上海市社区高血压患者缺血性脑卒中累积发病及其影响因素

Cumulative incidence and influence factors of ischemic stroke in hypertension patients in Shanghai community

【目的】探讨上海市社区管理高血压患者缺血性脑卒中累积发病及其影响因素。【方法】2008年10月建立上海市社区高血压患者队列。采用多阶段整群抽样法,在全市46个社区中招募到12 340名高血压患者。对高血压队列人群进行为期5年(2008年10月—2013年12月)的跟踪随访,观察缺血性脑卒中的发病情况。【结果】上海市35～75岁社区高血压患者缺血性脑卒中5年累积发病率为1 572.12/10万。高血压患者发生缺血性脑卒中的主要影响因素为年龄(OR=1.084,95%CI 1.062～1.106)、高血压病程(OR=1.021,95%CI 1.008～1.034)、吸烟(OR=1.774,95%CI 1.286～2.448)及低密度脂蛋白胆固醇增高(OR=1.284,95%CI 1.107～1.490)。【结论】上海市社区高血压患者缺血性脑卒中5年累计发病率较高,年龄大、高血压病程长、吸烟、低密度脂蛋白胆固醇增高的高血压患者是缺血性脑卒中预防控制的重点人群。

[Objective] To explore the cumulative incidence and influence factors of ischemic stroke in hypertension patients in Shanghai communities.[Methods] A cohort of hypertension patients from Shanghai communities was established in October 2008. By multi-stage cluster sampling 12 340 patients with hypertension in 46 communities of Shanghai.The incidence of ischemic stroke was observed in the cohort during a 5-year follow-up from October 2008 to December 2013 were recruited.[Results] The 5-year cumulative incidence of ischemic stroke was 1 572.12/10 5 in hypertension patients aged from 35 to 75 in Shanghai community.The major risk factors of ischemic stroke in hypertension patients were age( OR=1.084,95%CI 1.062~1.106 ),course of hypertension( OR=1.021,95%CI 1.008~1.034 ),smoking( OR=1.774,95%CI 1.286~2.448 ) and low density lipoprotein increased( OR=1.284,95%CI 1.107~1.490 ).[Conclusion] The 5-year cumulative incidence of ischemic stroke is high in hypertension patients in Shanghai communities.Hypertension patients with old age,long course of hypertension,smoking and low density lipoprotein increased are the key population for prevention of ischemic stroke.