不同类型高血压与代谢异常相关危险因素聚集的关系

The correlation between different types of hypertension and risk factors aggregation related to abnormal metabolism

目的了解不同类型高血压中代谢异常相关危险因素聚集程度的分布,探讨不同类型高血压的危害和防治措施。方法多阶段随机整群抽样方法和KISH表法确定18岁及以上常住居民600人为调查对象,通过问卷调查获得人群基本情况和健康状况,并测量身高、体重、腰围、血压,检测空腹血糖和血脂。结果如皋市18岁及以上人群高血压患病率为51.00%,治疗率为29.74%。不同类型高血压中,单纯舒张期高血压(IDH)患病率为5.83%,占全部高血压患者的11.44%,IDH患者平均年龄最低,为(45.7±9.4)岁;IDH患者中超重率(68.57%)、向心型肥胖率(62.86%)、高甘油三酯率(31.43%)均高于非高血压人群(分别为45.24%、34.69%、14.29%),差异均有统计学意义(P<0.01);代谢相关危险因素(向心型肥胖、血糖异常和高甘油三酯)在IDH患者中聚集程度最高,3个因素中有1个存在和有≥2个因素聚集均与单纯收缩期高血压(ISH)无关联,与IDH、收缩期和舒张期(双期)高血压(SDH)均有关联(P<0.05),与IDH关联度(OR)最高,多因素分析OR分别为3.46和4.35。结论与单纯收缩期高血压相比,IDH存在的危险因素多,危害可能更大,应成为高血压干预的重点人群。

Objective To understand the distribution of the risk factors aggregation degree related to abnormal metabolism in different types of hypertension and to explore the harm and preventive measures for different types of hypertension. Methods The multi-stage random clustering sampling and KISH methods were used to select 600 residents（18 over years old） as the subjects,the investigation was performed with questionnaire and physical examination（height, weight, waistline, blood pressure, fasting blood glucose and blood lipid）. Results The morbidity and treatment rate of hypertension in residents（18 years old） of Rugao city were 51.00% and 29.74%, respectively. The morbidity of isolated diastolic hypertension（IDH） was 5.83%, the proportion of IDH in hypertension patients was 11.44%. The average age in IDH patients was（45.7±9.4） years old, the rates of overweight, central obesity and high triglycerides in IDH patients were 68.57%, 62.86% and 31.43%, respectively, which were significantly higher than those（45.24%, 34.69% and 14.29%） in non-hypertension residents（P0.01）. Aggregation degree of risk factors related to metabolism（central obesity, abnormal blood sugar and high triglycerides） among IDH patients is the highest. Existing one factor and two factors aggregation in three factors were not associated with isolated systolic hypertension（ISH）, but were associated with IDH and SDH（P0.05）, the multivariate analysis indicated that the correlation between existing one factor/two factors aggregation and IDH was the highest（OR： 3.46 and 4.35）. Conclusion Compared with ISH, IDH has more risk factors and may be more harmful. The patients with IDH should become the focus of the intervention of hypertension.