上海市社区人群高血压危险因素聚集与患病关系的研究

Relationship between the clustering of risk factors and the prevalence of hypertension in the community residents living in Shanghai

目的研究超重与中心型肥胖、家族遗传史、不适量饮酒、吸烟、血脂异常和高血糖6项危险因素的聚集与高血压患病问的关系。方法利用2008-2011年对15158名35～74岁上海市社区居民进行的心脑血管疾病社区综合防治研究项目数据，采用单因素和多因素统计方法，描述危险因素聚集与高血压之间的相关性，使用纵向队列进一步对因果关系进行探讨。结果基线调查高血压总现患率为41．9％。随着高血压危险因素聚集数目的增加，与高血压患病关联的OR值（按年龄调整）增大。聚集数目为1。5项及以上的男性其OR值依次为3．157（95％CI：2．152—4．630）、6．428（95％CI：4．435～9．319）、11．797（95％CI：8．135—17．105）、19．723（95％CI：13．414～29．000）、33．051（95％CI：21．449—50．930），聚集数目为1～4项的女性其OR值依次为2．917（95％CI：2．374～3．585）、6．499（95％CI：5．307～7．959）、15．717（95％CI：12．609～19．591）、31．719（95％CI：21．744～46．270）。在纵向队列中，男性和女性的2年发病率分别为1．9％和1．6％。同无危险因素人群相比，聚集数目较多的人群2年发病率较高，女性中当聚集数目为2及3项时其RR值分别为2．111（95％CI：1．024～4．350）、3．000（95％CI：1．287～6．995），差异有统计学意义。结论随着危险因素聚集数目的增加，高血压患病风险升高，应对危险因素进行综合防控。

Objective To study the association between the clustering manifestation of factors as overweight and central obesity, family heredity, immoderate alcohol drinking, tobacco smoking, hyperlipidemia, hyperglycemia and the prevalence of hypertension. Methods Data was from a program related to the comprehensive prevention and control strategies on cardiac-cerebral vascular disease carried out in the communities of Shanghai, to describe the relationship between the clustering of risk factors and hypertension. This program included 15 158 people with complete data at the age of 35-74, from 2008-2011. Both single factor and multi-factor analysis were used and longitudinal study was performed to further explore the causal relationship. Results The overall prevalence of hypertension at the baseline survey was 41.9%. The associated ORs （age-adjusted） of hypertension parallelly increased with the number of risk factors under clustering. The associated OR of the males with 1, 2, 3, 4 as well as 5 and above risk factors were 3.157 [95% confidence interval （CI） ： 2.152-4.630] ,6.428（95%CI：4.435-9.319）, 11.797（95%C1： 8.135-17.105）, 19.723（95%CI： 13.414- 29.000） ,33.051 （95%CI：21.449-50.930） respectively. In females with 1,2,3 as well as 4 risk factors, the associated ORs were 2.917 （95%CI： 2.374-3.585）, 6.499 （95%CI： 5.307-7.959）, 15.717 （95%CI： 12.609-19.591 ） and 31.719 （95% CI： 21.744-46.270）, respectively. For longitudinal study, the 2-year incidence of hypertension in males and females were 1.9% and 1.6%, respectively. Compared to those people without risk factors, the incidence was higher in the people with a larger number of clustering. When the clustering number reaching 2 or 3 in females, the relative risk （RR） were 2.111 （95%CI： 1.024-4.350） and 3.000 （95%CI： 1.287-6.995） respectively, with statistically significant difference. Conclusion The risk of hypertension parallelly increased with the clustering number of relevant risk factors. Comprehensive prevention and control on related risk factors was required.