苏州、无锡和常州地区中年男性体检人群理想心血管健康行为和因素的调查分析

The prevalence of ideal cardiovascular health metrics in Southeast Chinese middle-aged men

目的 调查苏州、无锡和常州（简称：苏锡常）地区中年男性体检人群理想心血管健康行为和因素的分布状况,并探讨健康行为和健康因素间的联系.方法 采用横断面研究方法,选择2014年1月1日至2015年6月30日在江苏省太湖康复医院健康体检的中年男性27 824名作为研究对象,以美国心脏协会（AHA）理想心血管健康的界定为标准,分析该地区成人理想心血管健康的分布,并采用x2检验和方差分析分析健康行为和健康因素间的联系.结果 入选对象平均体重指数为（25.1±3.0）kg/m2,腰围为（87.3±8.4） cm,具有全部7项理想心血管健康指标者仅有133例（0.5％）,处于理想状态的比例由高到低依次为总胆固醇19 056例（68.5％）,其次为空腹血糖18 616例（66.9％）、体重指数13 963例（50.2％）、身体活动12 697例（45.6％）、吸烟11 216例（40.3％）、血压6 257例（22.5％）和食盐摄入4 351例（15.6％）.随着年龄增长,心血管健康状态处于良好者的比例逐渐降低、处于不良者的比例逐渐增高（x^2=106.746,P=0.000）.不吸烟者总胆固醇低于吸烟者（F=8.571,P=0.000）.总胆固醇、收缩压、舒张压和空腹血糖均随体重指数的增加而增高（F值分别为94.619、1 194.244、1 048.664和336.975,P均＜0.01）.经常活动者总胆固醇、空腹血糖低于不活动者（F值分别为16.953和11.933,P均＜0.01）.高食盐摄入者总胆固醇、收缩压和舒张压均高于低食盐摄入者（F值分别为21.300、13.754和13.934,P均＜0.01）.结论 苏锡常地区中年男性健康体检人群心血管健康处于理想状态的比例较低,且随着年龄的增加呈现下降趋势.吸烟、超重或肥胖、高食盐摄入和血压控制不良是该研究人群的主要心血管健康危险因素.

Objective To observe the prevalence and distribution of ideal cardiovascular health metrics in middle-aged men living in Su-Xi-Chang region and explore the relationship between health behavior and health factors.Methods A total of 27 824 middle-aged men,who took part in health examination in the Center for Healthcare Management,Taihu Rehabilitation Hospital of Jiangsu Province from January 2014 to June 2015,were enrolled in this cross-sectional study.The ideal cardiovascular health metrics were defined by the American Heart Association criteria with minor modification in that the amount of vegetable intake was replaced by salt intake.The prevalence and distribution of ideal cardiovascular health metrics as well as the association between ideal cardiovascular health metrics and health factors were analyzed in this cohort.Results The body mass index in the whole cohort was （25.1 ± 3.0） kg/m^2,waist circumference was （87.3 ± 8.42） cm;the percent of subjects with all seven ideal cardiovascular health metrics was only 0.5% （n =133）.The highest proportion of ideal metric was total cholesterol （68.5%,n =19 056）,followed by fasting glucose （66.9%,n =18 616）,body mass index （50.2%,n =13 963）,physical exercise （45.6%,n =12 697）,smoking （40.3%,n =11 216）,blood pressure （22.5%,n =6257） and salt intake （15.6%,n =4 351）.The proportion of ideal cardiovascular health metrics reduced gradually and the proportion of poor cardiovascular health metrics status increased gradually with aging（x2 =106.746,P =0.000）.The total cholesterol level of non-smokers was significantly lower than that of smokers （F =8.571,P =0.000）;total cholesterol,blood pressure and fasting glucose levels increased in proportion with increasing body mass index（all P 〈 0.01）;total cholesterol and fasting blood glucose of subjects with regular active physical exercise were significantly lower than those with inactive physical exercise （all P 〈 0.01）;total cholesterol and blood pressure of subjects with high salt intake were significantly higher than those with low salt intake （all P 〈 0.01）.Conclusions The proportion of subjects with ideal cardiovascular health metrics is very low in middle-aged men living in Su-Xi-Chang region,and the downtrend with poor cardiovascular health metrics increases with aging.Overweight or obese,smoking,high salt diet and poor control of blood pressure are the major cardiovascular risk factors in this cohort.