社区高血压患者多代谢异常的流行病学特征分析

The epidemiological characteristics of multiple metabolic disorders on hypertensive patients in the communities

目的 了解社区高血压患者多代谢异常的流行病学特征分布情况 ,探索高血压患者合并代谢异常的相关因素。方法 对上海市某社区 35岁及以上人群中 2 0 2 5名原发性高血压病人合并多代谢异常的分布特点进行了分析。研究的主要代谢异常包括脂代谢异常、糖尿病及肥胖。结果 高血压患者中有 5 9.2 %合并其他的代谢异常 ,其中合并一种、两种、三种代谢异常者的比例分别为 83.9%、15 .5 %和 0 .6 %。合并脂质代谢异常、糖尿病、肥胖的比例分别为 5 3.0 %、9.7%、6 .3%。男性高血压患者合并代谢异常标化率 (5 8.1% )高于女性 (5 4.5 % )。 6 0岁以上患者中有 6 2 .9%合并一种以上的代谢异常 ,高于 6 0岁以下 5 6 .7%的比例 (χ2 =7.5 6 ,P <0 .0 1)。绝经期后女性患者合并多代谢异常的比例 (6 7.6 % )显著高于绝经前 (44 .4% ) (χ2 =37.49,P <0 .0 1)。结论 该高血压患者人群中近 6 0 %合并有其他代谢异常 ,合并脂质代谢异常者占一半以上。老年合并代谢异常的比例高于低年龄组。女性绝经期后多代谢异常比例明显增高。提示在该高血压患者人群中除进行常规降压治疗外应着重控制脂质代谢紊乱、糖尿病 ,以减少冠心病的发生。

Objectives To describe the epidemiological characteristics of multiple metabolic disorders on hypertensive patients living in the communities. Methods The characteristics of metabolic disorders in the hypertensives from one community in Shanghai urban area were analyzed. Metabolic disorders would include dyslipidemia (high cholesterol and/or high triglycerides and/or low HDL cholesterol), diabetes and obesity. Results 59.2 % of the hypertensives at least had one metabolic disorder. Proportionally, 83.9 %, 15.5 %, 0.6 % of the patients would combine one, two, or all of the disorders. The percentages of patients combined with dyslipidemia, diabetes and obesity were 53.0 %, 9.7 %, 6.3 %, respectively. 74.0 % of patients with metabolic disorders were combined with dyslipidemia while 9.1 % were combined with both dyslipidemia and diabetes. The standardized prevalence rate of male patients with metabolic disorders was 58.1 %, higher than the rate of women ( 54.5 %). The prevalence rate of postmenopausal female patients with metabolic disorders was 67.6 %, significantly higher than that of the premenopausal women ( 44.4 %)(χ 2= 37.49 , P < 0.01 ). Conclusion Nearly 60% of the total patients combined with metabolic disorders. Dyslipidemia occurred in more than half of the patients in total. The proportion of senile patients with metabolic disorders was higher than the younger patients. Results suggested that attempts to maintain the coronary heart disease at low levels in the population should include treatment of dyslipidemia to keep lipid and diabetes prevalence at low levels other than regular antihypertensive therapy.