.27,P<0.001)。结论有高血压FH的人群高血压患病率明显升高,且随着家族中患病亲属代数的增加,高血压的患病风险逐渐增加。有FH的人能形成一个易于识别的群体,对该群体的针对性干预能够使其受益,从而降低高血压的发病风险。
Objective To investigate the prevalence of hypertension and its association with family history( FH)in Han people aged 20-80 living in Gansu Province. Methods By performing a multi-stage stratified clustering sampling method,4 247 Han people resident in four sites in Gansu Province were selected as study participants. All participants underwent face to face questionnaire interview,physical examination and biochemical tests. Results A total of 4 247 Han subjects aged 20-80 years were included,among which 1 777( 41. 8%) were men and 2 470( 58. 2%) were women. The response rate and the eligibility rate were 97. 4% and 98. 7%,respectively. The crude prevalence of hypertension was28. 2%. Along with elevated FH categories,participants had increased prevalence of hypertension. The multi-variable logistic regression analysis indicated that after adjusting for age,sex,current residential area,body mass index( BMI),educational level,tobacco use,alcohol consumption,physical activity and diabetes,participants with FH had 3. 36 times higher( OR = 3. 36,95% CI: 2. 58-4. 41,P < 0. 001) than those without FH of hypertension. The risk of hypertension also increased with the number of affected generations( one: OR = 2. 33,95% CI: 1. 77-3. 09,P < 0. 001; two: OR = 5. 97,95% CI: 4. 42-8. 13,P < 0. 001; three: OR = 14. 64,95% CI: 8. 30-26. 27,P < 0. 001). Conclusions The prevalence of hypertension is higher in people with hypertension family history. As FH categories increase,a consistent trend of increasing hypertension prevalence is observed. Since individual with FH of hypertension can be easily identified,screening and targeted intervention toward this population may improve the prevention of hypertension.
Objective To investigate the prevalence of hypertension and its association with family history( FH)in Han people aged 20-80 living in Gansu Province. Methods By performing a multi-stage stratified clustering sampling method,4 247 Han people resident in four sites in Gansu Province were selected as study participants. All participants underwent face to face questionnaire interview,physical examination and biochemical tests. Results A total of 4 247 Han subjects aged 20-80 years were included,among which 1 777( 41. 8%) were men and 2 470( 58. 2%) were women. The response rate and the eligibility rate were 97. 4% and 98. 7%,respectively. The crude prevalence of hypertension was28. 2%. Along with elevated FH categories,participants had increased prevalence of hypertension. The multi-variable logistic regression analysis indicated that after adjusting for age,sex,current residential area,body mass index( BMI),educational level,tobacco use,alcohol consumption,physical activity and diabetes,participants with FH had 3. 36 times higher( OR = 3. 36,95% CI: 2. 58-4. 41,P < 0. 001) than those without FH of hypertension. The risk of hypertension also increased with the number of affected generations( one: OR = 2. 33,95% CI: 1. 77-3. 09,P < 0. 001; two: OR = 5. 97,95% CI: 4. 42-8. 13,P < 0. 001; three: OR = 14. 64,95% CI: 8. 30-26. 27,P < 0. 001). Conclusions The prevalence of hypertension is higher in people with hypertension family history. As FH categories increase,a consistent trend of increasing hypertension prevalence is observed. Since individual with FH of hypertension can be easily identified,screening and targeted intervention toward this population may improve the prevention of hypertension.
引文
[1]Mills KT,Bundy JD,Kelly TN,et al.Global disparities of hypertension prevalence and control:a systematic analysis of populationbased studies from 90 countries[J].Circulation,2016,134(6):441-50.
[2]Wang X,Bots ML,Yang F,et al.Prevalence of hypertension in China[J].J Hypertens,2014,32(10):1919-1927.
[3]Lu J,Lu Y,Wang X,et al.Prevalence,awareness,treatment,and control of hypertension in China:data from 1.7 million adults in a population-based screening study(China PEACE Million Persons Project)[J].Lancet,2017,390(10112):2549-2558.
[4]Coy V.Genetics of essential hypertension[J].AANP,2010,17(6):219-224.
[5]MIALL WE,OLDHAM PD.The hereditary factor in arterial blood-pressure[J].Br Med J,1963,1(5323):75-80.
[6]吴小艳,李强,严惠,等.陕西省汉中市农村居民高血压与家族史的相关性分析[J].中华流行病学杂志,2017,38(8):1050-1054.
[7]Winnicki M,Somers VK,Dorigatti F,et al.Lifestyle,family history and progression of hypertension[J].J Hypertens,2006,24(8):1479-1487.
[8]Shan G,Wei D,Wang C,et al.Trends of overweight and obesity in Yi people between 1996 and 2007:an Yi migrant study[J].Biomed Environ Sci,2011,24(5):467-474.
[9]刘力生.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[10]Ranasinghe P,Cooray DN,Jayawardena R,et al.The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults[J].BMC Public Health,2015,15(1):576.
[11]Liu M,He Y,Jiang B,et al.Association between family history and hypertension among Chinese elderly[J].Medicine(Baltimore),2015,94(48):e2226.
[12]Igarashi R,Fujihara K,Heianza Y,et al.Impact of individual components and their combinations within a family history of hypertension on the incidence of hypertension[J].Medicine(Baltimore),2016,95(38):e4564.
[13]Khanna N,Sharma RS,Sidhu RS.A study of the basic and derived anthropometric indices among the healthy adults(20-30years of age)of amritsar city(punjab)having family history of hypertension[J].IJBMR,2011,2(3):743-746.
[14]陈燕,姚应水,汪全海,等.芜湖市某中学1 295名学生高血压流行现状及其与心理健康、生活方式的关系[J].中华疾病控制杂志,2018,22(5):538-539.
[15]谢文杰,黄从新,张琰,等.湖北省15~18岁青少年高血压流行病学调查[J].中华高血压杂志,2016,24(1):77-83.
[16]金静静,冯建启,彭城,等.徐州市13~16岁青少年高血压的流行病学调查[J].中国循证心血管医学杂志,2018,10(1):85-86.
[17]Rodriguez-Moran M,Aradillas-Garcia C,Simental-Mendia LE,et al.Family history of hypertension and cardiovascular risk factors in prepubertal children[J].Am J Hypertens,2010,23(3):299-304.
[18]Whelton PK,He J,Appel LJ,et al.Primary prevention of hypertension:clinical and public health advisory from the national high blood pressure education program[J].JAMA,2002,288(15):1882-1888.
[19]Hinderliter AL,Sherwood A,Craighead LW,et al.The long-term effects of lifestyle change on blood pressure:One-year follow-up of the ENCORE study[J].Am J Hypertens,2014,27(5):734-741.
[20]张晨韵,蔡晓露,黄慧玲,等.我国高血压社区综合干预效果的Meta分析[J].中华疾病控制杂志,2017,21(6):627-631.
[21]李洋,胡洁,郭海健,等.社区高血压前期生活方式群组干预研究[J].中华疾病控制杂志,2016,20(10):971-974.
[2]Wang X,Bots ML,Yang F,et al.Prevalence of hypertension in China[J].J Hypertens,2014,32(10):1919-1927.
[3]Lu J,Lu Y,Wang X,et al.Prevalence,awareness,treatment,and control of hypertension in China:data from 1.7 million adults in a population-based screening study(China PEACE Million Persons Project)[J].Lancet,2017,390(10112):2549-2558.
[4]Coy V.Genetics of essential hypertension[J].AANP,2010,17(6):219-224.
[5]MIALL WE,OLDHAM PD.The hereditary factor in arterial blood-pressure[J].Br Med J,1963,1(5323):75-80.
[6]吴小艳,李强,严惠,等.陕西省汉中市农村居民高血压与家族史的相关性分析[J].中华流行病学杂志,2017,38(8):1050-1054.
[7]Winnicki M,Somers VK,Dorigatti F,et al.Lifestyle,family history and progression of hypertension[J].J Hypertens,2006,24(8):1479-1487.
[8]Shan G,Wei D,Wang C,et al.Trends of overweight and obesity in Yi people between 1996 and 2007:an Yi migrant study[J].Biomed Environ Sci,2011,24(5):467-474.
[9]刘力生.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[10]Ranasinghe P,Cooray DN,Jayawardena R,et al.The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults[J].BMC Public Health,2015,15(1):576.
[11]Liu M,He Y,Jiang B,et al.Association between family history and hypertension among Chinese elderly[J].Medicine(Baltimore),2015,94(48):e2226.
[12]Igarashi R,Fujihara K,Heianza Y,et al.Impact of individual components and their combinations within a family history of hypertension on the incidence of hypertension[J].Medicine(Baltimore),2016,95(38):e4564.
[13]Khanna N,Sharma RS,Sidhu RS.A study of the basic and derived anthropometric indices among the healthy adults(20-30years of age)of amritsar city(punjab)having family history of hypertension[J].IJBMR,2011,2(3):743-746.
[14]陈燕,姚应水,汪全海,等.芜湖市某中学1 295名学生高血压流行现状及其与心理健康、生活方式的关系[J].中华疾病控制杂志,2018,22(5):538-539.
[15]谢文杰,黄从新,张琰,等.湖北省15~18岁青少年高血压流行病学调查[J].中华高血压杂志,2016,24(1):77-83.
[16]金静静,冯建启,彭城,等.徐州市13~16岁青少年高血压的流行病学调查[J].中国循证心血管医学杂志,2018,10(1):85-86.
[17]Rodriguez-Moran M,Aradillas-Garcia C,Simental-Mendia LE,et al.Family history of hypertension and cardiovascular risk factors in prepubertal children[J].Am J Hypertens,2010,23(3):299-304.
[18]Whelton PK,He J,Appel LJ,et al.Primary prevention of hypertension:clinical and public health advisory from the national high blood pressure education program[J].JAMA,2002,288(15):1882-1888.
[19]Hinderliter AL,Sherwood A,Craighead LW,et al.The long-term effects of lifestyle change on blood pressure:One-year follow-up of the ENCORE study[J].Am J Hypertens,2014,27(5):734-741.
[20]张晨韵,蔡晓露,黄慧玲,等.我国高血压社区综合干预效果的Meta分析[J].中华疾病控制杂志,2017,21(6):627-631.
[21]李洋,胡洁,郭海健,等.社区高血压前期生活方式群组干预研究[J].中华疾病控制杂志,2016,20(10):971-974.