郑州地区心血管疾病高危人群高危分型、风险等级及预防性药物使用情况调查

Investigation of high-risk classification,risk grade,and prophylactic drug use among high-risk groups of cardiovascular disease in Zhengzhou

目的 分析郑州地区心血管疾病高危人群高危分型、风险等级及预防性药物使用情况。方法 以2021年7月1日至12月31日在郑州大学第一附属医院进行体检并完成心血管科疾病筛查而评估为心血管疾病高危者作为研究对象,由具有执业资格的心血管科医师采用China-PAR模型完成评估,对评估结果为心血管疾病高危者进行预防性药物服用情况调查。采用描述性分析方法对心血管疾病高人群高危现状及预防性药物使用情况进行分析,并采用单、多因素分析方法对预防性药物使用影响因素进行分析。结果 研究共纳入1 684例心血管疾病高危者,男性896例,女性788例;年龄39~75岁,平均(56.9±9.4)岁;BMI为18.2~29.7 kg/m2,平均(22.8±3.1)kg/m2;居住为城镇者920例,农村者764例;吸烟753例;心脑血管病家族史114例。以血压高型者最多(48.28%),1种高危类型者比例最高(86.70%),心血管疾病10年发病中、高风险者占44.77%(754例)。共有233例研究对象遵医嘱需预防性用药,其中服用抗血栓药物者127例(7.54%),服用他汀类药物者106例(6.29%)。不同年龄、心血管病家族史者预防性药物使用情况差异有统计学意义(P<0.05或P<0.01)。不同种类高危类型者预防性药物使用情况差异有统计学意义(P<0.01),4种高危类型者预防性用药率更高;不同高危类型者预防性药物使用情况差异无统计学意义(均P>0.05);不同心血管疾病10年发病风险分层者预防性药物使用情况差异均有统计学意义(均P<0.01),高风险者预防性用药率更高。结论 郑州地区心血管疾病高危人群以单一高危类型者多见,以血压高型、血脂异常型者更多,年龄增加、有心血管病家族史、高危类型种类更多、心血管疾病10年发病风险分层更高者预防性用药率也更高,应根据心血管疾病高危人群个体状况加强健康管理工作,降低心血管病发病风险。

Objective To analyze the high-risk classification,risk grade,and prophylactic drug use among highrisk groups of cardiovascular disease in Zhengzhou.Methods The subjects of the study were those who were assessed as high risk for cardiovascular disease after a physical examination and cardiovascular disease screening in the First Affiliated Hospital of Zhengzhou University from July 1 to December 31,2021.Cardiovascular physicians with professional qualifications completed the assessment using the China-PAR model to investigate the use of prophylactic drugs in those who were assessed as high-risk for cardiovascular disease.The descriptive analysis method was used to analyze the high-risk status of cardiovascular disease high-risk groups and the use of prophylactic drugs,and univariate and multivariate analysis methods were used to analyze the influencing factors of prophylactic drug use.Results A total of 1 684 patients with a high risk of cardiovascular disease were included in the study,including 896 males and 788 females;The age ranged from 39 to75 years,with an average of(56.9±9.4)years;Body mass index(BMI)ranged from 18.2 to 29.7 kg/m2,with an average of(22.8±3.1)kg/m2;920 urban residents and 764 rural residents;753 cases smoked;114 cases of family history of cardiovascular and cerebrovascular diseases.The high blood pressure type was the most(48.28%),one high-risk type was the highest(86.70%),and 44.77%(754 cases)had middle and high 10-year risk of cardiovascular disease.A total of 233subjects were required to take prophylactic drugs according to doctor’s orders,of which 127 cases(7.54%)were taking antithrombotic drugs and 106 cases(6.29%)were taking statins.There were significant differences in the use of prophylactic drugs among people of different ages and family history of cardiovascular disease(P0.05);There were statistically significant differences in the use of prophylactic drugs among people with different 10-year risk stratification of cardiovascular disease(all P<0.01),and the rate of prophylactic drug use was higher in those with high risk.Conclusion The high-risk groups of cardiovascular disease in Zhengzhou are more common in single high-risk type,and more in high blood pressure type and dyslipidemia type.Older age,family history of cardiovascular disease,more high-risk types,and higher 10-year risk stratification of cardiovascular disease is associated with a higher rate of prophylactic drug use.Health management should be strengthened according to the individual status of high-risk groups of cardiovascular disease to reduce the incidence of cardiovascular disease.