云南省不同海拔地区藏族及其他民族血压分布及患病情况对比分析

Comparative analysis of blood pressure distribution and prevalence in different altitudes regions between Tibetan and other ethnicities in Yunnan Province

目的 通过对云南省不同海拔地区藏族和其他民族居民的血压分布及高血压患病情况进行对比分析,为高原人群的高血压精准防控提供科学依据。方法 2020―2021年,采用多阶段分层整群随机抽样方法,将云南省迪庆藏族自治州香格里拉市海拔≥2 500 m的建塘镇、小中甸镇以及海拔<2 500 m的五镜乡、金江镇等4个乡镇作为调查点。抽取1 549名≥18岁常住居民进行问卷调查、体格检查和血生化检查,采用χ^(2)检验分析不同海拔条件下不同民族居民血压水平分布及高血压患病情况,采用多因素非条件logistic回归分析模型分析不同海拔人群高血压患病影响因素。结果 海拔≥2 500 m组的高血压患病率高于<2 500 m组(P=0.002)。藏族居民平均收缩压水平比汉族居民高5.29 mmHg(P<0.001)。海拔<2 500 m组的藏族居民高血压患病率高于同等海拔条件的其他民族(P<0.017),但海拔≥2 500 m组的藏族居民高血压患病率低于同等海拔条件的汉族及其他民族(均P<0.017)。不同海拔条件的藏族人群高血压患病率及平均收缩压和舒张压水平差异均无统计学意义(均P>0.05)。藏族与海拔之间对高血压患病风险有负向交互作用。居住在海拔≥2 500 m组居民与海拔<2 500 m组相比,有更多的高血压危险因素。结论 随海拔升高,汉族及其他民族居民高血压患病率增加。藏族对于高原及不同海拔的血压变化表现出更强的适应性。

Objective This study aims to comparatively analyse the risk of hypertension in Tibetans and other ethnicities at different altitudes regions in Yunnan Province,and to provide a scientific basis for the control of hypertension among people living at high altitudes.Methods During 2020-2021,a multistage stratified cluster random sampling method was used to select four townships in the Diqing Tibetan Autonomous Prefecture,Shangri-La City,Yunnan Province as survey points.These included Jiantang Town and Xiaozhongdian Town at altitudes≥2500 meters,and Wujing Township and Jinjiang Town at altitudes<2500 meters.A total of 1549 permanent residents aged 18 years and above were sampled for questionnaire survey,physical examination and blood biochemistry tests.Theχ^(2) test was used to analyse the distribution of blood pressure levels and the prevalence of hypertension in different ethnic groups at different altitudes,and multifactorial logistic regression was used to analyse the factors affecting the prevalence of hypertension in people at different altitudes.Results The prevalence of hypertension was higher in the group with an altitude of≥2500 m than in the group with an altitude of<2500 m(P=0.002).The average systolic blood pressure of Tibetan nationality was 5.29 mmHg higher than that of Han nationality(P<0.001).The prevalence of hypertension was higher among Tibetans than among other ethnic living at the same altitude in the altitude<2500 m group(P<0.017),but lower among Tibetans than among Han Chinese and other ethnic groups living at the same altitude in the altitude≥2500 m group(P<0.017).There were no significant differences in the hypertension prevalence and mean systolic and diastolic blood pressure among Tibetan populations at different altitudes(all P>0.05).There was a negative interaction between Tibetan ethnicity and altitude on the risk of developing hypertension.People living at≥2500 m altitude have more risk factors for hypertension compared to those at<2500 m altitude.Conclusions The hypertension prevalence among Han and other people increased as the altitude increased.Tibetans seem to show greater adaptation to plateaus and changes in blood pressure at different altitudes.