疗养中心老年高血压病人心血管事件发生现状及危险因素分析

Analysis on the status and risk factors of cardiovascular eventsin elderly patients with hypertension in convalescent center

目的:探讨疗养中心老年高血压病人心血管事件发生现状及危险因素。方法:选取老年高血压病人825例,统计心血管事件发生情况,并根据是否发生心血管事件分为心血管事件组、无心血管事件组。收集2组临床资料,分析老年高血压病人心血管事件发生的危险因素。结果:825例老年高血压病人的心血管事件发生率为10.42%(86/825),男女比例为1.53∶1,以70岁及以上为主(46/86,53.49%),包括心绞痛41例、急性心肌梗死24例、慢性心力衰竭13例、心源性死亡8例。心血管事件组与无心血管事件组冠心病史、吸烟、饮酒、心率、脉压、收缩压(SBP)和尿蛋白、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白、低密度脂蛋白(LDL)、纤维蛋白原(FIB)、血尿素氮、尿酸(UA)、同型半胱氨酸(Hcy)、载脂蛋白(ApoA)、肌酐水平差异均有统计学意义(P<0.05~P<0.01);logistic回归分析显示,冠心病史、吸烟、饮酒和SBP、TC、TG、LDL、FIB、UA、Hcy、ApoA异常均为老年高血压病人心血管事件的独立危险因素(P<0.05)。结论:疗养中心老年高血压病人心血管事件发生率偏低,以男性、70岁及以上群体为主,可针对冠心病史、吸烟、饮酒、SBP、TC、TG、LDL、FIB、UA、Hcy、ApoA异常等独立危险因素采取干预措施,降低心血管事件发生风险。

Objective:To explore the status quo and risk factors of cardiovascular events in elderly hypertensive patients in convalescent center.Methods:A total of 825 elderly patients with hypertension were investigated,and the patients were divided into the cardiovascular event group and non-cardiovascular event group according to whether cardiovascular events occurred.The clinical data of all cases were collected to analyze the risk factors of cardiovascular events.Results:The incidence rate of cardiovascular events in 825 elderly patients with hypertension was 10.42%(86/825),the ratio of male to female was 1.53∶1,the majority age of patients was 70 years or above(46/86,53.49%),and the patients included 41 cases of angina pectoris,24 cases of acute myocardial infarction,13 cases of chronic heart failure and 8 cases of cardiogenic death.The differences of the levels of coronary heart disease history,smoking,alcohol consumption,heart rate,pulse pressure,SBP and urinary protein,TC,TG,HDL,LDL,FIB,BUN,UA,Hcy,ApoA and Cr between two groups were statistically significant(P<0.05 to P<0.01).The results of logistic regression analysis showed that the history of coronary heart disease,smoking,alcohol consumption,and abnormalities of SBP,TC,TG,LDL,FIB,UA,Hcy and ApoA were the independent risk factors of cardiovascular events in elderly patients with hypertension(P<0.05).Conclusions:The incidence rate of cardiovascular events in elderly patients with hypertension in convalescent center is low,and the majority of them are male,and 70 years old and over.Taking the intervention measures for the independent risk factors such as history of coronary heart disease,smoking,alcohol consumption,SBP,TC,TG,LDL,FIB,UA,Hcy and ApoA abnormalities can reduce the risk of cardiovascular events.