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山东省中西部农村居民高血压危险因素分类树分析

摘要

Objective To explore the risk factors of hypertension and risk population for adults aged≥25 in the mid-western rural areas of Shandong province and to provide evidence for development of intervention measure. Methods Subjects aged ≥25 were selected by multi-stage stratified random sampling method. All participants were interviewed with a standard questionnaire and physically examined on height, weight, waist circumference, blood pressure and fasting plasma glucose (FPG). Classification tree analysis was employed to determine the risk factors of hypertension and high risk populations related to it. Results The major risk factors of hypertension would include age, abdominal obesity, overweight or obesity, family history and high blood sugar. The major populations at high risk would include populations as: a) being clderly, b) at middle-age but with: high blood sugar or with abdominal obesity/overweight, or with family history, c) people at middle-age but with family history and abdominal obesity. Through classification tree analysis, sensitivity, specificity and overall correct rates were 71.87%, 66.38% and 68.79 %, respectively on ' learning sample' while 70.70 %, 65.84 % and 67.97 % respectively on ' testing sample'. Conclusion Efforts on both weight and blood sugar reduction were common prevention measures for general population. Different kinds of prevention and control measures should be taken according to different risk factors existed in the targeted high-risk population of hypertension. Community-based prevention and control for hypertension measures should be integrated when targeting the population at high risk.%目的 探讨山东省中西部地区25岁以上农村常住居民高血压的危险因素及高危人群.方法 采用多阶段分层随机抽样的方法 ,对该地区调查对象进行问卷调查、体格检查以及实验室检测.应用分类树分析高血压人群的危险因素及高危人群.结果 高血压的主要危险因素为年龄、腹型肥胖、超重或肥胖、高血压家族史、血糖值较高等.高血压的高危人群主要为高年龄者;年龄较大且血糖值较高者;年龄较大且腹型肥胖或超重者;有高血压家族史且年龄较大者;有高血压家族史、腹型肥胖且年龄较大者.分类树模型学习集的灵敏度为71.87%,特异度为66.38%,总正确率为68.79%;检验集的灵敏度为70.70%,特异度为65.84%,总正确率为67.97%.结论 控制体重和血糖为一般人群的预防措施,不同高危人群应根据所具有的危险因素采取不同的防治措施.高血压的人群防治应将对一般人群的普遍预防和对高危人群的重点预防相结合.

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