重庆市化龙桥社区高血压知晓状况与危险因素分析

Awareness and risk factors of hypertension in a community-based population in Chongqing

目的研究高血压病社区知晓状况、患病特征和危险因素.方法采用问卷调查与体格检查相结合的方法,系统抽样调查社区内15岁以上居民4 913人.结果该社区HT患病率8.55%(95%可信区间:5.88%～11.22%),比'知晓患病率'(6.29%,95%可信区间:3.58%～9.00%)增高36%,年龄越小,增高幅度越大.55～74岁两年龄组女性居民HT患病率显著高于男性(P＜0.05),相对危险度RR分别为1.7(95%可信区间:1.10～2.64)和1.8(95%可信区间:1.31～2.61);在非HT居民中,除55～74岁的血压无性别差异外,其余年龄组男性的血压均显著高于女性(P＜0.001).Logistic分析表明HT家族史、高层居住、糖尿病伴中心性肥胖和老年化是社区主要危险因素,女性患病危险性高于男性,患者饮食费用高、健康满意度低、就诊次数多、冠心病危险性高;不知已患病的患者还表现出清淡饮食少和体育锻炼少.结论高血压病患者受生理、心理和社会等因素影响,其知晓状况在青壮年中最差,高血压病的治疗应包括对社区因素的综合控制,防治应从青壮年开始做起.

Objective To identify the awareness and the sociodemographic characteristics of hypertension(HT) and its risk in a certain community.Methods Using questionnaire combined with physical examination, a systemic sampling survey, including 4913 community-dwelling individuals aged 15 and over, was carried out.Results In the community, the prevalence of HT was 8.55%(95% C.I.:5.88%-11.22%)and 36% higher than 'awareness incidence'(6.29%,95% C.I.:3.58%-9.00%), in which the amplitudes increased with age decreasing. In the two groups aged 55 and over, the prevalence was more significantly elevated in women than in men(P< 0.05), in which the relative risk indices were 1.7(95% C.I.:1.10%-2.64%) and 1.8(95% C.I.: 1.31 %-2.61%). In the normotensive residents, the blood pressure in men was significantly higher than that in women(all P less than 0.001) with the exception of the age from 55 to 74. Multivariate logistic regression demonstrated that HT family history, living in high building, diabetes with central obesity and aging were major risk factors for HT. The risk for development of the disease was higher in women than in men. There were higher payment for diet, lower degree of satisfaction at health, more times of visiting and higher risk of coronary heart disease in patients. Otherwise, fewer insipid food and exercise had been showed in the patients without awareness of suffering. Conclusion Development of HT is affected by complex interaction among physical, psychological and social factors. The HT awareness rate was lowest in the prime of life. Prevention and effective treatment should include the control for these sociodemographic characteristics in community and begin in young residents.