上海市杨浦区中老年人打鼾与高血压患病的关系探讨

Relationship between snoring and hypertension in middle-aged and elderly residents in Yangpu District,Shanghai

【目的】探讨上海市杨浦区居民打鼾与高血压的患病关系。【方法】分析数据来源于国家心血管病中心2017年在杨浦区开展的“心血管病高危人群早期筛查与综合干预”项目,该项目以社区为单位,对35~75岁常住居民进行问卷调查、体格检查和实验室检查。采用logistic回归模型分析打鼾对高血压患病的影响。【结果】最终纳入11100名调查对象,男性自报打鼾者占48.12%,高于女性的36.21%(χ^(2)=137.70,P<0.01)。调查对象偶尔打鼾、经常打鼾和天天打鼾者分别占14.67%(1628/11100)、7.59%(843/11100)和17.50%(1943/11100),并且随着打鼾频率的增加,高血压患病率逐渐增高(年龄≤60岁人群:男性,χ^(2)_(趋势性)=51.83,P<0.01;女性,χ^(2)_(趋势性)=95.01,P<0.01。年龄>60岁人群:男性,χ^(2)_(趋势性)=9.22,P<0.01;女性,χ^(2)_(趋势性)=27.10,P<0.01)。多因素logistic回归分析发现,在年龄≤60岁人群中,与不打鼾者相比,调整文化程度、家庭年总收入、吸烟、饮酒、糖尿病、体重指数和腰围后,不同打鼾频率与高血压均相关,其中男性偶尔打鼾者的OR值(95%CI)为1.95(1.36,2.80),经常打鼾者的OR值(95%CI)为1.55(1.04,2.31),天天打鼾者的OR值(95%CI)为1.92(1.43,2.59);女性偶尔打鼾者的OR值(95%CI)为1.31(1.08,1.59),经常打鼾者的OR值(95%CI)为1.41(1.07,1.88),天天打鼾者的OR值(95%CI)为1.63(1.32,2.00)。在年龄>60岁人群中,调整文化程度、家庭年总收入、吸烟、饮酒、糖尿病、体重指数和腰围后,不同打鼾频率与高血压无关,其中男性偶尔打鼾者的OR值(95%CI)为1.31(0.97,1.78)、经常打鼾者的OR值(95%CI)为1.22(0.87,1.73),天天打鼾者的OR值(95%CI)为1.19(0.94,1.73);女性偶尔打鼾者的OR值(95%CI)为1.06(0.87,1.29),经常打鼾者的OR值(95%CI)为1.30(0.99,1.72),天天打鼾者的OR值(95%CI)为1.19(0.97,1.46)。【结论】在≤60岁人群中,打鼾与高血压患病存在关联,应更加注重这一年龄段人群的打鼾监测,以早期发现高血压。

[Objective]To explore the relationship between snoring and hypertension in middle-aged and elderly residents in Yangpu District,Shanghai.[Methods]The data of this study were obtained from the project of“early screening and comprehensive intervention for high-risk of cardiovascular diseases”carried out by the National Cardiovascular Disease Center in Yangpu District in 2017.Questionnaire survey,physical examination and laboratory test were conducted among permanent residents aged 35‒75 years.Logistic regression model was used to analyze the influence of sleep snoring on hypertension.[Results]A total of 11100 people with complete data were included in the analysis,The selfreported snoring rate of male was significantly higher than female(48.12%vs 36.21%,χ^(2)=137.70,P<0.01).The proportion of self-reported occasional snoring,frequent snoring and daily snoring were 14.67%(1628/11100),7.59%(843/11100)and 17.50%(1943/11100),respectively,and the prevalence of hypertension gradually increased with the increase of snoring frequency(≤60 years,male:χ^(2)_(trend)=51.83,P<0.01;female:χ^(2)_(trend)=95.01,P<0.01;>60 years,male:χ^(2)_(trend)=9.22,P<0.01;female:χ^(2)_(trend)=27.10,P<0.01).Multivariate logistic regression analysis showed that in people aged≤60 years,both men and women,snoring frequency was significantly associated with hypertension after adjusting for education,total family income,smoking,alcohol consumption,diabetes,body mass index(BMI)and waist circumference.In the males:occasional snoring OR(95%CI)was 1.95(1.36,2.80),frequent snoring OR(95%CI)was 1.55(1.04,2.31),daily snoring OR(95%CI)was 1.92(1.43,2.59).In the females:occasional snoring OR(95%CI)was 1.31(1.08,1.59),frequent snoring OR(95%CI)was 1.41(1.07,1.88),daily snoring OR(95%CI)was 1.63(1.32,2.00).But in people aged>60 years,the significant association between snoring frequencies and hypertension did not exist,after adjusting for education,total family income,smoking,alcohol consumption,diabetes,BMI and waist circumference.In the males:occasional snoring OR(95%CI)was 1.31(0.97,1.78),frequent snoring OR(95%CI)was 1.22(0.87,1.73),daily snoring OR(95%CI)was 1.19(0.94,1.73).In the females:occasional snoring OR(95%CI)was 1.06(0.87,1.29),frequent snoring OR(95%CI)was 1.30(0.99,1.72),daily snoring OR(95%CI)was 1.19(0.97,1.46).[Conclusion]In people≤60 years old,snoring is significantly associated with hypertension,so more attention should be paid to sleep snoring monitoring in middle-aged people for early detection of hypertension.