高血压与腹型肥胖聚集对心血管病的归因疾病负担研究

The Attributable Disease Burden of Hypertension and Abdominal Obesity Together to Cardiovascular Disease

目的分析高血压、腹型肥胖聚集对心血管病事件的归因疾病负担。方法选取中国高血压调查中基线数据和队列数据,共纳入22754名35岁及以上无心血管病史的调查对象,于2018年—2019年随访心血管事件。利用Cox比例风险模型对高血压、腹型肥胖聚集与心血管病事件的风险比(HR)和95%置信区间(95%CI)进行分析。基于以上相对危险度,计算归因于高血压、腹型肥胖聚集的心血管病人群归因百分比(PAF),采用Bootstrap方法计算PAF的95%CI。结果以非高血压、腹型肥胖(-)人群为参照组,高血压、腹型肥胖(+)人群发生心血管病、冠心病和脑卒中的HR(95%CI)分别为1.95[1.64,2.32]、2.15[1.58.2.94]和1.90[1.52,2.39]。心血管病归因于高血压、腹型肥胖(+)聚集的PAF(95%CI)为15.45%[10.26%,21.05%],冠心病为18.12%[12.15%,24.40%],脑卒中为14.77%[9.78%,19.60%]。结论加强高血压伴腹型肥胖人群的管理,可降低心血管病的疾病负担。

Objective To analyze the attributable disease burden of hypertension and abdominal obesity together to cardiovascular disease events.Methods A total of 22754 subjects aged 35 years and without cardiovascular history were included in the Chinese Hypertension Survey based on baseline and cohort data.Cardiovascular outcome events were followed up from 2018 to 2019.Hazard ratio(HR)and 95%confidence interval(95%CI)of hypertension,abdominal obesity and cardiovascular events were analyzed by Cox proportional risk model.Based on the above relative risk,the population attributable fraction(PAF)of cardiovascular disease attributed to hypertension and abdominal obesity was calculated,and the 95%CI of PAF was calculated by Bootstrap method.Results Using non-hypertensive and abdominal obesity(-)as the reference group,the HR(95%CI)of cardiovascular disease,coronary heart disease and stroke in hypertensive and abdominal obesity(+)were 1.95[1.64,2.32],2.15[1.58.2.94]and 1.90[1.52,2.39],respectively.The PAF(95%CI)of cardiovascular diseases attributed to hypertension and abdominal obesity(+)was 15.45%[10.26%,21.05%],coronary heart disease was 18.12%[12.15%,24.40%],and stroke was 14.77%[9.78%,19.60%].Conclusion Strengthening the management of hypertension with abdominal obesity was significant to reduce the burden of cardiovascular disease.