昆山市居民高血压患病率、知晓率、服药率和服药控制率及其影响因素分析

Morbidity, awareness, treatment and control rates of hypertension and influencing factors in Kunshan residents

目的了解昆山市2016年居民高血压患病率、知晓率、服药率及服药控制率及其影响因素,为昆山地区高血压社区综合防治提供依据。方法于2016年7-10月,采用多阶段整群随机抽样法抽取江苏省昆山市18~69岁常住居民8 529名进行问卷调查与体格检查。样本数据通过复杂加权后,估计高血压患病率、知晓率、服药率及服药控制率在一般特征变量之间的分布特征。采用SAS 9.3进行多因素logistic回归,分析高血压患病情况、知晓情况、服药情况及服药控制情况的影响因素。结果 2016年昆山市18~69岁常住人口高血压患病率为16.28%(95%CI:15.18%~17.37%),其中男性高血压患病率为19.47%(95%CI:17.72%~21.22%),女性高血压患病率为13.59%(95%CI:12.21%~14.97%)。高血压知晓率、服药率以及服药控制率分别为64.28%(95%CI:60.81%~67.74%)、50.66%(95%CI:47.06%~54.27%)、62.81%(95%CI:57.87%~67.74%)。调整混杂因素之后,男性(OR=1.72,95%CI:1.44~2.05)、小学及以下教育程度(OR=1.73,95%CI:1.05~2.86)、较高的BMI水平(BMI 24.0~<28.0 kg/m2,OR=3.99,95%CI:1.98~8.06;BMI≥28.0 kg/m2,OR=9.41,95%CI:4.53~19.56)和高腰臀比(OR=2.12,95%CI:1.76~2.56)与高血压患病存在关联;高腰臀比与高血压不知晓(OR=0.64,95%CI:0.46~0.89)、高血压未服药(OR=0.67,95%CI:0.53~0.85)及高血压服药未控制(OR=1.45,95%CI:1.04~2.03)之间存在关联。结论昆山市2016年18~69岁常住居民中高血压患病率较高,但高血压知晓率、服药率及服药控制率相对较低,应该采取有针对性的综合措施,应对高血压所造成的疾病负担。

Objective To investigate the morbidity, awareness, treatment and control rates of hypertension in Kunshan residents,and to provide the basis of preventing and treating measures for communities. Methods During July to October of 2016, the multistage cluster random sampling method was used to select 8 529 permanent residents（18-69 years old） in Kunshan as the subjects.The investigation was performed with questionnaire and physical examination. After being weighted according to complex sampling scheme and post-stratification, the sample data were used to estimate the morbidity, awareness, treatment and control rates of hypertension.Rao-Scott χ^2 test, Cochran-Armitage test and multiple factor logistic regression method were used to analyze the influencing factors for the morbidity, awareness, treatment and control rates of hypertension. Results In 2016, the hypertension morbidity of permanent residents（18-69 years old） in Kunshan was 16.28%（95% CI： 15.18%-17.37%）, the hypertension morbidities of males and females were 19.47%（95%CI： 17.72%-21.22%） and 13.59%（95%CI： 12.21%-14.97%）, respectively.The awareness, treatment and control rates of hypertension were 64.28%（95%CI： 60.81%-67.74%）, 50.66%（95%CI： 47.06%-54.27%）, 62.81%（95%CI： 57.87%-67.74%）, respectively.After adjusting confounding factors,male（OR=1.72, 95%CI： 1.44-2.05）, low educational levels（OR=1.73, 95%CI： 1.05-2.86）, high BMI（BMI 24.0-〈28.0 kg/m^2, OR=3.99, 95%CI： 1.98-8.06;BMI ≥28.0 kg/m^2, OR=9.41, 95%CI： 4.53-19.56） and high waist to hip ratio（OR=2.12, 95%CI： 1.76-2.56） were significantly associated with the hypertension.High waist to hip ratio were associated with not awareness of hypertension（OR =0.64, 95% CI：0.46-0.89）, not taking anti-hypertension medication（OR=0.67, 95%CI： 0.53-0.85） and not controlling hypertension（OR=1.45, 95%CI： 1.04-2.03）. Conclusion The morbidity of hypertension in permanent residents（18-69 years old） of Kunshan was higher, but the awareness, treatment and control rates remained relatively low. Therefore, it is necessary to take the comprehensive measures of healthy life-style intervene and anti-hypertension medication to reduce the burden caused by hypertension.