东营市城乡40～79岁人群高血压前期患者的现患率及相关危险因素

Prevalence and relative risk factors for prehypertensive patients aged 40–79 years old in urban and rural areas of Dongying City

目的:观察东营市40~79岁人群高血压前期患者的城乡现患率差异。比较及合并不同心血管危险因素时高血压前期患者的城乡分布情况。方法:采取整群随机抽样方法,2015年至2016年对东营市2个社区和2个农村的40~79岁人群进行问卷调查,并测量身高、体重、体重指数、血压,采集清晨空腹静脉血检测空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白、高密度脂蛋白、血同型半胱氨酸。结果:所有完成研究的4 109人中,高血压前期患者1 287人,现患率为31.32%,男性患者582人(31.34%),女性705人(31.31%),性别间差异无统计学意义(χ~2=0.0006,P>0.05)。城市高血压前期现患率为41.63%,农村为20.32%,差异有统计学意义(χ~2=2 1 6.6 2 0,P<0.0 0 1)。高血压前期人群合并高同型半胱氨酸血症的现患率最高,为76.38%,城市现患率低于农村(74.41%v s.8 0.6 9%),差异有统计学意义(χ~2=6.0 7 3 9,P<0.0 5),城市男性与农村男性、城市女性与农村女性之间现患率差异均无统计学意义。高血压前期人群中,城市吸烟率高于农村(36.24%vs.2 7.9 7%),差异有统计学意义(χ~2=8.4 9 1,P<0.0 5);城市女性吸烟率为农村女性的2.3 5倍(2 1.7 6%v s.9.2 5%),差异有统计学意义(χ~2=1 6.5 0 2 8,P<0.0 5)。城市高血压前期合并肥胖人群高于农村(23.67%v s.17.57%),差异有统计学意义(χ~2=6.0491,P<0.05),且城市男性高于农村男性(24.44%v s.1 2.9 9%),差异有统计学意义(χ~2=9.7 4 6 6,P<0.0 5)。高血压前期合并血脂异常、糖代谢异常时,城乡之间差异均无统计学意义(P>0.05)。结论:高同型半胱氨酸血症和血脂异常是高血压前期人群最主要合并的危险因素。应重点干预农村高血压前期合并高同型半胱氨酸血症的居民。高血压前期现患率与日常生活习惯密切相连,因此高血压前期的防治应结合城镇及农村高血压前期的危险因素的流行特征,有针对性的制定防治策略和措施。

Objective： To investigate the prevalence of prehypertensive status as well as the differences of cardiovascular risk factors in prehypertension patients aged 40-79 years old in urban and rural areas in Dongying City. Methods： By cluster sampling method, subjects aged 40-79 years old in two urban areas and two rural areas in Dongying City were studied by questionnaires, physical examinations and blood chemistry tests. Physical examinations included height, weight, BMI and BP. Overnight fasting blood sample were collected to detect fasting glucose, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, and homocysteine. Results： ~he number of patients with prehypertension is 1 287 in the all 4 109 people, lhe overall prevalence ofprehypertensive status was 31.32%, including 582 （31.34%） male and 705 （31.31%） female, which showed no statistical differences （X^2=0.0006, P〉0.05）. The prevalence of prehypertensive status in urban and rural areas were 41.63% and 20.32%, respectively. And it showed a significant difference between these two groups （X^2=216.620, P〈0.001）. When combining the risk factors （one factor each time） with prehypertension, homocysteine is the risk factor that showed the highest prevalence （76.38%）. The prehypertensive population accompanied with homocysteine was higher in rural （80.69%） than in urban （74.41%）, there was statistically significant difference （X^2=6.0739, P〈0.0S）. The prehypertensive population accompanied with smoke was higher in urban （36.24%） than in rural （27.97%）, there was statistically significant difference （X^2=8.491, P〈0.0S）. Among female populations, the prevalence was higher in urban areas （21.76%）, as 2.35 times as that in rural areas （9.25%）, there was statistically significant difference （X^2= 16.5028, P〈0.05）. The prevalence of prehypertension associated with obesity was higher in urban residents （23.67%） than that in rural residents （17.57%）, there was statistically significant difference（X^2=6.0491, P〈0.0S）; urban men （24.44%） were more than rural men （12.99%）, the difference was statistically significant （X^2=9.7466, P〈0.05）. In prehypertensive population associated with dyslipidemia or abnormal carbohydrate metabolism, there were no differences between urban area and rural area. Conclusion： Hyperhomocysteinemia is the most commonly seen risk factor for prehypertensive population, followed by dyslipidemia. Prehypertensive population combined with hyperhomocysteinemia in rural area should be taken into account with earlier intervention. The prevalence of prehypertension is closely related to the living habits. Therefore the prevention of prehypertension should be combined with urban and rural prehypertension epidemiological characteristics of risk factors, making the targeted prevention and control strategies.