陕西汉中地区农村女性绝经与高血压及单纯性收缩期高血压的关系

Relationship between Female Menopause and Hypertension /Isolated Systolic Hypertension in Rural Districts of Hanzhong in Shaanxi Province

目的分析陕西汉中地区农村女性绝经与高血压和单纯性收缩期高血压(ISH)的关系。方法采用横断面设计,通过随机抽样方法抽取汉中市汉台区9个农业乡镇3030名常住居民进行问卷调查和体格检查,选取所有女性资料进行分析,采用分位数回归探讨绝经对血压的影响,Logistic回归探讨绝经与高血压和ISH的关系。结果调查人群未绝经和已绝经者分别为965、998例,未绝经组平均年龄为(41.0±8.1)岁,已绝经组平均年龄为(58.0±7.1)岁(P<0.001)。绝经前、后的高血压患病率分别为21.9%、49.3%。分位数回归结果显示,绝经对收缩压的影响随着百分位数的增大而增大,当舒张压(DBP)在q≥0.40(DBP=84mmHg,1mmHg=0.133kPa)的任何百分位点上时,绝经者与未绝经者之间的差异均有统计学意义(P<0.05);当q≤0.30(DBP=80mmHg)时,两者差异无统计学意义(P<0.05)。Logistic回归分析结果表明,控制可能的影响因素(年龄、受教育水平、婚姻、职业、高血脂、高血压家族史、锻炼、睡眠质量、看电视、吸烟、被动吸烟、喝酒、体重指数、财富指数和腰围)后,绝经与高血压和ISH的发生呈正相关。结论绝经与高血压和ISH的发生有关,应对农村女性高血压和ISH采取重点防治措施,从而更有效地预防和减少高血压的发生。

Objective To analyze the associations between menopause and hypertension/isolated systol- ic hypertension （ISH） among rural females in Hanzhong, Shaanxi Province, China. Methods In this cross- sectional study, 3030 residents were selected by stratified random sampling and investigated by questionnaire sur- vey and physical examinations. Data of the females were analyzed to explore the impact of menopause on blood pressure by quantile regression and to investigate the associations between menopause and hypertension, ISH,and isolated distolic hypertension （IDH） by logistic regression. Results The number of premenopausal and postmenopausal women was 965 and 998. The average age was （41.0 ± 8.07） years in the premenopausal group and （58.0 ± 7. 12） years in the postmenopausal group （ P 〈 0. 001 ） . The prevalence of hypertension among the premenopausal group and postmenopausal group was 21.9% and 49.3%, respectively. Quantiles regression analysis showed that the impact of menopause on systolic blood pressure increased as the percentile increased. The diastolic blood pressure （I）BP） of the premenopausal group was significantly lower than that in the postmenopa- usal at q≥0.40 （DBP=84 mmHg, 1 mmHg =0. 133 kPa） percentile points （P 〈0.05）, while the differ- ence was not significant at q ≤0. 30 （ DBP - 80 mmHg） percentile points （P 〉 0. 05） . After the potential con- founders including age, education level, marriage, occupational, hyperlipidemia, family history, exercise, sleep, watching TV, smoking, passive smoking, alcohol consumption, body mass index, wealth index, waist circumference were controlled, positive associations were observed between menopause and hypertension/ISH in logistic regression models. Conclusions Menopause is positively related with hypertension/ISH. More effective interventions should be taken to prevent hypertension and ISH among rural women.