北京社区中老年人H型高血压患病率及其危险因素分析

摘要

目的 调查北京社区中老年人H型高血压患病率及其危险因素.方法 分析"北京老龄化多维纵向研究"2009年的调查数据,纳入北京社区人群共1 458人,调查人群完成调查问卷、体格检查及实验室检查.以同型半胱氨酸(Hcy)>15 μmol/L定义为高Hcy血症,原发性高血压合并高同型半胱氨酸血症定义为H型高血压.采用2000年北京市人口普查的结果对数据进行权重统计H型高血压患病率.应用多因素Logistic回归模型分析H型高血压患病的独立危险因素.结果 调查人群年龄(69.48 ± 8.09)岁,Hcy中位数16.56 μmol/L.经权重后,调查人群高Hcy血症患病率为57.20%(834/1 458),H型高血压患病率为35.32%(515/1 458),占高血压患者的59.47%(515/866).高龄、男性、血尿酸升高、估算肾小球滤过率(eGFR)下降和不经常食用鱼虾是H型高血压患病的独立危险因素(OR=2.30、1.04、1.02、0.95、0.67,95% CI 1.54～3.44、1.02～1.06、1.04～1.06、0.94～0.97、0.46～0.97,P＜0.01或＜0.05).结论 北京社区中老年人H型高血压患病率较高,控制血尿酸、保护肾功能、经常进食鱼虾类食物可能有助于H型高血压的预防.%Objective To investigate the prevalence and risk factors of H-type hypertension among middle-aged and elderly people in Beijing community. Methods A cross-sectional study by recruiting 1 458 middle-aged and elderly people from a cohort of the "Beijing Longitudinal Study of Aging" in 2009 was conducted. All participants were asked to complete a standardized questionnaire, physical examination and laboratory examinations. Hyperhomocysteinemia was defined as homocysteine (Hcy) > 15 μmol/L, and H- type hypertension was defined as having hypertension and hyperhomocysteinemia simultaneously. The prevalence of H-type hypertension was estimated by using the results of 2000 Beijing population census to weight the data. Multivariate Logistic regression analysis was preformed to estimate the associated factors of H-type hypertension. Results The age was (69.48 ± 8.09) years, and the distribution of Hcy was skewed with the median of 16.56 μmol/L. After weight, the prevalence of hyperhomocysteinemia was 57.20% (834/1 458), and the prevalence of H-type hypertension was 35.32% (515/1 458), accounting for 59.47% (515/866) in patients with hypertension. The ageing, male, hyperuricemia, estimated glomerular filtration rate (eGFR) and insufficiency of fishes/ shrimps were independent risk factors of H-type hypertension ( OR = 2.30, 1.04, 1.02, 0.95 and 0.67; 95% CI 1.54-3.44, 1.02-1.06, 1.04-1.06, 0.94-0.97 and 0.46-0.97; P＜0.01 or＜0.05). Conclusions The proportion of H-type hypertension is high in the middle-aged and elderly people in Beijing community. Lowering uric acid, protection of renal function and intake sufficient fishes and shrimps might prevent and control H-type hypertension.