重庆市老年高血压患者终止高血压膳食现况及其评分与心血管疾病危险因素的关联性研究

Investigation of DASH and analysis of the relationships between DASH scores and cardiovascular risk factors in elderly hypertensive patients in Chongqing

目的:了解重庆市老年高血压患者终止高血压膳食(dietary approaches to stop hypertension,DASH)评分现况,探讨DASH评分与主要心血管疾病危险因素的关系。方法:2016年4至6月,随机抽取重庆市的2个城区,再从2区中各随机抽取1个卫生服务站作为调查点,采用DASH问卷对前来体检的高血压患者进行问卷调查,并收集体格检查和实验室检测数据。结果:共调查435例重庆老年高血压患者。患者DASH评分的中位数为5.0分,得分范围为2~8分(总分10分),在水果类、奶类、坚果类各条目中得到满分的比例分别仅为1.6%、1.6%、2.5%。单因素方差分析显示不同DASH得分五分位数分组的患者收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、体质指数(body mass index,BMI)、腰围(waist circumference,WC)(P<0.05)。Spearman相关分析显示DASH得分与SBP、DBP、TC、TG、LDL-C、BMI和WC水平均呈负相关(r分别为-0.175、-0.323、-0.532、-0.521、-0.483、-0.169、-0.360,P<0.001),与高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)水平呈正相关(r=0.108,P<0.05)。多元线性回归分析结果显示患者DBP、TC、TG、LDL-C、HDL-C和WC水平与DASH评分关系密切(P<0.05)。结论:重庆老年高血压患者DASH评分较低,DASH评分与心血管疾病危险因素水平有显著的相关性,提高患者DASH评分能降低心血管疾病危险因素的水平。应加强高血压患者DASH干预,改善患者饮食模式,进而降低心血管相关疾病的发生与发展。

Objective ： To assess the dietary approaches to stop hypertension （DASH） scores, and to analyze the relationship between DASH scores and cardiovascular risk factors in elderly hypertensive patients in Chongqing. Methods：Two districts were randomly selected from nine urban districts in Chongqing City. In each district, one community health service station was randomly selected as study site. All the hypertensive who visited those two health service stations during the time from April to June in 2016 were inves- tigated by questionnaire. The data of physical examination and laboratory test were collected. Results ：Totally 435 patients completed this survey with median DASH scores of 5.0 points（the scores ranges from 2 to 8 points and the total scores was 10 points）. The max- imum scores＇ proportion of the items in fruit,milk and nuts were 1.6%, 1.6% and 2.5%,respectively, among the patients. AN OVA analysis showed that the level of systolic blood pressure （SBP）,diastolic blood pressure （DBP）,total cholesterol （TC）,triglyceride （TG）,and low density lipoprotein-cholester （LDL-C） were significantly different in patients with different subgroups of DASH scores （all P〈0.05）. Spearman correlation analysis showed that DASH scores was negatively correlated with SBP, DBP, TC, TG, LDL- C, BMI, WC （r=-0.175, -0.323, -0.532, -0.521, -0.483, -0.169, -0.360,respectively,all P〈0.001）,whereas DASH scores and high density lipoprotein-eholester（HDL-C） were positively correlated （r=-0.108, P〈0.05）. Multiple linear regression analysis showed that the level of DBP, TC, TG, LDL-C, HDL-C, WC were closely related to DASH scores （all P〈0.05）. Conclusion：Elderly hypertensive patients in Chongqing have poor DASH scores. The DASH scores are significantly correlated with the level of cardiovascular disease risk factors. Improving DASH scores can reduce the level of risk factors of cardiovascular disease. DASH interventions should be strengthened to change the dietary pattern of hypertensive patients, and to reduce the cardiovascular risk.