1984～1993年北京城乡心血管病危险因素变化趋势的比较

Trends in CVD risk factors in urban and rural areas of Beijing during 1984—1993

目的 评价并对比北京城乡人群 1984～ 1993年 10年中 ,心血管病危险因素的变化趋势。方法 于 1984～ 1985年 ,1988～ 1989年和 1993年分别在北京 70万MONICA监测人群中进行了 3次独立的心血管病危险因素调查。分别采用分层随机抽样方法抽取 2 5～ 6 4岁、男女两性的独立样本。对收缩压、舒张压、高血压患病率、知晓率、治疗率、控制率、血清总胆固醇、高密度脂蛋白胆固醇(HDL C)、体重指数 (BMI)、腰围臀围比 (WHR)和吸烟率在城乡中的变化趋势进行了比较。结果 (1)10年中 ,北京城市和农村心血管病危险因素的变化趋势不同 ,城市男性的收缩压、舒张压和高血压患病率下降 ,而农村男性的收缩压、舒张压和高血压患病率均升高 ,其收缩压升高了 4 3mmHg(1mmHg =0 133kPa) ,患病率升高了 3 1个百分点 ;农村男女两性的总胆固醇各升高了 0 37mmol/L和 0 40mmol/L ;(2 )城市女性的收缩压和高血压患病率升高 ,高血压知晓率、治疗率和控制率分别下降了 0 7、2 9 2、37 5个百分点 ;(3)农村女性除吸烟率下降外 ,其它各项指标均呈不良发展趋势。结论 北京城乡人群的多项心血管病危险因素水平呈上升趋势 ,尤其农村危险因素水平高于城市 ,上升趋势更明显 。

Objective To examine and compare the trends of major CVD (cardiovascular diseases) risk factors in urban and rural areas of Beijing. Methods From 1984 to 1993, three independent CVD risk factor surveys were carried out in the MONICA monitoring population in Beijing, which covered 700 000 residents in urban and rural areas. Stratified-random sampling was used. Trends of major CVD risk factors were compared, including systolic and diastolic blood pressures (SBP,DBP), prevalence of hypertension, the rates of hypertension awareness, treatment and control, serum total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), body mass index (BMI), waist to hip ratio (WHR) and smoking rate. Results There were remarkable differences in the trends in CVD risk factors between urban and rural areas: SBP, DBP and the prevalence of hypertension decreased in urban males, but increased in rural males, for instance, SBP increased 4 3 mm Hg and the prevalence increased by 3 1 percentage. In urban females, SBP and the prevalence of hypertension increased, while the rates of hypertension awareness, treatment and control decreased by 0 7, 29 2 and 37 5 percentage, respectively. In rural females, all risk factors were changed unfavorably, except smoking rate. Conclusions Unfavorable trends were found in several CVD risk factors in urban and rural populations of Beijing during 1984-1993. It is suggested that more attention should be paid to rural population in CVD prevention, since its risk factor level is higher and it increases faster.