就地城市化居民心血管病危险因素及风险9年变化

Changes of cardiovascular risk factors and risk among rural urbanized residents in Chaoyang district of Beijing over nine years

目的研究北京朝阳区小红门地区35~64岁就地城市化居民心血管病危险因素及患病风险的变化,为卫生行政部门完善疾病防控策略提供科学依据。方法研究对象来自“心血管疾病监测、预防预警和诊治技术应用研究”北京项目点人群。2010年7月用整群抽样的方法从北京市朝阳区小红门地区抽取1000名35~64岁就地城市化居民,收集其人口学、疾病和行为危险因素、体检及血生化结果,基线样本942人,2019年进行随访调查,有效样本667人。使用广义估计方程分析就地城市化9年后心血管疾病危险因素相关指标的变化,根据中国血脂管理指南(2023年)动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)风险评估法进行总体风险评估。结果调整人口学、生活方式和家族史后,9年间667名就地城市化居民舒张压升高2.217 mmHg,总胆固醇升高0.121 mmol/L,体质指数升高0.907 kg/m2,有效锻炼率(PRR=1.484)和高血压患病率(PRR=1.255)上升;222人(33.28%)ASCVD的10年风险增加,127人(19.04%)风险降低。结论小红门地区35~64岁就地城市化居民健康行为有所提升,但血压、血脂、超重肥胖指标仍上升明显,高血压患病率及心血管病风险的增加不容忽视。

Objective To examine the changes in cardiovascular risk factors and risk among rural urbanized residents aged 35-64 in Xiaohongmen area of Chaoyang district between 2010 and 2019,and to provide scientific basis for health administration departments to improve disease prevention and control strategies.Methods Data were obtained from“the study of application of cardiovascular disease monitoring,prevention,warning and diagnosis techniques(Beijing monitoring stations)”.Cluster sampling method was used to select 1000 rural urbanized residents aged 35-64 in 2010,and their demographic,medical history,lifestyles,physical examination and blood biochemical information were collected.A total of 942 residents provided complete baseline information in 2010 and 667 residents participated in follow-up surveys.The generalized estimation equation was used to analyze the change degree of major risk factors after 9 years.Overall risk was assessed based on the method for atherosclerotic cardiovascular disease,following the Chinese Guidelines for Lipid Management(2023).Results From 2010 to 2019,DBP elevated by 2.217 mmHg,TC increased by 0.121 mmol/L,BMI increased by 0.907 kg/m2,effective exercise rate(PRR=1.484)and prevalence of hypertension increased significantly(PRR=1.255)after adjusting for demographic,lifestyle and family history factors.The 10-year risk of ASCVD increased in 33.28%of participants and decreased in 19.04%of individuals.Conclusions The health behavior of local urbanized residents aged 35 to 64 in Xiaohongmen area has improved.Blood pressure,blood lipids,overweight and obesity indicators still showed significant increases.The increase in hypertension prevalence and cardiovascular disease risk cannot be ignored.