高血压家族史与超重/肥胖对高血压患病交互作用

Interactive effect of family hypertension history and overweight/obesity on hypertension in an occupational population

目的了解高血压家族史与超重/肥胖对高血压患病的交互作用,为高血压的防治提供参考依据。方法于2017年9-12月采用普查的方法对北京市某科研院所的1250名在职职工进行问卷调查和体格检查;应用logistic回归模型分析高血压家族史和超重/肥胖与高血压发病风险的关联强度,并采用相加作用模型分析其交互作用。结果北京市某科研院所1250名职工中,患高血压者273例,高血压患病率为21.84%;有60.80%(760/1250)的职工有高血压家族史,有48.72%(609/1250)的职工超重/肥胖。在调整了性别、年龄、文化程度、家庭月收入、吸烟、饮酒和睡眠时间等混杂因素后,多因素非条件logistic回归分析结果显示,有高血压家族史者患高血压的风险为无高血压家族史者的2.59倍(OR=2.59,95%CI=1.38~4.84),超重/肥胖者患高血压的风险为正常体重者的3.21倍(OR=3.21,95%CI=1.66~6.21),有高血压家族史且超重/肥胖者患高血压的风险为无高血压家族史且非超重/肥胖者的7.64倍(OR=7.64,95%CI=4.21~13.89)。交互作用分析结果显示,高血压家族史及超重/肥胖的交互作用超额相对危险度、交互作用归因比和交互作用指数分别为2.85(95%CI=0.35~5.35)、0.37(95%CI=0.13~0.62)和1.75(95%CI=1.06~2.89),纯交互作用归因比为42.8%,即高血压家族史和超重/肥胖对高血压患病具有相加交互作用。结论有高血压家族史和超重/肥胖均可增加高血压的患病风险,且两者的交互作用增加了患高血压的风险。

Objective To examine the interactive effect of family hypertension history and overweight/obesity on hypertension and to provide references for hypertension prevention and treatment. Methods We conducted a questionnaire interview and physical examination among all employees (n = 1 250) in a science research institute in Beijing city from September to December 2017. Logistic regression model was adopted to analyze the correlation between family history of hypertension and overweight/obesity and additive model was used to analyze the interaction between the two variables. Results Among all the employees, 273 hypertensives were identified and the hypertension prevalence rate was 21.84%. Of the employees, 60.80%(760) reported a family history of hypertension and 48.72%(609) were assessed with overweight/obesity (with the body mass indexes of ≥ 24.0 kg/m2). After adjusting for potential confounding factors such as age, sex, monthly income, education, smoking alcohol, drinking, and sleeping time, multivariate logistic regression analyses revealed that the participants with family history of hypertension had a 2.59 times higher risk of hypertension (odds ratio [OR]= 2.59, 95% confidence interval [95% CI]: 1.38-4.84) than those without the history;the participants with overweight/obesity had a 3.21 times higher risk of hypertension compared to those with normal body weight (OR = 3.21, 95% CI: 1.66-6.21);and the participants with both family history of hypertension and overweight/obesity had a 7.64 times higher risk of hypertension in comparison with those with neither the history nor overweight/obesity (OR = 7.64, 95% CI: 4.21-13.89). Further interaction analysis resulted in following indices for the interactive effect of family history of hypertension and overweight/obesity on hypertension: relative excess risk due to interaction (RERI) of 2.85 (95% CI: 0.35-5.35), attributable proportion (AP) of 0.37 (95% CI: 0.13-0.62), interaction index of 1.75,(95% CI: 1.06-2.89), and pure interaction attributable proportion (AP*) of 42.8%, respectively, indicating an additive interactive effect of the two variables on hypertension. Conclusion Both family history of hypertension and being overweight/obese can increase the risk of hypertension and the interaction between the two variables increases the risk of hypertension.