我国十组人群高血压发病率及其影响因素

The incidence of hypertention and associated factors in 10 population groups of China

目的 调查我国高血压的发病率及其影响因素，方法研究人群为不同地区、不同职业的１０个年龄为３５～５９岁的人群，共计２５６５６人。用统一设计、统一表格和统一标准化的调查方法，按国标规定方法测量血压。结果经过平均５年的定群随访，确诊高血压年发病率男性为１．２０％，女性为１．０７％，临界及以上分别为３．２７％和２．６８％。同患病率一样，人群间存在着北方高（３．０１％～５．６２％）南方低（０．７６％～１．５０％）的趋势。在工、农、渔不同职业、不同性别间也存在着明显差别。多元回归分析还表明，基线时收缩压（ＳＢＰ）、舒张压（ＤＢＰ）平均水平和体重指数对高血压发病率的影响最为明显。在控制了其他危险因素后，体重指数每增加一个单位，未来５年内，确诊高血压发病危险增加９％；在正常范围内的ＳＢＰ每增加１．３ｋＰａ（１０ｍｍＨｇ），未来５年内确诊高血压发病危险增加７１．５％。ＤＢＰ每增加１．３ｋＰａ（１０ｍｍＨｇ），确诊高血压发病危险增加１０２．４％。此外，分层分析表明，在３５～５９岁之间，年龄越小，相对危险增加幅度愈大。结论高血压的一级预防应在３５岁前尽早进行。

Objective To study the natural populations studied including 3 groups of workers , 6 groups of farmers and 1 group of fishermen , distributed in Heilongjiang , Hebei , Shanxi , Shannxi , Jiangsu and Zhejiang provinces and Guangxi Autonomous Region. Methods In 1982～1985 , a total of 25656 per- sons (male 13 390, female 12 266) aged 35～59 were surveyed for the risk factors of cardiovascular dis- eases. Results 20641 (male 10584, female 10057) of them were re-examined in 1988～1989 , giving a response race of 80. 5%. During the 5 year follow-up period , the incidence of definite hypertention was 1. 20% (male) and 1. 07% (female) , with the borderline plus definite rates being 3. 27% and 2. 68 % per year , respectively. The incidence varied from 0. 76% to 5. 62 % per year for borderline plus definite. The incidence was higher in the north than in the south , higher in farmers than in workers , and lowest in fishermen. The incidence rates were higher in men than in women , and the older the age , the higher the incidence of hypertension, Both univariate and logistic regression indicated that the main risk factors of hypertension are the levels of baseline systolic and diastolic blood pressure , BMI , and al- cohol intake , all of which showed a dose-response relation to the incidence rate of hypertension. These relationships were affected by age : the younger , the more marked the increase of relative risk ( RR ) with risk factor levels After adjusting for age , sex and location by logistic regression , with ever. 10 mmHg increase of SBP or DBP within the normotensive range , or every 1 unit increase of BMI , the RR of hypertension was estimated to increase by 71. 5%、 102. 4 % and 10. 8% , respectively. No significant relationship was found between the level of serum cholesterol and the incidence of hypertension , but person. with faster heart rates showed a higher RR. Conclusion Primary prevention of hypertension in persons should be starteil before age of 35 years.