郑州市年龄≥18岁居民正常高值血压流行状况与相关危险因素

Epidemiological status of high normal blood pressure and related risk factors in residents aged 18 and over in Zhengzhou city

目的分析2018年郑州市年龄≥18岁居民正常高值血压的流行现状及其影响因素,为预防心血管病提供参考。方法2018年6—11月,采用多阶段随机抽样方法,抽取郑州市年龄≥18岁居民6809人进行问卷调查,并测量身高、体质量、腰围和血压,采集血标本进行血糖及血脂检测。比较不同特征人群正常高值血压检出率。采用多因素logistic回归分析正常高值血压的影响因素。结果2018年郑州市年龄≥18岁居民正常高值血压检出率为35.3%(标化率35.7%),男性高于女性(40.8%比31.4%,χ^(2)=63.227,P<0.001),农村高于城市(39.1%比31.6%,χ^(2)=42.432,P<0.001)。在未诊断为高血压的居民中正常高值血压检出率为49.8%。正常高值血压检出率随年龄增长呈先升后降趋势(χ_(趋势)^(2)55.466,P<0.001),50岁之前上升,50岁之后下降。正常高值血压人群血脂异常率为33.1%,糖代谢异常率为31.0%。多因素logistic回归分析显示,居住在农村(OR=2.305,95%CI 2.028~2.620)、男性(OR=1.934,95%CI 1.695~2.208)、高龄(与18~<30岁相比:40~<50岁OR=1.626,95%CI 1.341~1.971;50~<60岁,OR=1.909,95%CI 1.568~2.325;60~<70岁,OR=1.982,95%CI 1.548~2.538;≥70岁OR=2.661,95%CI 1.882~3.763)、文化程度(与初中以下相比:初中及高中OR=1.825,95%CI 1.553~2.114;大专及以上OR=3.440,95%CI 2.847~4.062)、超重肥胖(与正常体质量相比:超重OR=1.568,95%CI 1.334~1.841;肥胖OR=2.581,95%CI 2.050~3.251)、中心性肥胖(OR=1.247,95%CI 1.061~1.467)、血脂异常(OR=1.209,95%CI 1.041~1.404)、糖尿病前期(OR=1.698,95%CI 1.347~2.140)、糖尿病(OR=1.382,95%CI 1.149~1.663)、吸烟(OR=1.748,95%CI 1.509~2.026)和饮酒(OR=1.279,95%CI 1.126~1.454)均是正常高值血压的危险因素。结论郑州市年龄≥18岁居民正常高值血压处于较高流行水平并存在多种危险因素,且血脂异常和糖代谢异常患病率较高。

Objective To analyze the prevalence and influencing factors of high normal blood pressure in residents aged 18 years and over in Zhengzhou city,so as to provide a reference for the prevention of cardiovascular disease.Methods A multi-stage random sampling method was conducted.From June to November 2018,a total of 6809 residents aged 18 and above in Zhengzhou City were selected for questionnaire survey.The height,weight,waist circumference and blood pressure were measured.Blood samples were collected for blood glucose and blood lipid detection.The prevalence of high normal blood pressure in different characteristic populations was compared.Multivariate logistic regression analysis was used to analyse the influencing factors of high normal blood pressure.Results In 2018,the prevalence of high normal blood pressure in residents aged 18 and over in Zhengzhou city was 35.3%(standardized rate was 35.7%),which was higher in male than in female residents(40.8%vs 31.4%,χ^(2)=63.227,P<0.001),and higher in rural adults than in urban adults(39.1%vs 31.6%,χ^(2)=42.432,P<0.001).Among the adults without history of hypertension,49.8%had high normal blood pressure.The prevalence of high normal blood pressure increased first and then decreased with age(χ^(2)_(trend)=55.466,P<0.001),increased before the age of 50 and decreased after the age of 50.In the subjects with high normal blood pressure,the dyslipidemia rate was 33.1%,and the abnormal glucose metabolism rate was 31.0%.Multivariate logistic regression analysis showed that living in rural areas(OR=2.305,95%CI 2.028-2.620),men(OR=1.934,95%CI 1.695-2.208),old age(compared with 18-<30 years:40-<50 years,OR=1.626,95%CI 1.341-1.971;50-<60 years,OR=1.909,95%CI 1.568-2.325;60-<70 years,OR=1.982,95%CI 1.548-2.538;≥70 years,OR=2.661,95%CI 1.882-3.763),educational level(compared with <middle school:OR=1.825.,95%CI 1.553-2.114 for middle and high school;OR=3.440,95%CI 2.847-4.062 for college),overweight and obesity(compared with normal bodymass:OR=1.568,95%CI1.334-1.841 for overweight;OR=2.581,95%CI 2.050-3.251 for obesity),central obesity(OR=1.247,95%CI 1.061-1.467),dyslipidemia(OR=1.209,95%CI 1.041-1.404),prediabetes(OR=1.698,95%CI1.347-2.140),diabetes(OR=1.382,95%CI1.149-1.663),smoking(OR=1.748,95%CI1.509-2.026)and drinking(OR=1.279,95%CI 1.126-1.454)were risk factors for the prevalence of high normal blood pressure.Conclusions The prevalence of high normal blood pressure in residents aged 18 and over in Zhengzhou is at a high level and is affected by many risk factors.The prevalence of dyslipidemia and abnormal glucose metabolism is relatively high in high normal blood pressure population.