摘要
目的分析上海市城乡结合部老年高血压患者H型高血压(HHT)的检出率及其危险因素,为有效减少其脑血管事件的发生提供参考。方法 2018年3-6月,采用分层随机抽样方法选取上海市浦东新区唐镇社区户籍人口中老年(≥60岁)高血压患者1 500例,采用自行设计的健康状况调查表收集其人口社会学特征、慢性病患病情况及体格检查项目;老年高血压患者HHT的影响因素分析采用多因素Logistic回归分析。结果(1)1 500例老年高血压患者实际受检1 212例,受检率为80.80%。1 212例老年高血压患者平均Hcy水平为(19±12)μmol/L,HHT检出率为94.72%;男性平均Hcy水平及HHT检出率高于女性(P<0.05)。(2)60~69岁组、70~79岁组男性平均Hcy水平高于女性(P<0.05),而80~89岁组男女平均Hcy水平比较,差异无统计学意义(P>0.05);60~69岁组男性HHT检出率高于女性(P<0.05),而70~79岁组、80~89岁组男女HHT检出率比较,差异无统计学意义(P>0.05)。(3)有无糖尿病,不同体质指数(BMI),总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)水平是否升高,高密度脂蛋白(HDL)水平是否降低老年高血压患者HHT检出率比较,差异无统计学意义(P>0.05);有无腹型肥胖,肌酐(Cr)水平是否升高、是否合并高尿酸血症(HUA)、估算肾小球滤过率(eGFR)是否受损老年高血压患者HHT检出率比较,差异有统计学意义(P<0.05)。(4)多因素Logistic回归分析结果显示,年龄〔OR=2.148,95%CI(1.271,3.631)〕、腹型肥胖〔OR=1.851,95%CI(1.075,3.189)〕、Cr升高〔OR=1.061,95%CI(1.039,1.084)〕及HUA〔OR=1.005,95%CI(1.001,1.009)〕是老年高血压患者HHT的独立影响因素(P<0.05)。结论上海市城乡结合部老年高血压患者HHT检出率为94.72%,年龄、腹型肥胖、Cr水平升高及HUA是老年高血压患者HHT的危险因素,针对该类患者应开展多种危险因素的综合评估和Hcy的检测。
Objective To analyze the detection rate and risk factors of H-type hypertension(HHT)in elderly hypertensive patients in peri-urban areas in Shanghai,to provide a reference for reducing the risk of cerebrovascular events.Methods From March to June 2018 and by using stratified random sampling method,a total of 1 500 registered hypertensive patients(≥ 60 years old)were selected in Community Health Service Center of Tang Town,Pudong New Area,Shanghai,self-designed Health Status Questionnaire was used to collect their demographic sociological features,prevalence of chronic diseases and physical examination items;multivariate Logistic regression analysis was used to analyze the influencing factors of HHT.Results(1)Finally,1 212 cases completed the questionnaire(80.80%).In the 1 212 cases,the mean Hcy level was(19±12)μmol/L,the detection rate of HHT was 94.72%;mean Hcy level and detection rate of HHT in males were statistically significantly higher than those in female(P<0.05).(2)Age-subgroup analysis results showed that,mean Hcy level in males in both 60-69 age-subgroup and 70-79 age-subgroup was statistically significantly higher than that in females,respectively(P<0.05),while there was no statistically significant sex-related difference in mean Hcy level in 80-89 agesubgroup(P>0.05);detection rate of HHT in males was statistically significantly higher than that in females in 60-69 agesubgroup(P<0.05),while there was no statistically significant sex-related difference in detection rate of HHT in 70-79 agesubgroup or 80-89 age-subgroup(P>0.05).(3)Detection rate of HHT in elderly hypertensive patients differed statistically significantly by abdominal obesity,elevated Cr,HUA and abnormal eGFR(P<0.05),but not by diabetes,BMI,elevated TC,elevated TG,elevated LDL and decreased HDL(P>0.05).(4)Multivariate Logistic regression analysis results showed that,age〔OR=2.148,95%CI(1.271,3.631)〕,abdominal obesity〔OR=1.851,95%CI(1.075,3.189)〕,elevated Cr〔OR=1.061,95%CI(1.039,1.084)〕and HUA〔OR=1.005,95%CI(1.001,1.009)�
作者
陈建峰
CHEN Jianfeng(Department of General Practice,Community Health Service Center of Tang Town,Pudong New Area,Shanghai,Shanghai 201210,China)
出处
《实用心脑肺血管病杂志》
2019年第7期56-60,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
高血压
H型高血压
老年人
检出率
数据收集
危险因素
上海
Hypertension
H-type hypertension
Aged
Prevalence
Data collection
Risk factors
Shanghai
