杭州市老年高血压患者血压控制的影响因素研究

Influencing factors for blood pressure control in elderly patients with hypertension in Hangzhou

目的了解杭州市老年高血压患者血压控制情况,并分析其影响因素,为社区老年高血压患者管理提供依据。方法选择杭州市基本公共卫生服务社区健康管理的≥60岁高血压患者为调查对象,采用问卷调查收集人口学资料和生活行为,并进行体格检查和实验室检测。采用多因素Logistic回归模型分析老年高血压患者血压控制的影响因素。结果共调查109583人,其中男性50500人,占46.08%;女性59083人,占53.92%。血压控制52273例,控制率为47.70%。多因素Logistic回归分析结果显示,调整性别和年龄后,规律服药(OR=0.874,95%CI:0.838~0.912)有利于老年高血压患者血压控制;肥胖(OR=1.291,95%CI:1.260~1.324),空腹血糖异常(OR=1.218~1.344,95%CI:1.178~1.410),不良生活方式数量越多(OR:1.271~1.292,95%CI:1.231~1.344),血脂异常项目数量越多(OR:1.047~1.253,95%CI:1.017~1.311),合并未规律服药、肥胖、空腹血糖异常等心血管危险因素数量越多(OR:1.254~2.109,95%CI:1.175~2.281)不利于老年高血压患者血压控制。结论杭州市老年高血压患者血压控制率为47.70%;未规律服药、不良生活方式、肥胖、血脂异常、空腹血糖异常及合并这些因素的数量可能影响老年高血压患者的血压控制。

Objective To understand the situation of blood pressure control and its influencing factors in elderly patients with hypertension in Hangzhou,and to provide basis for the management of elderly patients with hypertension in community.Methods The subjects of this study were hypertension patients aged 60 years and over in Hangzhou community health management of basic public health services.Demographic data and life behaviors were collected by a questionnaire survey,physical examination and laboratory tests were carried out.The multivariate logistic regression model was used to analyze the influencing factors for blood pressure control in elderly patients with hypertension.Results A total of 109583 people were investigated,with 50500(46.08%)males and 59083(53.92%)females.The control rate was 47.70%(52273/109583).After adjusted for age and gender,regular medication(OR=0.874,95%CI:0.838-0.912)was the protective factor,obesity(OR=1.291,95%CI:1.260-1.324),abnormal fasting plasma glucose(OR=1.218-1.344,95%CI:1.178-1.410),the number of unhealthy lifestyles(OR=1.271-1.292,95%CI:1.231-1.344),the items of dyslipidemia(OR=1.047-1.253,95%CI:1.017-1.311),and the number of cardiovascular risk factors above(OR=1.254-2.109,95%CI:1.175-2.281)were the risk factors for blood pressure control in elderly patients with hypertension.Conclusions The control rate of elderly patients with hypertension in Hangzhou is 47.70%,which is associated with irregular medication,unhealthy lifestyle,obesity,dyslipidemia,abnormal fasting plasma glucose and clustering of these factors.