重庆市社区中老年居民高血压发生情况、流行病学特征及健康管理需求调查

Investigation on the Incidence, Epidemiological Characteristics and Health Management Requirement of Hypertension in Middle-aged and Elderly Community Residents in Chongqing

背景高血压是危害居民身体健康的常见病和多发病,也是导致心脑血管意外的主要病因,其流行病学特征在各地区存在较大差异,并且随时间不断发生变化。因此,适时开展高血压流行病学调查有助于当地高血压的防控和为临床提供数据指导。目的了解重庆市社区中老年居民高血压发生情况、流行病学特征及健康管理需求。方法采用整群抽样法于2019年12月至2020年12月在重庆市梅家梁社区、龙华社区、龙德社区随机抽取45岁以上居民352例为调查对象。对居民进行健康体检,采用自制流行病学调查问卷(主要内容包括性别、年龄、文化程度、体质量、身高、肥胖情况、高血压发生情况、糖尿病发生情况、血脂异常发生情况、高血压家族史、吸烟情况、饮酒情况)和健康管理调查问卷(主要内容包括高血压患者高血压知晓情况、治疗情况、控制情况、自我管理现状和健康管理需求)对其进行调查。结果共发放问卷352份,回收有效问卷331份,有效回收率为94.0%。居民高血压发生率为24.2%(80/331)。高血压患者高血压知晓率为78.8%(63/80),高血压治疗率为57.5%(46/80),高血压控制率为32.5%(26/80)。高血压患者≥60岁者所占比例、肥胖者所占比例、糖尿病发生率、血脂异常发生率、有高血压家族史者所占比例、吸烟率、饮酒率高于非高血压居民(P <0.05)。多因素Logistic回归分析结果显示,≥60岁[OR=4.150,95%CI(1.495,11.521)]、肥胖[OR=3.755,95%CI(1.030,13.689)]、发生糖尿病[OR=3.865,95%CI(1.199,12.455)]、发生血脂异常[OR=4.035,95%CI(1.282,12.700)]、有高血压家族史[OR=3.360,95%CI(1.117,10.110)]、吸烟[OR=3.165,95%CI(1.126,8.890)]、饮酒[OR=3.099,95%CI(1.012,9.489)]是重庆市社区中老年居民发生高血压的独立危险因素(P <0.05)。高血压患者在关注血压、控制吸烟、定期测量血压方面自我管理能力较好,分别占60.0%、57.5%、51.2%,但在知晓高血压的范围及分级、知晓测量血压的注意事项、控制饮酒、锻炼身体、控制情绪、用药依从性、处理药物不良反应方面自我管理能力较差,占比均<50.0%。高血压患者对疾病及用药知识、并发症预防的需求最高,均占76.2%;其次为对心理疏导的需求,占72.5%;再者为对定期评估病情的需求,占63.8%。结论重庆市社区中老年居民高血压发生率为24.2%,高血压知晓率相对较高,而高血压治疗率、控制率相对较低,≥60岁、肥胖、发生糖尿病、发生血脂异常、有高血压家族史、吸烟、饮酒是居民发生高血压的独立危险因素,同时患者自我管理能力普遍偏低,对健康管理需求较高。

Background Hypertension is a common and frequently occurring disease that endangers the health of residents, and is a major cause of cerebrovascular accidents. The epidemiological characteristics of hypertension are totally different in different regions and change constantly over time. Therefore, timely epidemiological investigation of hypertension is conducive to the prevention and control of local hypertension and can provide data guidance for clinical practice. Objective To understand the incidence, epidemiological characteristics and health management requirement of hypertension in middle-aged and elderly community residents in Chongqing. Methods A total of 352 residents over 45 years old were randomly selected as investigation objects from the Meijialiang community, Longhua community, and Longde community in Chongqing from December 2019 to December 2020 by the cluster sampling method. Health examination was conducted on residents, and self-made epidemiological questionnaire(mainly including gender, age, educational level, body mass, height, obesity condition, hypertension, diabetes, dyslipidemia, family history of hypertension, smoking condition and drinking condition) and health management questionnaire(mainly including hypertension awareness, treatment, control, self-management status and health management requirements of hypertension patients) were used for investigations. Results A total of 352 questionnaires were issued, and 331 valid questionnaires were collected with an effective recovery rate of 94.0%. The incidence of hypertension of residents was 24.2%(80/331). The awareness rate of hypertension among hypertension patients was 78.8%(63/80), the treatment rate was 57.5%(46/80), and the control rate was 32.5%(26/80). The proportion of residents over 60 years old, the proportion of obesity, the incidence of diabetes, the incidence of dyslipidemia, the proportion of family history of hypertension, the smoking rate and the drinking rate in hypertension patients were higher than those of non-hypertension residents(P < 0.05). Multivariate Logistic regression analysis showed that ≥ 60 years old [OR=4.150, 95%CI(1.495, 11.521) ], obesity [OR=3.755, 95%CI(1.030, 13.689) ], diabetes [OR=3.865, 95 %CI(1.199, 12.455) ], dyslipidemia [OR=4.035, 95%CI(1.282, 12.700) ], family history of hypertension [OR=3.360, 95%CI(1.117, 10.110) ], smoking [OR=3.165, 95%CI(1.126, 8.890) ], drinking [OR=3.099, 95%CI(1.012, 9.489) ] were independent risk factors for the development of hypertension in middle-aged and elderly residents in Chongqing community(P < 0.05). Patients with hypertension had good self-management ability in paying attention to blood pressure, controlling smoking and measuring the blood-pressure regularly, accounting for 60.0%, 57.5%, 51.2%, respectively, but had poor self-management ability in knowing the range and grade of blood pressure, knowing cautions in blood pressure measurement, controlling drinking, exercising, controlling emotion, medication compliance and dealing with adverse drug reactions, accounting for less than 50.0%. Patients with hypertension had the highest demand for disease and medication knowledge, and the prevention of complications, both accounting for 76.2%;the second is the need for psychological counseling, accounting for 72.5%;and the need for regular assessment of the condition, accounting for 63.8%. Conclusion The incidence of hypertension among middle-aged and elderly residents in Chongqing community is 24.2%. The awareness rate of hypertension is relatively high, while the rate of treatment and control of hypertension is relatively low. ≥ 60 years old, obesity, diabetes, dyslipidemia, family history of hypertension, smoking and drinking are independent risk factors for hypertension in residents. At the same time, the self-management ability of patients is generally low, and their requirement for health management is relatively high.