杭州市中老年人群2010—2018年“三高”指标变化趋势分析

Trends in Prevalence,Incidence and Negative Conversion of Hypertension,Fasting Hyperglycemia and Elevated Total Cholesterol in Middle-aged and Elderly Populations from Hangzhou in Even-numbered Years between 2010 and 2018

背景随着居民生活水平的日益提高,社区中老年人群慢性病发病率呈上升趋势,疾病负担加重。目的分析2010—2018年杭州市居民血压正常高值、高血压、空腹血糖增高、总胆固醇增高的患病率、新发率、转归率变化情况,为保障居民健康、实现慢性病健康管理提供科学依据。方法从杭州市闸弄口社区卫生服务中心体检数据库中,获取2010年1月—2018年12月在杭州市闸弄口社区卫生服务中心参加免费体检的50岁以上的中老年人体检资料(包括物理检查、病史询问、特殊检查及实验室检查等),运用Excel软件计算2010年、2012年、2014年、2016年、2018年居民总体、不同性别及不同年龄段(50~59岁、60~69岁、70~79岁、80~89岁)居民“三高”患病率、新发率及转归率。结果杭州市闸弄口街道2018年50~90岁人群的总体人数和分布与2018年体检人群的总体人数和分布相近,因此,本次体检人群能代表该社区中老年人群。2010、2012、2014、2016、2018年参与体检的人数依次为9609人、19727人、13610人、13941人、10801人,其中2010年、2012年均参与体检人数为5578人,2012年、2014年均参与体检人数为7185人,2014年、2016年均参与体检人数为10968人,2016年、2018年均参与体检人数为8580人。2012—2018年,偶数年居民血压正常高值患病率依次为39.95%、38.81%、36.96%、34.33%,高血压患病率依次为27.04%、41.45%、42.94%、38.85%;2010—2018年,偶数年居民空腹血糖增高患病率依次为22.65%、22.40%、26.99%、23.74%、29.01%,总胆固醇增高患病率依次为7.96%、13.76%、4.90%、9.64%、16.05%。2014—2018年,偶数年居民血压正常高值新发率依次为37.78%、36.19%、10.47%,高血压新发率依次为29.72%、26.94%、23.71%;2012—2018年,偶数年居民空腹血糖增高新发率依次为10.84%、13.64%、8.42%、13.82%,总胆固醇增高新发率依次为13.22%、12.27%、17.34%、11.57%。2014—2018年,偶数年居民血压正常高值转归率依次为13.32%、17.83%、21.69%,高血压转归率依次为31.25%、31.51%、38.90%;2012—2018年,偶数年居民空腹血糖增高转归率依次为32.87%、26.36%、32.44%、19.05%,总胆固醇增高转归率依次为39.86%、34.61%、39.33%、36.91%。2014年、2018年男性血压正常高值新发率高于女性(P<0.05);2014年、2016年、2018年男性高血压新发率高于女性(P<0.05);2014年、2016年、2018年男性空腹血糖增高新发率高于女性(P<0.05);2012年、2014年、2016年、2018年男性总胆固醇增高新发率低于女性(P<0.05)。2014—2018年,偶数年50~59岁、60~69岁年龄段居民血压正常高值、高血压新发率逐年上升,而70~79岁、80~89岁年龄段居民血压正常高值、高血压新发率逐年下降。2012—2018年,偶数年50~59岁年龄段居民空腹血糖增高新发率由6.33%增长到19.22%,而80~89岁年龄段居民空腹血糖增高新发率由21.77%下降到8.21%,其余各年龄段变化不大。2012—2018年,偶数年50~59岁年龄段居民总胆固醇增高新发率由6.82%增长到19.18%,而70~79岁年龄段居民总胆固醇增高新发率由20.34%下降到11.62%,其余各年龄段变化不大。结论2010—2018年居民血压正常高值、高血压、空腹血糖增高、总胆固醇增高患病情况不容乐观,总体呈上升趋势,虽然新发率降低,转归率增高,但仍需加强对“三高”的监测和管理。

Background The incidence rates of chronic diseases in middle-aged and elderly people in the community is increasing with the development of society,which aggravate burden of diseases.Objective To analyze the trends in prevalence,incidence and negative conversion rates of prehypertension,hypertension,fasting hyperglycemia,and increased total cholesterol(TC)in even-numbered years between 2010 and 2018 in residents from Hangzhou,to provide a scientific basis for ensuring the health of residents and implementation of chronic disease management.Methods The physical examination data of middle-aged and elderly people over 50 years old who underwent free medical examination from January 2010 to December 2018 were obtained from the physical examination database of the Zhalongkou Community Health Service Center,Hangzhou,including physical measurement,history taking,special examination and laboratory examination.Microsoft Excel was used to calculate the overall,sex-and age(50-59,60-69,70-79,80-89)-specific annual prevalence,incidence and negative conversion rates of prehypertension,hypertension,fasting hyperglycemia,and increased TC among the residents in 2010,2012,2014,2016 and 2018.Results The overall number and distribution of the 50-90-year-old population in Zhalongkou street in 2018 is similar to those of the physical examination population in 2018.Therefore,this group can represent the middle-aged and elderly people in this community.In 2010,2012,2014,2016,and 2018,the number of physical examinees was 9609,19727,13610,13941,and 10801,respectively.The mean number for the physical examinees in 2010 and 2012,2012 and 2014,2014 and 2016,and 2016 and 2018 was 5578,7185,10968,and 8580,respectively.The overall prevalence rates of prehypertension were 39.95%,38.81%,36.96%,34.33%,respectively,in 2012,2014,2016,and 2018.And those of hypertension were 27.04%,41.45%,42.94%,38.85%,respectively.In 2010,2012,2014,2016,and 2018,the overall prevalence rates of fasting hyperglycemia were 22.65%,22.40%,26.99%,23.74%,and 29.01%,respectively.And those of increased TC were 7.96%,13.76%,4.90%,9.64%and 16.05%,respectively.In 2014,2016 and 2018,the overall incidence rates of prehypertension were 37.78%,36.19%,and 10.47%,respectively.And those of hypertension were 29.72%,26.94%,and 23.71%,respectively.In 2012,2014,2016,and 2018,the overall incidence rates of fasting hyperglycemia were 10.84%,13.64%,8.42%and 13.82%,respectively.And those of increased TC were 13.22%,12.27%,17.34%and 11.57%,respectively.In 2014,2016 and 2018,the negative conversion rates of prehypertension were 13.32%,17.83%and 21.69%,respectively,and those of hypertension were 31.25%,31.51%and 38.90%,respectively.In 2010,2012,2014,2016,and 2018,the negative conversion rates of fasting hyperglycemia were 32.87%,26.36%,32.44%and 19.05%,respectively,and those of increased TC were 39.86%,34.61%,39.33%and 36.91%,respectively.Compared with women,men showed higher incidence rates of prehypertension in 2014 and 2018(P<0.05),higher incidence rates of hypertension and fasting hyperglycemia in 2014,2016 and 2018(P<0.05),and higher incidence rates of increased TC in 2012,2014,2016 and 2018(P<0.05).In 2014,2016 and 2018,the overall incidence rates of prehypertension and hypertension increased annually in age groups of 50-59 and 60-69,but decreased annually in age groups of 70-79 and 80-89.The overall incidence rate of fasting hyperglycemia increased from 6.33%in 2012 to 19.22%in 2018 in age group of 50-59,but decreased from 21.77%to 8.21%in age group of 80-89,and showed little changes in other two age groups.The overall incidence rate of increased TC increased from 6.82%in 2012 to 19.18%in 2018 in age group of 50-59,decreased from 20.34%to 11.62%in age group of 70-79,and demonstrated insignificant changes in other two age groups.Conclusion The prevalence of prehypertension,hypertension,fasting hyperglycemia,and increased TC in residents in the community in even-numbered years between 2010 and 2018 was not optimistic,showing an overall increasing trend.Although the incidence rate decreased and the conversion rate increased generally during the period,there is still a need to strengthen the monitoring and management of these diseases.