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四川省高原和平原地区高血压患者血压控制率差异及其影响因素

The Disparities of Hypertension Control Rate and Risk Factors among Hypertensive Residing in High-altitude and Plain in Sichuan Province

  • 摘要:
      目的  探究四川省高原和平原地区高血压患者血压控制率的差异及其影响因素。
      方法  本研究为横断面研究,于2017年5月在四川省成都市晋阳、成华社区医院序贯纳入正在服用降压药物的原发性高血压患者231例,2017年9月在四川省甘孜州九龙县及其周边乡镇纳入正在服用降压药物的原发性高血压患者220例。纳入患者均为40周岁以上。采用统一编制的调查问卷收集研究对象人口学特征、既往病史、家族史、生活方式、认知功能及服药依从性等信息,所有纳入研究的患者均测量诊室血压、心电图、采集血样。按常住地点为高原或平原分层后,采用二分类logistic回归分析血压控制率的影响因素。
      结果  平原地区高血压患者血压控制率高于高原地区(19.05% vs. 8.64%),logistic回归分析中,平原组70~80岁组控制率高于40~50岁组(OR=4.037,95%CI:1.269~12.848);有中心性肥胖(OR=0.480,95%CI:0.233~0.987)和血尿酸水平高(OR=0.994,95%CI:0.989~0.998)的患者控制率较低。高原组依从性好(OR=4.793,95%CI:1.407~16.326)、尿酸水平高(OR=1.008,95%CI:1.003~1.012)的研究对象血压控制率更高;而认知功能低(OR=0.234,95%CI:0.071~0.767)的患者血压控制率较低。
      结论  平原地区高血压患者血压控制率比高原地区高。平原地区应重点关注中心性肥胖、高尿酸水平、40~50岁患者;高原地区应注意积极提升高血压患者依从性及认知功能。

     

    Abstract:
      Objective  To explore the disparities of hypertension control rate and its affecting factors between plateau and plain regions in Sichuan province.
      Methods  The cross-sectional study was conducted from May to September 2017. We recruited 231 subjects in Jinyang and Chenghua community health service center in Chengdu and 220 subjects in Jiulong County in Ganzi Autonomous Prefecture, Sichuan Province. Demographic characteristics, medical history, family history, lifestyle, cognitive function and medication compliance were collected using a structured questionnaire. Blood pressure and electrocardiogram were measured, and blood samples were collected among participants included in the study. Bivariate logistic regression analysis was used to investigate the affecting factors of hypertension control rate. All the statistical analyses were stratified by plateau and plain regions.
      Results  Hypertension control rate in the plain group was higher than the plateau group (19.05% vs. 8.64%). The logistic regression model showed that the control rate of hypertension was higher among the participants who were 70-80 years old than 40-50 years old in the plain group (OR=4.037, 95%CI: 1.269-12.848). Central obesity (OR=0.480, 95%CI: 0.233-0.987) and high uric acids (OR=0.994, 95%CI: 0.989-0.998) were the risk factors of control rate. In the plateau group, high medication compliance (OR=4.793, 95%CI: 1.407-16.326) and high uric acids (OR=1.008, 95%CI: 1.003-1.012) were the protective factors, and low cognitive function (OR=0.234,95%CI: 0.071-0.767) was risk factor.
      Conclusion  The control rate of hypertension in the plain is higher than that in the plateau. In the plain, the risk factors are central obesity and high uric acids, and aged 40-50 years. In the plateau, the risk factors are poor medication compliance and low cognitive function.

     

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