职业人群理想心血管健康状况及其与社会经济地位的关联研究

摘要

目的:了解企业职工心血管健康行为和因素的流行情况,并探讨其与社会经济地位的关联.方法:采用整群抽样,在全国45家企业共抽取27607人18~60岁的职工进行调查.参考美国心脏协会定义的心血管健康行为和因素,以文化程度和职业阶层衡量职工的社会经济地位,采用多水平Logistic回归分析社会经济地位与理想心血管健康行为和因素的关联.结果:在可改变的心血管健康行为(吸烟、体重指数、低盐饮食、体育锻炼)中处于理想状态的分别占51.3%、67.9%、14.0%、31.2%;可定量评估的心血管健康因素(空腹血糖、总胆固醇、血压)中处于理想状态的分别占72.9%、81.6%、27.3%.研究人群中,有全部7项理想健康行为和因素者仅占0.6%.调整个体和企业水平因素后,与初中及以下学历相比,高中(OR=1.18, 95%CI: 1.08~1.29)、大学及以上学历者(OR=1.52, 95%CI: 1.37~1.69)更易具备理想心血管健康行为和因素;与蓝领相比,白领职工(OR=1.18; 95%CI: 1.08~1.29)更易具备理想心血管健康行为和因素.结论:理想心血管健康行为和因素在企业职工中的流行情况不容乐观,且与社会经济地位存在正向关联.%Objectives: To investigate the prevalence of ideal cardiovascular health behaviors and factors, and its association with socioeconomic status (SES) in enterprise employees. Methods: The cluster sampling method was adopted to recruit 27 607 employees aged 18 to 60 years from 45 enterprises across China. The ideal cardiovascular health metrics including behaviors and factors, which were defined according to the AHA criteria, were obtained, and SES was measured by education and occupational class. Multilevel logistic regression models were used to analyze the association between SES and ideal cardiovascular health metrics. Results: Overall, the prevalence of ideal cardiovascular health behavior (smoking, body mass index, salt intake, physical activity) was 51.3%, 67.9%, 14.0%, 31.2%, respectively; prevalence of the ideal cardiovascular factors (fasting blood glucose, total cholesterol, blood pressure) was 72.9%, 81.6%, 27.3%,respectively in this cohort. Among the employees, only 0.6% population met all 7 cardiovascular health metrics. After adjusting the individual and workplace factors, employees with high school (OR=1.18, 95%CI: 1.08-1.29) and college or above education (OR=1.52, 95%CI: 1.37-1.69) were more likely to have ideal cardiovascular health status compared with those with less education; white-collar workers were more likely to have ideal cardiovascular health status compared with blue-collar workers (OR=1.18; 95%CI: 1.08-1.29). Conclusions: The prevalence of ideal cardiovascular health behaviors and factors is low, and is positively associated with SES, suggesting the importance of promoting the cardiovascular health behavior, monitoring/controlling the related cardiovascular factors and reducing the socioeconomic inequalities among Chinese enterprise employees.