H型高血压影响因素分析及健康干预探讨——以北京市某三甲医院体检人群为例

Analysis the Influence Factors of H-type Hypertension and explore of Intervention Methodology——A Study Based on Physical Examination Sample Population in a‘3A’Hospital in Beijing

目的探究体检人群H型高血压的影响因素,并探讨健康干预方法。方法回顾性分析2017年6月―2019年3月在北京某三甲医院体检中心接受健康体检的人员,以调查问卷的方式记录体检者的性别、年龄、吸烟和饮酒偏好等基本信息,所有体检者检测血压、叶酸、维生素B 12(VitB 12)及同型半胱氨酸(Homocysteine,Hcy)指标,根据检测结果将人群分为4组,分别是H型高血压组、单纯高血压组、单纯高Hcy组及正常组。用多因素logistics回归分析H型高血压的影响因素。同时采用spearman相关分析Hcy与叶酸、VitB 12的相关性。结果本研究获得有效数据12315例,H型高血压患者2467例,单纯高血压患者1519例,单纯高Hcy组4206例,正常组4123例。多因素分析结果显示:性别、年龄、BMI、吸烟、饮酒为H型高血压的危险因素,血液叶酸和VitB 12水平是其保护因素(P<0.05)。Spearman相关性结果显示:血液叶酸、VitB 12水平与Hcy呈负相关。结论H型高血压的危险因素有:性别(男性)、年龄(40岁及以上)、不良生活方式(超重肥胖、吸烟、大量饮酒)及维生素(叶酸、VitB 12)缺乏。H型高血压的预防应从单纯高血压和高Hcy血症两方面同时入手,从青年开始,重点关注中年男性及不良生活方式者,定期检测血压和Hcy。干预策略以减重降脂维持健康体重为主,同时戒烟限酒、均衡饮食,适量补充叶酸和VitB 12,必要时服用药物进行综合治疗。

Objective To explore the influencing factors of H-type hypertension in physical examination population,and to explore health intervention methods.Methods This study conducted a retrospective analysis who had taken physical examination in the Physical Examination Center of Hospital X,a‘3A’Hospital(tertiary healthcare in the Chinese structure)in Beijing,from June 2017 to March 2019,The basic information of gender,age,smoking and drinking preference were recorded by questionnaires.Blood pressure,folic acid,vitamin B 12,homocysteine(Hcy)were measured in all subjects.According to the results,the population was divided into four groups:H-type hypertension group,simple hypertension group,simple high Hcy group and normal group.The influence factors of H-type hypertension were analyzed by multi-classification logistic regression,and the correlation of Hcy with folic acid and vitamin B 12(VitB 12)was analyzed by Spearman correlation.Results Among the 12315 subjects,2467 patients with H-type hypertension,1519 patients with simple hypertension,4206 patients with simple high Hcy and 4123 patients with normal Hcy were included.The logistic regression results showed that sex,age,BMI,smoking and drinking were risk factors for H-type hypertension,and blood folic acid and VitB 12 levels were protective factors(P<0.05).Spearman correlation results showed that blood folic acid and VitB 12 levels were negatively correlated with Hcy.Conclusion In conclusion,the risk factors of H-type hypertension include gender(male),age(40 years and above),unhealthy lifestyle(overweight and obesity,smoking,heavy drinking)and vitamin deficiency(folic acid,VitB 12).The prevention of H-type hypertension should start from both simple hypertension and hyperhomocysteinemia.Addressing the young people,and pay special attention to the middle-aged male people,and the people with unhealthy lifestyle,and regularly test blood pressure and Hcy should be conducted.Intervention strategies mainly are as such:lose weight,reduce fat and maintain healthy weight,at the same time,stop smoking and limit alcohol,have a balanced diet,take the supplement of folic acid and VitB 12 appropriately,and take medicine when necessary for comprehensive treatment.