深圳市南山区高血压患者脑卒中患病情况及其影响因素分析

Prevalence and determinants of stroke among community-dwelling hypertensive patients in Nanshan district,Shenzhen:an analysis of health service registration data

目的了解广东省深圳市南山区高血压患者脑卒中患病情况及其影响因素,为今后社区高血压管理及脑卒中防控工作提供参考依据。方法收集深圳市社区健康服务信息系统中2021年1月—2022年5月在南山区社区健康服务中心签约建档且资料完整的47432例高血压患者的相关数据,分析南山区高血压患者脑卒中患病情况,并应用多因素非条件logistic回归模型分析该地区高血压患者脑卒中患病的主要影响因素。结果深圳市南山区47432例高血压患者中,患脑卒中者3630例,脑卒中患病率为7.65%;其中男性高血压患者脑卒中的患病率[8.34%(2144/25696)]高于女性高血压患者脑卒中的患病率[6.84%(1486/21736)],差异有统计学意义(χ^(2)=37.846,P<0.001)。多因素非条件logistic回归分析结果显示,年龄≥65岁、高血压病程>5年、吸烟、患糖尿病、患冠心病和肌酐水平较高是南山区高血压患者脑卒中患病的危险因素,女性、文化程度初中及以上、进行体育锻炼、服用降压药物、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平较高是南山区高血压患者脑卒中患病的保护因素;年龄≥65岁、高血压病程>5年、吸烟、患糖尿病、患冠心病和肌酐水平较高是南山区男性高血压患者脑卒中患病的危险因素,文化程度初中和大专及以上、服用降压药物、总胆固醇(TC)、TG和LDL-C水平较高是南山区男性高血压患者脑卒中患病的保护因素;年龄≥65岁、高血压病程>5年、吸烟、患糖尿病、患冠心病和肌酐水平较高是南山区女性高血压患者脑卒中患病的危险因素,文化程度初中及以上、服用降压药物和LDL-C水平较高是南山区女性高血压患者脑卒中患病的保护因素。结论深圳市南山区高血压患者脑卒中患病率较低,性别、年龄、文化程度、高血压病程、是否吸烟、是否进行体育锻炼、是否患糖尿病、是否患冠心病、是否服用降压药物以及肌酐、TC、TG和LDL-C水平为该地区高血压患者脑卒中患病的主要影响因素。

Objective To understand the prevalence and influencing factors of stroke among community-dwelling hypertensive patients in Nanshan district of Shenzhen city,Guangdong province,to provide a reference for hypertension management and stroke prevention and control in communities.Methods We collected data on 47432 hypertensive patients with complete information registered in the Shenzhen Community Health Service Information System from January 2021 to May 2022.The prevalence of stroke among the patients was analyzed,and a multivariate unconditional logistic regression model was used to identify the main factors influencing the prevalence of stroke in this population.Results Of the 47432 hypertensive patients,3630(7.65%)had stroke,with a significantly higher prevalence of stroke in male hypertensive patients(8.34%,[2144/25696])than in female patients(6.84%,[1486/21736])(x2=37.846,P<0.001).Multivariate unconditional logistic regression analysis showed that age≥65 years,hypertension for more than 5 years,smoking,diabetes,coronary heart disease,and higher creatinine levels were risk factors for stroke in patients;conversely,being female,having an education level of junior high school or higher,being physically active(not for female patients),taking antihypertensive medication,and having higher levels of low-density lipoprotein cholesterol(LDL-C)(for both male and female patients)and higher levels of total cholesterol(TC)and triglycerides(TG)(for male patients only)were protective factors against stroke.Conclusion The prevalence of stroke among community-dwelling hypertensive patients in Nanshan district,Shenzhen city,is relatively low.Gender,age,educational level,duration of hypertension,smoking status,physical activity,diabetes,coronary heart disease,the use of antihypertensive medication,and levels of creatinine,TC,TG,and LDL-C are the main factors influencing the prevalence of stroke in this population.