文化程度与血压水平的关系:中国心血管病流行病学多中心协作研究

Relationship of Education Attainment to Blood Pressure :A multi-center Cooperative Cardiovascular Epidemiology Study in China

目的 研究不同类型中国人群文化程度与血压水平的关系。方法 分析数据来自 1998年对 15组中年人群 (35～ 5 9岁 )进行的抽样调查 ,包括城市居民、工人、农民和渔民。调查项目均采用国际标准化方法 ,由合作中心进行统一培训、考核和质量控制。资料完整可供分析者共计 15 5 70人。结果 (1)文化程度构成存在显著的年龄差异、性别差异和地区差异。各人群文化程度与SBP、DBP水平的关联方向及强度也各不相同。 (2 )根据文化程度构成将人群分成Ⅰ、Ⅱ两类 ,大专以上学历在人群中所占的比例分别为男性 2 5 .8% (95 %CI:2 4 .2 %～ 2 7.4 % )、2 0 % (95 %CI:1.6 %～ 2 .6 % ) ,女性 11.7% (95 %CI:10 5 %～ 12 .9% )、0 3%(95 %CI:0 2 8%～ 0 32 % )。Ⅰ类人群SBP均值及女性DBP均值随文化程度增加而明显降低 ,Ⅱ类人群男性DBP则随之上升。(3)分析BMI、体力活动强度、业余不活动时间、新鲜水果摄入量、过量饮酒等因素在两类人群中随文化程度变化的趋势 ,发现Ⅰ类人群出现血压保护因素水平上升而有害因素水平下降的趋势 ,Ⅱ类人群则出现相反趋势。结论 中国人群的个体文化程度与血压水平有关 ,其关联方向受人群总体文化程度高低的显著影响。生活方式、膳食模式可能是导致该关联产生的部分中介因素。

Objective To explore the relationship of education attainment to blood pressure among different Chinese populations. Methods Data were collected in 1998 from 15 random samples, including urban residents, enterprise workers, rural residents and fishermen, aged 35～59 years. The survey methods were internationally standardized, all the local investigators were trained and certified by the Coordinating Center. The data of 15570 participants were available for analysis. Results (1)The level of education attainment differed significantly among different groups. The percentage of college or above was much higher in younger group than that in older group, higher in men than in women, and higher in urban area than in rural area. Education attainment was associated with SBP/DBP levels in different directions among populations. (2)The 15 populations were classified into 2 groups, using the method of cluster analysis, according to the proportion of high education attainment. The proportion of college and above education attainment in Group Ⅰwas much higher than that in Group Ⅱ, 25.8%(95%CI: 24.2%～27.4%) vs 2 0%(95%CI: 1.6%～2.6%) for men, 11.7%(95%CI: 10 5%～12.9%) vs 0 3%(95%CI: 0 28%～0 32%) for women, respectively. (3)SBP in both genders and DBP in women were lower significantly in higher education attainment in Group Ⅰ, while higher DBP in men was associated with hihger grade of education in Group Ⅱ. (4) BMI, average hours of physical inactivity per day, and percent of ovenrdrink was decreased with higher education attainment in Group Ⅰ, while increased in Group Ⅱ. However, physical activity intensity increased in GroupⅠ, while decreased in GroupⅡ. Conclusions The results indicate that education attainment is related to blood pressure in Chinese, but the direction of association is influenced by the proportion of high education attainment in the population. Life style and diet pattern may play a role as medium factors.