北京局部地区农村老年高血压患者危险分层评估

Assessment of risk stratification in elderly patients with hypertension in rural areas of Beijing

目的：对北京局部地区农村老年高血压患者危险分层进行评估，为采取强化措施降低靶器官损害提供依据。方法2012年4月～9月间，调查北京大兴长子营地区农村60岁以上确诊高血压患者2223例。通过问卷调查获得患者合并糖尿病、吸烟、心脑血管疾病等情况，通过体格检查和实验室检查获得患者体重指数、血压、血糖、血脂、血尿酸等数据。按照我国高血压防治指南标准进行危险分层的评估。结果2223例农村高血压患者中极高危患者1094例，占49.2%；高危患者637例，占28.65%；中危患者475例，占21.4%；低危患者17例，占0.76%。合并其他心血管病危险因素多，其中血脂紊乱比率高达60.0%，超重和肥胖者高达60%以上。合并糖尿病和心脑肾靶器官损害比率高，其中合并糖尿病比率达25.78%，合并心脏疾病占13.99%，合并脑血管病占15.02%，合并肾脏疾病占3.46%。结论北京局部地区农村老年高血压患者合并心脑血管危险因素多、合并症多、心脑血管事件风险大。除控制血压外，调整血脂、血糖，合理膳食和改变生活方式尤为重要。

Objective To assess the risk stratification in elderly patients with hypertension in rural areas of Beijing. Methods From Apr. 2012 to Sept. 2012, 2 223 elderly patients （over 60 years old） with hypertension were surveyed. The status of diabetes, smoking and cardiovascular diseases were collected from the patients by using questionnaire, and the data of BMI, blood pressure （BP）, blood glucose, blood fat and blood uric acid （BUA） was collected through body examination and laboratory tests. All data was given assessment of risk stratification according to the Chinese Guideline for the Management of Hypertension. Results Among 2 223 patients, there were 1 094 （49.2%） in very high risk, 637 （28.65%） in high risk, 475 （21.4%） in medium risk, and 17 （0.76%） in low risk. The other cardiovascular risk factors were more and dyslipidemia accounted for 60.0%, and overweight and obesity reached over 60%. The percentage of patients with complicating diabetes and heart-brain-kidney target organ damage was higher, and diabetes reached 25.78%, heart disease, 13.99%, cerebrovascular diseases, 15.02%, and renal diseases, 3.46%. Conclusion The elderly patients with hypertension in rural areas of Beijing have more risk factors of cardiovascular and cerebrovascular diseases, more complications and higher risk of cardiovascular and cerebrovascular events. It is important for them to control BP, blood fat, blood glucose, diet and lifestyle.