上海市郊区老年不同级别高血压患者危险因素比较研究

目的:了解上海市青浦民惠社区老年高血压患病现状及其合并心血管危险因素和心脑血管病的情况,为社区老年高血压患者制定有效干预措施提供依据,从而最大限度降低心血管病的死亡和病残的发生。方法:对民惠社区常住的1043例≥60岁老年人进行了高血压患病调查,调查发现高血压患者477例。并对477例老年高血压患者作为研究对象,在不同性别、不同级别高血压患者危险因素进行比较研究。结果:①老年高血压患者合并其他心血管危险因素所占比例较高,居前3位是腹型肥胖(70.4%)、缺乏体力活动(54.7%)、高脂血症(44.7%)。合并心脑血管病的比例为冠心病(29.6%)、脑卒中或TIA(23.8%)和糖尿病(16.4%)。男女患者比较,合并心血管危险因素和心脑血管疾病的比例除吸烟外差异无显著性。②不同级别老年高血压患者合并心脑血管病和心血管危险因素的比较,除肥胖、糖尿病和吸烟外差异有显著性(P<0.05),具有统计学意义。结论:民惠社区老年高血压患者存在高比例的多种其他心血管危险因素,以腹型肥胖、缺乏体力活动和高脂血症最为突出,是高血压干预的主要内容。不同级别老年高血压患者的危险因素,除肥胖、糖尿病和吸烟外和及其合并心脑血管病呈逐渐加重趋势,差异有统计学意义(P<0.05),2、3级高血压是社区高血压防治的重点目标。但1级高血压占有较高比例,也是社区防治不可忽视的对象。

Objective：To study the old people from Huimin Community in Qingpu District, Shanghai’s present physical situation of hypertension and their risk factors of combinedcardiovascular and cardiovascular disease’s status,to provide base for formulating effective intervention measure for old patients suffered hypertension in community,thus reducing the incidents of death and disease of cardiovascular to a maximum. Method： Investigation about hypertension was carried out to 1043 old residents aged 60 and above from Huimin Community,finding out 477 cases hypertensive,comparison and study were conducted on the risk factors of hypertensive in different gender and level based on the target of these 477 cases. Results：① The proportion of old hypertensive combined with other cardiovascular risk factor was higher,and the first three： abdominal obesity （ 70. 4% ）,lack of physical labor （54. 7%） and hyperlipidemia （44. 7%）. The proportion of combined cardiovascular disease was coronary heart disease （29. 6%）,stroke or TIA（23. 8%）and diabetes （16. 4% ）. Compared with male and female,combined cardiovascular risk factor and cardiovascular disease （ except smoking） had few notable differences. ② The comparison of old hypertensive combined cardiovascular disease and cardiovascular risk factor,except obesity,diabetes and smoking,had notable differences （ P 0. 05） and statistical significance. Conclusion：The old hypertensive in Huimin Community high proportionally exists other various cardiovascular risk factors,most noted in abdominal obesity,lack of physical labor and hyperlipidemia,which should be the primary contents of hypertensive intervention. Old hypertensive risk factors in different level （ except obesity,diabetes and smoking） and their combined cardiovascular disease turns into gradually serious trend and the difference has statistical significance （ P 0. 05）. Level Ⅱ,Ⅲ hypertension is the key target of hypertension preventive treatment in community. But the proportion of Lever Ⅰ hypertension is higher,which is the target not to be neglected in community.