北京市某回族聚居社区成人心血管病高危风险的流行特征分析

Epidemic characteristics of high-risk cardiovascular disease among adults in a Hui community in Beijing

目的评价北京市某回族聚居社区心血管病(CVD)高危风险的流行特征和治疗情况,识别与CVD高危风险相关的个体特征。方法本研究基于国家心血管病高危人群早期筛查与综合干预项目,在北京市某回族聚居社区于2017-02-22-2019-08-29,使用方便采样的方式纳入年龄在35~75岁的常住居民,调查其CVD高危人群的比例、个体特征以及他汀类、阿司匹林的使用等情况。使用χ^(2)检验比较不同特征人群中CVD高危比率,并对人群中的4种高危类型(心血管病史型、高血压型、高血脂型、预测高危型)进行分析。采用logistic回归模型进行多因素分析评估人群的流行特征与CVD高危风险之间的关系。结果1830名调查对象中,平均年龄(60.6±8.6)岁,其中女性1158名(63.3%),回族559名(30.5%)。CVD高危率为20.8%(381/1830),标化高危率为18.0%。男性(χ^(2)=14.20,P<0.001)、≥65岁(χ^(2)=22.80,P<0.001)人群高危率增高;接受高等教育(χ^(2)=19.20,P<0.001)、身体质量指数(BMI;χ^(2)=29.04,P<0.001)处于正常范围的人群CVD高危率低。各高危类型中,除高血脂型女性高危比例高于男性,其余3种类型均为男性高于女性;回族人口中各型高危率与汉族差异无统计学意义。多因素logistic回归分析发现,≥65岁(OR=1.73,95%CI:1.37~2.18)、超重/肥胖(OR=1.83,95%CI:1.38~2.44)、退休(OR=1.54,95%CI:1.15~1.2.10)与心血管高危风险呈正相关,与女性(OR=0.62,95%CI:0.49~0.78)、受高等教育(OR=0.61,95%CI:0.48~0.77)呈负相关。在CVD高危人群中,高血压是最常见的危险因素(占77.4%),他汀类药物和阿司匹林的服用比例分别为23.6%和26.3%。结论在该地区35~75岁成年人中,CVD高危率大约五分之一。≥65岁、男性、超重/肥胖人口为防控重点人群,回族与汉族差异无统计学意义。

Objective To evaluate the epidemiological characteristics and treatment status of cardiovascular disease(CVD)high-risk population and identify individual characteristics related to high-risk CVD in a Hui community in Beijing.Methods Based on the national cardiovascular disease high-risk population early screening and comprehensive intervention project,this study enrolled local residents aged 35-75years from a Hui community from February 22,2017to August 29,2019using convenient sampling method.The proportion and individual characteristics of the CVD high-risk population,as well as the use of statins and aspirin were investigated.Theχ^(2)test was used to compare the CVD high-risk rates among different populations with various characteristics,and the four high-risk types(CVD history type,hypertension type,hyperlipidemia type,and predictive-high-risk type)in the population were analyzed separately.The logistic regression model was used to conduct multivariate analysis to evaluate the relationship between the prevalence characteristics of the population and the high risk of CVD.Results Among the 1830respondents,the average age was(60.6±8.6)years,including 1158women(63.3%)and 559 Hui people(30.5%).The prevalence of CVD high-risk was 20.8%(381/1830),and the standardized high-risk rate was 18.0%.The high-risk rates were significantly higher in males(χ^(2)=14.20,P<0.001)and people aged≥65years(χ^(2)=22.80,P<0.001),while individuals with higher education levels(χ^(2)=19.20,P<0.001)and normal body max index had a lower high-risk rate(χ^(2)=29.04,P<0.001).Among the high-risk types,except the hyperlipidemia type,the high-risk rate of females was significantly higher than that of males;the rates of the other 3types were higher in males than in females;there was no significant difference between the high-risk rates of Hui population and Han population.Multivariate logistic regression analysis showed that age≥65years(OR=1.73,95%CI:1.37-2.18),overweight or obesity(OR=1.83,95%CI:1.38-2.44),retirement(OR=1.54,95%CI:1.15-2.10)were positively correlated with CVD high-risk;while females(OR=0.62,95%CI:0.49-0.78),individuals with higher education levels(OR=0.61,95%CI:0.48-0.77)were negatively associated with CVD high-risk.Among the CVD highrisk population,hypertension was the most common risk factor(77.4%),and the proportion of statin and aspirin use was 23.6%and 26.3%,respectively.Conclusions The prevalence of CVD high-risk is approximately one fifth in adults aged 35-75years in this area.People aged 65years and above,males,and overweight/obese individuals are the key population for prevention and control,and there is no statistically significant difference between Hui and Han peoples.