太原市城乡青春期高血压流行病学调查

Epidemiological analysis on the related factors of primary hypertension of adolescents in Taiyuan

目的了解太原市青春期血压水平以及高血压的发生状况,探索青春期原发性高血压的易患因素,为开展成年期心血管疾病的预防提出理论依据。方法采用分层整群随机抽样方法对太原市1 749名13～18岁青春期少年进行身高、体质量、收缩压(SBP)、舒张压(DBP)的测定,并计算体质量指数(BMI),以血压值在其年龄、性别第95百分位以上者为高血压,经进一步体检排除继发性高血压,筛选出原发性高血压者69例,将其作为研究对象,用随机抽样法在所有血压正常青少年中选择69名作为对照,进行1∶1病例对照配对,抽取静脉血查空腹血糖、甘油三酯、胆固醇,并填写统一制定的调查表。对可能影响高血压发生的因素进行Logistic回归分析。结果①城乡间SBP、DBP均值差异有统计学意义,城乡原发性高血压发生率差异无统计学意义。②同性别、不同年龄组间SBP、DBP均值差异无统计学意义,男女之间SBP、DBP差异有统计学意义。③单因素分析显示:BMI升高、高脂血症是青春期原发性高血压的重要危险因素。将SBP和DBP分别进行分析,发现肥胖、高血压家族史、高脂血症是收缩期高血压的危险因素,肥胖、高脂血症是舒张期高血压的危险因素。多因素Logistic回归分析显示:BMI是青春期原发性高血压发病的危险因素。收缩期原发性高血压的危险因素有肥胖、高脂血症、感到入睡困难、高血压家族史;舒张期原发性高血压的危险因素有肥胖、高脂血症。结论肥胖、高脂血症是青春期原发性高血压的重要危险因素,与收缩期及舒张期原发性高血压均有关系,高血压家族史是收缩期高血压的危险因素。

Objective To investigate the level of the blood pressure and the prevalence rate of primary arterial hypertension in adolescents in Taiyuan.To investigate the risk factors associated with primary hypertension in adolescents.Methods A stratified-clustered-random sampling study of 1 749 adolescents aged 13 to 18 years in Taiyuan were used and age,height,weight,systolic blood pressure and diastolic pressure were conducted from September 2006 to January 2007,undergoing further medical examination to exclude the secondary hypertension,69 cases of primary hypertension were screened.These cases were selected as study objects.①Random sampling were used to select 69 cases as control group from all the normotensive adolescents,the clinical case-control study was performed.Venous blood was collected for fasting blood glucose,triglyceride and cholesterol.And relative information about cases was filled in the unified questionnaires forms.②The data were analyzed with the software of SPSS 11.5.Logistic regression analysis for risk factors of primary hypertension was used.Results ①The prevalence rate of hypertension in Taiyuan was 3.9%,5.0% in boys and 2.8% in girls,respectively.There was significant difference in SBP,DBP mean and there was no significant difference in the prevalence rate of hypertension between urban and rural areas.②The prevalence rate of pre-hypertension was 7.4%,with 7.9% in boys and 6.8% in girls.There was no significant difference in the prevalence rate between boys and girls（P0.05）.③Single factor analysis approved that increased body mass index and hyperlipidemia are important risk factors for adolescent primary hypertension.Systolic and diastolic blood pressure were analyzed and we found that increased BMI,family history of hypertension,hyperlipidemia are isolated risk factors of systolic hypertension.And obesity,hyperlipidemia are risk factors of diastolic hypertension.Multivariate Logistic regression analysis showed that increased BMI during adolescence was one of primary hypertension risk factors.Risk factors of systolic hypertension were BMI,hyperlipidemia,and family history of hypertension,and risk factors of diastolic hypertension were BMI and hyperlipidemia.Conclusion Obesity and hyperlipidemia are the risk factors for primary hypertension in adolescence.Family history of hypertension is the isolated risk factor of systolic hypertension.