广西城乡居民高血压流行病学研究

Epidemiological study of hypertension in Guangxi intabitants

目的掌握城乡居民高血压流行病学特征及其患病的危险因素，为广西高血压制定防治策略提供依据。方法运用多阶段随机整群抽样方法，先抽取广西4个城市和4个县，每个市、县再抽取2个乡镇（街道）、6个村（居委），采取现场问卷调查获取15岁及以上居民相关情况数据资料，并进行现场血压、身高、体重测量，其中膳食调查户要对15岁以上居民进行抽血化验血糖、血脂等指标。结果调查15岁及以上城乡居民9127人，SBP／DBP平均值119．7／74．8mg，其中城市居民118．9／74．7mmHg，略低于农村120．5／74．9mmHg；高血压粗患病率17．9％，标化患病率15．3％，其中城市粗患病率、标化率分别为19．5％、17．1％，高于农村（16．3％、14．8％）；农村15-44岁男性居民SBP／DBP和高血压患病率均显著高于城市同年龄组男性居民；高血压患病率从35岁开始大幅上升；Ⅰ、Ⅱ、Ⅲ高血压患病率分别为11．0％、3．61％和1．70％，随着年龄增长，Ⅱ、Ⅲ患病率呈增长趋势；高血压患者知晓率、治疗率和控制率分别为22．6％、15．4％和4．0％，城市显著高于农村。单因素分析发现高收入、文盲、肥胖、饮酒、糖尿病、高TG、高TC和轻体力活动等人群是高血压高危人群；而Logistic回归模型多因素分析，结果显示，年龄、高TG、饮酒、肥胖和高血压家族史是城乡居民高血压的共同危险因素，糖尿病还是城市居民的重要的危险因素（OR2．72），高TC则是农村居民不可忽视的危险因素（OR2．01），女性是保护因素（OR0．65）。结论估计广西15岁及以上居民有507．97万高血压病人，其中城市138．46万，农村更是高达369．53万；25．44岁农村男性青壮年血压值和高血压病高发问题，需要严重关注。控制体重、限制饮酒、减少高脂肪食物摄入和积极防治糖尿病对有效预防控制城乡居民高血压病的流行十分重要。

Objective To master the epidemical characteristics and risk factors of hypertension in residents of urban and rural areas in Guangxi for reference to the strategy of hypertension intervention. Methods Using the multistage stratified randomized cluster sampling way, 4 cities and 4 counties were selected, from each of them, the 3 towns or streetes, 6 villages or denizen committees were selected afterwards. The individual data was collected by face to face interviw, and blood pressure, body weight, height by physical examinatin, blood sugar, blood lipid were tested in residents of urban and rural areas who aged above 15 years in Guangxi. Results The sample size was 9127 intabitants who aged above 15 years.The means of SBP/DBP was 119.7/ 74.8 mmHg, which in urban area（ 120.8/ 76.5 mmHg） was slightly lower than that in rural area（ 124.2/ 77.4 mmHg） .The hypertension prevalence raw rate was 17.9%, and standard rate was 15.3 %, which in urban area（ 19.5 % , 17.1% respectively） was slightly higher than that in rural area（ 16.3%, 14.8% respectively） .The means of SBP/DBP and the rate of hypertension prevalence in the age group of 15 - 44 years old in rural area was signficantly higher than that in urban area. The rate of hypertension prevalence in the age after 35 years old was rapidly increased especially.The hypertension prevalence of model Ⅰ,Ⅱ,Ⅲ was 11.0% ,3.61%, 1.70% respectively,in which of model Ⅱ,Ⅲ showed higher with the age increasing. The rates of awareness, treatment and under - control in hypertensive were 22.6 %, 15.4 %, 4.0 % respectively, which in urban area showed signficantly higher than those in rural area. The single factors anabsys showed that the high hypertension risk people were the people with high income, illiteracy, hypertriglyceridemia, hypereholesterolemia, and light body activity.The Logistic regression muhifactor analisys showed that the age, hypertriglyeeridemia, drink, obesity and family hypertension history were dangerous factors in urban and rural areas; diabetes mellitus was an important dangerous factor in urban area （OR 2.72） ; in urban area, the hypercholesterolemia was an important dangerous factor（OR2.01）, the female sex was a protected factor（OR 0.65）. Conclusions It is estimated that 5079700 people are suffering from hypertension in Guangxi, among them, 1384600 in urban area and 3695300 in rural area. It is necessary to pay great attention to the problem of the high means of blood pressure value and the high rate of hypertension prevalence in the age group of 25 - 44 years old in rural area. It is very important to control body weight, restrict the drinking, reduce intake of superfatted foods,prevent and treat diabetes mellitus for hypertension prevention and control.