安徽省40岁以上人群高血压患病情况及影响因素的地区差异分析

武肖肖; 张琳琳; 王旭帆; 邸东升; 冷瑞雪; 查震球

doi:10.16766/j.cnki.issn.1674-4152.002279

安徽省40岁以上人群高血压患病情况及影响因素的地区差异分析

doi: 10.16766/j.cnki.issn.1674-4152.002279

1.
安徽医科大学公共卫生学院流行病学与卫生统计学系，安徽合肥 230031
2.
安徽省疾病预防控制中心，安徽合肥 230000

基金项目:

安徽省科技重大专项计划项目 201903a07020015

安徽省卫生健康委科研项目 AHWJ2021a032

详细信息

通讯作者:
冷瑞雪，E-mail：lengruixue@ahmu.edu.cn

中图分类号: R544.1 R195.4
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出版历程
- 收稿日期: 2021-02-18
- 网络出版日期: 2022-03-03

Regional differences in the prevalence and influencing factors of hypertension amongst people over 40 years old in Anhui Province

1.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230031, China

摘要

摘要: 目的了解分析安徽省皖北、皖中、皖南三个地区≥40岁人群高血压患病率、意识率、控制率差异及相关危险因素，为不同地区高血压防治提供针对性意见。方法以长江、淮河为界，将安徽省分为皖北、皖南、皖中3个地区。采用多阶段分层整群抽样方法，通过问卷调查和体格测量对2015年安徽省≥40岁人群高血压患病、知晓、控制情况以及相关影响因素进行调查。采用χ²检验分析高血压加权患病率、意识率和控制率的地区差异，加权logistic逐步回归分析高血压危险因素，logistic逐步回归分析高血压知晓率和控制率的影响因素。结果共纳入2 967名≥40岁的居民。安徽省高血压总体患病率为37.7%(皖中40.1%、皖北38.6%、皖南34.3%)，皖北≥60岁人群高血压患病率明显高于皖中、皖南。本次调查高血压知晓率为52.5%，控制率为18.6%，3个地区间差异有统计学意义。皖南高血压知晓率是皖中2.19倍，控制率是其3.88倍，远高于皖北(均P < 0.05)。结论安徽省≥40岁人群高血压患病率较高，且皖北高血压控制率远低于皖南，年龄、BMI、文化程度均是影响高血压患病率和控制率的因素。安徽省南北地区、城乡预防卫生保健水平存在较大差异。
- 高血压 /
- 患病率 /
- 危险因素 /
- 地区
Abstract: Objective To analyse the differences in the prevalence, awareness rate, control rate and related risk factors of hypertension amongst people aged ≥ 40 years in North Anhui, Central Anhui and South Anhui and provide targeted suggestions for hypertension prevention and treatment in different regions. Methods Using the Yangtze and the Huaihe River as the boundary, Anhui Province was divided into three areas: North Anhui, South Anhui and Central Anhui. Multi-stage stratified cluster sampling was used to investigate the prevalence, awareness, control and related factors of hypertension in Anhui Province in 2015 using a questionnaire survey and physical measurement. χ² test was used to analyse the regional differences in the weighted prevalence rate, awareness rate and control rate of hypertension. In addition, weighty logistic stepwise regression was conducted to analyse the risk factors of hypertension. Logistic stepwise regression was used to analyse the influencing factors of hypertension awareness and control rate. Results A total of 2 967 residents aged ≥ 40 years were included in this study. The overall prevalence of hypertension in Anhui Province was 37.7% (40.1% in Central Anhui, 38.6% in North Anhui and 34.3% in South Anhui). The prevalence of hypertension in people aged ≥ 60 years in North Anhui was significantly higher than that in Central Anhui and South Anhui. The awareness rate of hypertension was 52.5%, and the control rate was 18.6%. The difference amongst the three regions was statistically significant. The awareness rate and control rate of hypertension in South Anhui were 2.19 times and 3.88 times as high as those in Central Anhui, which were higher than those in North Anhui, and this difference was significant (all P < 0.05). Conclusion The prevalence of hypertension amongst people aged ≥ 40 years was high in Anhui Province, and the control rate of hypertension in North Anhui was lower than that in South Anhui. Age, BMI and the level of education were considered as factors affecting the prevalence and control rate of hypertension. Great differences in the level of preventive health care were found between North and South of Anhui Province and between urban and rural areas.
- Hypertension /
- Prevalence /
- Risk factors /
- Region

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表 1 调查对象的基本信息[加权后，例(%)]

项目	总人数	皖北	皖中	皖南
总人数	2 967(100.0)	594(39.6)	1 188(29.2)	1 185(31.2)
年龄(岁)
40~49	1 091(46.3)	295(56.1)	320(32.8)	476(46.7)
50~59	833(23.6)	153(21.5)	304(22.0)	376(27.6)
60~69	688(18.0)	115(16.0)	336(22.9)	237(16.0)
≥70	355(12.1)	31(6.4)	228(22.3)	96(9.8)
性别
男性	1 470(48.6)	257(45.5)	640(49.3)	573(51.8)
女性	1 497(51.4)	337(54.5)	548(50.7)	612(48.2)
BMI
<18.5	47(1.2)	0(0)	18(0.9)	29(3.1)
18.5~23.9	1 257(39.9)	188(31.6)	501(42.6)	568(47.7)
24.0~27.9	1 198(41.1)	266(44.5)	470(39.1)	462(38.7)
≥28.0	465(17.8)	140(23.9)	199(17.3)	126(10.5)

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表 2 不同地区高血压加权患病率、知晓率和控制率(%)

项目	患病率(加权)			χ²值	P值	知晓率(未加权)			χ²值	P值	控制率(未加权)			χ²值	P值
项目	皖北	皖中	皖南	χ²值	P值	皖北	皖中	皖南	χ²值	P值	皖北	皖中	皖南	χ²值	P值
患病率	38.6(244/594)	40.1(499/1 188)	34.3(430/1 185)	6.965	0.365	42.6(104/244)	49.1(245/499)	62.1(267/430)	27.357	< 0.001	11.5(28/244)	15.0(75/499)	33.3(143/430)	63.056	< 0.001
年龄(岁)
40~49	25.0(80/295)	24.3(79/320)	19.2(97/476)	4.144	0.100	36.3(29/80)	27.8(22/79)	48.5(47/97)	8.028	0.018	8.8(7/80)	7.6(6/79)	25.8(25/97)	14.801	0.001
50~59	43.9(70/153)	34.7(113/304)	36.7(136/376)	5.474	0.121	42.9(30/70)	46.0(52/113)	64.7(88/136)	12.582	0.002	15.7(11/70)	15.9(18/113)	35.3(48/136)	16.114	< 0.001
60~69	65.6(73/115)	49.7(172/336)	51.3(130/237)	14.903	0.012	52.1(38/73)	51.7(89/172)	60.8(79/130)	2.628	0.269	13.7(10/73)	15.1(26/172)	35.4(46/130)	21.342	< 0.001
≥70	73.3(21/31)	58.7(135/228)	72.1(67/96)	7.557	0.008	33.3(7/21)	60.7(82/135)	79.1(53/67)	15.757	< 0.001	0(0/21)	18.6(25/135)	35.8(24/67)	14.347	0.001
性别
男性	37.1(106/257)	43.7(295/640)	39.2(251/573)	4.546	0.307	46.2(49/106)	44.4(131/295)	60.2(151/251)	14.339	0.001	14.2(15/106)	14.2(42/295)	32.3(81/251)	30.164	< 0.001
女性	39.9(138/337)	36.5(204/548)	29.1(179/612)	13.348	0.137	39.9(55/138)	55.9(114/204)	64.8(116/179)	19.764	< 0.001	9.4(13/138)	16.2(33/204)	34.6(62/179)	30.384	< 0.001
BMI
<18.5	0(0)	15.2(4/18)	32.9(10/29)	1.193	0.028	0(0)	25.0(1/4)	80.0(8/10)	3.764	0.052	0(0)	25.0(1/4)	70.0(7/10)	2.363	0.124
18.5~23.9	23.8(46/188)	33.1(172/501)	28.3(166/568)	8.411	0.149	30.4(14/46)	44.2(76/172)	54.2(90/166)	8.578	0.014	4.3(2/46)	16.3(28/172)	30.7(51/166)	19.393	< 0.001
24.0~27.9	38.0(111/266)	39.5(200/470)	38.6(189/462)	0.186	0.888	39.6(44/111)	51.5(103/200)	65.1(123/189)	19.058	< 0.001	10.8(12/111)	15.0(30/200)	32.8(62/189)	27.340	< 0.001
≥28.0	59.5(87/140)	59.8(123/199)	46.7(65/126)	4.804	0.058	52.9(46/87)	52.8(65/123)	70.8(46/65)	6.501	0.039	16.1(14/87)	13.0(16/123)	35.4(23/65)	14.514	0.001

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表 3 各变量赋值方法

变量	赋值方法	参照组
性别	男性=1，女性=2	女性
城乡	城镇=1，农村=2	农村
教育水平	小学及以下=1，初中=2，高中及以上=3	小学及以下
婚姻	未婚=(1, 0)，已婚=(0，1)，丧偶/离婚/分居=(0, 0)	未婚
吸烟	从不吸烟=(1，0)，现在吸烟=(0，1)，以前吸烟=(0, 0)	从不吸烟
BMI	< 18.5=1，18.5~23.9=2，24.0~27.9=3，≥28.0=4	18.5~23.9
地区	南=(1，0)，中=(0, 1)，北=(0, 0)	南
高血压知晓率	已知=1，未知=0
高血压控制率	已控制=1，未控制=0

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表 4 高血压患病率相关影响因素的logistic回归分析

项目	患病率(加权)
项目	B	SE	Wald χ²	P值	OR(95% CI)
年龄	0.078	0.007	120.266	0.002	1.081(1.057~1.106)
性别	0.201	0.287	0.489	0.535	1.222(0.490~3.045)
城乡	0.227	0.125	3.278	0.168	1.254(0.842~1.867)
教育水平
初中	0.148	0.052	13.015	0.065	1.159(0.983~1.368)
高中及以上	0.295	0.082	13.291	0.037	1.343(1.035~1.742)
婚姻
未婚	-0.676	0.416	2.629	0.203	0.509(0.135~1.917)
丧偶/离婚/分居	0.271	0.177	3.111	0.224	1.311(0.746~2.304)
吸烟
以前吸烟	0.005	0.240	< 0.001	0.986	1.005(0.468~2.156)
现在吸烟	0.109	0.122	0.789	0.440	1.115(0.755~1.647)
BMI
<18.5	-0.428	0.206	4.307	0.130	0.652(0.339~1.256)
24.0~27.9	0.601	0.084	51.683	0.006	1.823(1.398~2.379)
≥28.0	1.532	0.153	100.284	0.002	4.626(2.843~7.526)
地区
北	0.286	0.084	11.482	0.043	1.331(1.018~1.740)
南	0.107	0.106	1.029	0.385	1.113(0.795~1.558)

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表 5 高血压意识率相关影响因素的logistic回归分析

项目	知晓率(未加权)
项目	B	SE	Wald χ²	P值	OR(95% CI)
年龄	0.042	0.007	36.534	< 0.001	1.043(1.029~1.057)
性别	0.216	0.182	1.407	0.236	1.241(0.868~1.775)
城乡	0.190	0.136	1.944	0.163	1.209(0.926~1.579)
教育水平
初中	0.298	0.156	3.636	0.057	1.348(0.992~1.831)
高中及以上	0.312	0.221	2.003	0.157	1.366(0.887~2.105)
婚姻
未婚	0.060	0.523	0.013	0.909	1.062(0.380~2.962)
丧偶/离婚/分居	0.229	0.207	1.223	0.269	1.257(0.838~1.887)
吸烟
以前吸烟	-0.194	0.237	0.668	0.414	0.824(0.517~1.311)
现在吸烟	-0.010	0.187	0.287	0.592	0.905(0.628~1.304)
BMI
<18.5	0.119	0.589	0.041	0.840	1.126(0.355~3.568)
24.0~27.9	0.475	0.145	10.704	0.001	1.607(1.210~2.136)
≥28.0	0.808	0.176	21.188	< 0.001	2.243(1.590~3.165)
地区
北	-0.123	0.174	0.497	0.481	0.885(0.629~1.244)
南	0.786	0.155	25.684	< 0.001	2.195(1.620~2.975)

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表 6 高血压控制率相关影响因素的logistic回归分析

项目	控制率(未加权)
项目	B	SE	Wald χ²	P值	OR(95% CI)
年龄	0.017	0.008	3.977	0.046	1.017(1.000~1.034)
性别	-0.000	0.220	< 0.001	0.999	1.000(0.649~1.539)
城乡	0.471	0.170	7.656	0.006	1.602(1.147~2.237)
教育水平
初中	0.130	0.192	0.460	0.498	1.139(0.781~1.661)
高中及以上	-0.018	0.258	0.005	0.944	0.982(0.593~1.628)
婚姻
未婚	1.080	0.543	3.952	0.047	2.944(1.015~8.536)
丧偶/离婚/分居	-0.179	0.244	0.539	0.463	0.836(0.518~1.348)
吸烟
以前吸烟	-0.070	0.282	0.061	0.805	0.933(0.537~1.621)
现在吸烟	-0.233	0.229	1.034	0.309	0.792(0.505~1.242)
BMI
<18.5	1.260	0.578	4.748	0.029	3.526(1.135~10.955)
24.0~27.9	0.132	0.176	0.559	0.455	1.141(0.808~1.610)
≥28.0	0.295	0.215	1.894	0.169	1.344(0.882~2.046)
地区
北	-0.050	0.254	0.038	0.845	0.952(0.578~1.566)
南	1.356	0.190	51.148	< 0.001	3.882(2.677~5.630)

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参考文献(15)

[1]	OPARIL S, ACELAJADO M C, BAKRIS G L, et al. Hypertension[J]. Nat Rev Dis Primers, 2018, 4: 18014. DOI: 10.1038/nrdp.2018.14.
[2]	HU L, HUANG X, YOU C, et al. Prevalence and risk factors of prehypertension and hypertension in Southern China[J]. PLoS One, 2017, 12(1): e0170238. doi: 10.1371/journal.pone.0170238
[3]	邢秀雅, 徐伟, 陈叶纪, 等. 安徽省2013年≥18岁居民高血压患病、知晓、治疗及控制现状分析[J]. 中国医学前沿杂志(电子版), 2016, 8(12): 6-12. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY201612003.htm
[4]	ZHA Z, LENG R, XU W, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: A population-based survey[J]. BMC Pulm Med, 2019, 19(1): 102. doi: 10.1186/s12890-019-0864-0
[5]	FANG L, GAO P, BAO H, et al. Chronic obstructive pulmonary disease in China: A nationwide prevalence study[J]. Lancet Respir Med, 2018, 6(6): 421-430. doi: 10.1016/S2213-2600(18)30103-6
[6]	中国老年医学学会高血压分会. 中国老年高血压管理指南2019[J]. 中国心血管杂志, 2019, 24(1): 81-106. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLQG201902001.htm
[7]	LI Y, YANG L, WANG L, et al. Burden of hypertension in China: A nationally representative survey of 174, 621 adults[J]. Int J Cardiol, 2017, 227: 516-523. doi: 10.1016/j.ijcard.2016.10.110
[8]	LU J, LU Y, WANG X, et al. Prevalence, awareness, treatment, and control of hypertension in China: Data from 17 million adults in a population-based screening study (China PEACE Million Persons Project)[J]. Lancet, 2017, 390(10112): 2549-2558. doi: 10.1016/S0140-6736(17)32478-9
[9]	李娟丽, 吴炳义, 董惠玲. 2016年山东省成人高血压患病状况及影响因素研究[J]. 中国初级卫生保健, 2019, 33(4): 37-40. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW201904015.htm
[10]	刘志军, 欧凤英, 饶文博, 等. 贵州省城乡居民高血压患病情况及其影响因素分析[J]. 中国公共卫生, 2019, 35(10): 1311-1316. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW201910008.htm
[11]	LI Y, WANG L, FENG X, et al. Geographical variations in hypertension prevalence, awareness, treatment and control in China: Findings from a nationwide and provincially representative survey[J]. J Hypertens, 2018, 36(1): 178-187. doi: 10.1097/HJH.0000000000001531
[12]	WANG Y, PENG X, NIE X, et al. Burden of hypertension in China over the past decades: Systematic analysis of prevalence, treatment and control of hypertension[J]. Eur J Prev Cardiol, 2016, 23(8): 792-800. doi: 10.1177/2047487315617105
[13]	FAZLIANA M, LIYANA A Z, OMAR A, et al. Effects of weight loss intervention on body composition and blood pressure among overweight and obese women: Findings from the MyBFF@home study[J]. BMC Women's Health, 2018, 18(S1): 93.
[14]	JOHANN A F, HERTENSTEIN E, KYLE S D, et al. Insomnia with objective short sleep duration is associated with longer duration of insomnia in the Freiburg Insomnia Cohort compared to insomnia with normal sleep duration, but not with hypertension[J]. PLoS One, 2017, 12(7): e180339. DOI: 10.1371/journal.pone.0180339.
[15]	张鹏祥, 王蕊, 张爱爱, 等. 老年高血压患者睡眠时间及睡眠质量与血压变异性的关系[J]. 中国医药, 2020, 15(4): 526-529. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG202004012.htm