四川省通江县35~75岁高血压患者的高血压知晓率、治疗率、控制率及其影响因素分析

Analysis of rate of awareness,treatment and control of hypertension and influencing factors in hypertensives aged 35-75 years in Tongjiang county,Sichuan province

目的分析四川省通江县35~75岁高血压患者高血压知晓率、治疗率、控制率及其影响因素,为制订高血压综合防治管理策略提供决策依据。方法基于实施国家心血管病高危人群早期筛查与综合干预项目,于2018年9月至2019年3月采用多阶段分层随机整群抽样法抽取通江县35~75岁常住居民6003人,收集基本信息、生活行为方式、相关疾病及服药史,测量身高、体重、腰围和血压,实验室检测空腹血脂及血糖,将其中完成调查且高血压相关信息完整的3008例高血压患病居民纳入研究对象。结果通江县35~75岁高血压患者的高血压知晓率、治疗率、控制率分别为43.25%,34.94%和5.22%,标化高血压知晓率、治疗率、控制率分别为35.93%,25.56%和5.32%。多因素Logistic回归分析结果显示,高血压患者中,女性是高血压控制的危险因素(OR=0.487,95%CI:0.344~0.689),年龄35~44岁和45~59岁是高血压知晓(OR=0.323,0.660;95%CI:0.208~0.500,0.563~0.774)和治疗(OR=0.186,0.704;95%CI:0.103~0.335,0.597~0.831)的共同危险因素,初中及以下文化程度是高血压知晓的危险因素(OR=0.522,95%CI:0.363~0.753),饮酒是高血压知晓(OR=0.646,95%CI:0.537~0.778)、治疗(OR=0.552,95%CI:0.452~0.676)和控制(OR=0.427,95%CI:0.263~0.691)的共同危险因素;超重/肥胖、血脂异常、糖尿病是高血压知晓(OR=1.553,1.296,1.478;95%CI:1.330~1.813,1.110~1.512,1.199~1.822)和治疗(OR=1.630,1.247,1.816;95%CI:1.385~1.917,1.062~1.464,1.472~2.242)的共同促进因素;经常锻炼是高血压控制的促进因素(OR=1.596,95%CI:1.142~2.230)。结论通江县35~75岁高血压患者的高血压知晓率、治疗率、控制率均较低。女性、中青年、初中及以下、非超重/肥胖、非血脂异常、非糖尿病、饮酒、不经常锻炼的高血压患者是高血压知晓、治疗、控制的重点人群,应当采取针对性干预措施。

Objective To analyze the awareness rate,treatment rate and control rate of hypertension and the influencing factors among the hypertensives residents aged 35-75 years in Tongjiang county of Sichuan province,so as to provide decision-making basis for formulating comprehensive prevention and management strategy of hypertension.Methods As part of the national program of early screening and comprehensive intervention in the population with high risk cardiovascular diseases,there were 6003 inhabitants aged 35-75 years selected with multi-stage stratified random cluster sampling method in Tongjiang county from September 2018 to March 2019.The basic information,lifestyle,related diseases and medication history were collected.The height,weight,waist circumference and blood pressure were measured,and fasting lipid and blood glucose were detected in the laboratory.Totally 3008 patients with hypertension who finished the survey and had completed hypertension information were selected as the study subjects.Results The awareness rate,treatment rate and control rate of the hypertensives aged 35-75 years was 43.25%,34.94%and 5.22%,respectively,and was35.93%,25.56%and 5.32%,respectively after standardized in Tongjiang county.The results of multivariate logistic regression analysis showed that in the hypertensives,female was the risk factor for hypertension control(OR=0.487,95%CI:0.344-0.689),the age of 35-44 years and 45-59 years were the common risk factors on awareness(OR=0.323,0.660,95%CI:0.208-0.500,0.563-0.774)and treatment(OR=0.186,0.704,95%CI:0.103-0.335,0.597-0.831),the education level of junior middle school and below was the risk factor on the hypertension awareness(OR=0.522,95%CI:0.363-0.753),Drinking was the common risk factors on hypertension awareness(OR=0.646,95%CI:0.537-0.778),treatment(OR=0.552,95%CI:0.452-0.676)and control(OR=0.427,95%CI:0.263-0.691),overweight/obesity,dyslipidemia and diabetes were the common promoting factors on the hypertension awareness(OR=1.553,1.296,1.478,95%CI:1.330-1.813,1.110-1.512,1.199-1.822)and treatment(OR=1.630,1.247,1.816,95%CI:1.385-1.917,1.062-1.464,1.472-2.242),regular exercise was the promoting factor on hypertension control(OR=1.596,95%CI:1.142-2.230).Conclusions The awareness rate,treatment rate and control rate of hypertension are low in the hypertensives aged 35-75 years in Tongjiang county.The hypertensives of female,young and middle-age,education of junior middle school and below,non-overweight/obesity,non-dyslipidemia,non-diabetes,drinking,not exercising regularly are the key population on hypertension awareness,treatment and control,and the targeted intervention measures should be carried out.