黑龙江省克山病历史重病区居民高血压患病率、知晓率、治疗率和控制情况分析

Prevalence, awareness, treatment, and control of hypertension among residents in the severe historical endemic areas of Keshan disease in Heilongjiang Province

目的 调查黑龙江省克山病历史重病区居民高血压患病率、知晓率、治疗率、控制率，为病区弱势人群高血压防控提供科学依据。方法 2015年12月，采用横断面研究方法，选择黑龙江省齐齐哈尔市富裕县繁荣乡作为调查乡，选取克山病历史重病区永进村的永进、永利，丰年村的丰年、丰田和丰富共5个自然村作为调查点，采用整群抽样方法选择18岁以上常住居民作为调查对象。通过问卷调查收集调查对象一般人口学、危险因素、高血压相关信息；通过体格检查收集调查对象血压、身高、体重等指标。血压测量使用欧姆龙HEM-1020上臂式电子血压计，诊断以《中国高血压防治指南》（2010修订版）为标准。结果 共调查克山病病区居民683人，其中669人为有效调查数据，高血压患病率为49.2%（329／669），标化患病率为37.9%，男性患病率［58.0%（164／283）］高于女性［42.7%（165／386），χ2 = 15.103，P 〈 0.01］，患病率有随年龄增加而升高的趋势（总体、男性、女性：χ2趋势 = 9.044、4.560、7.789，P均 〈 0.01）。高血压知晓率为60.8%（200／329），标化知晓率为41.2%，男性患者知晓率［54.3%（89／164）］低于女性患者［67.3%（111／165），χ2 = 5.836，P 〈 0.05］，知晓率有随年龄增加而升高的趋势（总体、男性、女性：χ2趋势 = 3.638、2.686、2.419，P均 〈 0.05）。高血压治疗率为51.1%（168／329），男性患者治疗率［43.9%（72／164）］低于女性患者［58.2%（96／165），χ2 = 6.711，P 〈 0.05］，治疗率有随年龄增加而升高的趋势（总体、男性、女性：χ2趋势 = 4.422、2.704、3.633，P均 〈 0.01）。高血压控制率为5.5%（18／329），服药控制率为10.7%（18／168）。结论 黑龙江省克山病历史重病区居民高血压标化患病率高于全国平均水平（25.2%），标化知晓率低于全国平均水平（46.5%），治疗率、控制率偏低，需要进行全面干预。

Objective To describe the status of prevalence, awareness, treatment, and control of hypertension among the residents in severe historical endemic areas of Keshan Disease in Heilongjiang Province, and to provide scientific evidence for prevention and control of hypertension. Methods In December 2015, Yongjin, Yongli groups of Yongjin Village, and Fengnian, Fengtian, Fengfu groups of Fengnian Village in Fanrong Township, Fuyu County, Qiqihaer City, Heilongjiang Province were selected via the cross-sectional method. The residents aged 18 years or older were surveyed as respondents by cluster sampling. Demography, risk factors, hypertension related information were collected through questionnaire survey. Blood pressure, height and weight were measured through physical examination. Blood pressure measurement was conducted with Omron HEM-1020 electronic sphygmomanometer, the diagnostic criteria was ＂Chinese Guidelines for Prevention and Treatment of Hypertension＂ （revised in 2010）. Results Totally 683 residents were surveyed, the valid participants were 669, the prevalence of hypertension was 49.2% （329/669）, the standardized prevalence was 37.9%, the prevalence of men [58.0% （164/283）] was higher than that of women [42.7% （165/386）, χ2 = 15.103, P 〈 0.01], the prevalence increased with increasing age （total, men, women： χ2tendency = 9.044, 4.560, 7.789, all P 〈 0.01）. The awareness of hypertensive patients was 60.8% （200/329）, the standardized awareness was 41.2%, the awareness of men [54.3% （89/164）] was lower than that of women [67.3% （111/165）, χ2 = 5.836, P 〈 0.05], the awareness of hypertensive patients increased with increasing age （total, men, women： χ2tendency = 3.638, 2.686, 2.419, all P 〈 0.05）. The treatment of hypertensive patients was 51.1% （168/329）, the treatment of men [43.9% （72/164）] was lower than that of women [58.2% （96/165）, χ2 = 6.711, P 〈 0.05], the treatment of hypertensive patients increased with increasing age （total, men, women： χ2tendency = 4.422, 2.704, 3.633, all P 〈 0.01）. The control rate of hypertensive patients was 5.5% （18/329）, the control rate among the treatment was 10.7% （18/168）. Conclusions The standardized prevalence of hypertension among the residents of the severe historical endemic areas of Keshan disease in Heilongjiang Province is higher than the national average （25.2%）, the standardized awareness is lower than the national average （46.5%）, the treatment and the control are low. We should pay more attention to the hypertension in the severe historical endemic areas of Keshan disease.