中国城乡取暖燃料与高血压患病的相关性分析

The association between heating fuels and hypertension prevalence in China's urban and rural areas

目的:探讨中国城乡地区取暖用燃料种类与高血压患病率的关联。方法:本研究为横断面设计。于2005年至2009年,采用整群抽样在我国12个省(中心)的279个城市社区和农村自然村招募35~70岁的常住居民,进行问卷调查和查体。采集取暖燃料信息,并根据种类分为清洁燃料和固体燃料。高血压的诊断标准采用中国高血压的预防和治疗指南的定义。采用Logistic连接函数的广义线性混合模型进行多因素分析,以校正中心效应,以校正比值比(AOR)展示燃料种类与高血压患病率的关联。结果:本研究共入选47863人社区居民,其中43642人(城市21361人,农村22281人)纳入分析。城市和农村采用固体燃料取暖的比例分别为21.4%和72.5%。城市和农村使用固体燃料与高血压患病的关联分别为1.02(95%CI:0.90~1.15)和1.07(95%CI:0.91~1.26)。城市使用木材取暖与高血压患病有关(AOR=2.3395%CI:1.15~4.69)。而农村使用农作物取暖与高血压患病有关(AOR=1.54,95%CI:1.12~2.13)。结论:固体燃料类型(木材和农作物)可能与高血压患病有关且存在城乡差异。

Objective:We aimed to explore the association between the types of heating fuels and the prevalence of hypertension in China's urban and rural areas.Methods:This study is a cross-sectional design.From 2005 to 2009,cluster sampling was used to recruit participants aged 35-70 in 279 urban communities and rural natural villages in 12 provinces(centers)in China.We collected the types of heating fuels and classified them into clean fuels and solid fuels by questionnaires survey.Hypertension was defined according to the Chinese Guidelines for Prevention and Treatment of Hypertension.The generalized linear mixed model by logistic connection function was used to evaluate the association of heating fuels and hypertension by correcting center effect,and the adjusted odds ratio(AOR)and 95%CI were reported.Results:A total of 47863 participants were enrolled.Among these,a total of 43,642 participants(21361 in urban and 22281 in rural)were included in the analysis.The proportion of solid fuel heating in urban and rural areas were 21.4%and 72.5%.The association of solid fuels for heating and hypertension in urban and rural areas were 1.02(95%CI:0.90-1.15)and 1.07(95%CI:0.91-1.26).However,the use of wood for heating was associated with hypertension(AOR=2.3395%CI:1.15-4.69)in urban,and burning of crops for heating was associated with hypertension(AOR=1.54,95%CI:1.12-2.13)in rural.Conclusions:Solid fuel(Wood and Agriculture/crop)for heating may be associated with hypertension.However,the risk role of fuel type was not consistent in urban and rural areas.