Detection rate for population at high-risk of cardiovascular diseases and its influencing factors in Liaoning province
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摘要:
目的 了解辽宁省心血管疾病高危人群检出率及其影响因素,为心血管病有效防控提供依据。 方法 于2014 — 2017年采用多阶段分层随机整群抽样方法对辽宁省3个城镇和3个农村项目点,抽取6个区/县的居民进行调查。收集调查对象性别、教育程度、职业等基本信息;测量身高、体重、腰围、肺功能;检测血糖、血脂以及尿常规;收集吸烟、饮酒情况,高血压、糖尿病及心血管病史以及用药史等心血管病危险因素。 结果 共收集问卷138 554份,查出高危个体36 435例,高危率为26.3 %。其中男性高危16 111例,高危率为25.8 %;女性20 324例,高危率为26.7 %,男性高危率低于女性,差异有统计学意义(χ2 = 14.155,P < 0.001)。随着年龄增长,男、女性高危检出率均增高,65~75岁人群高危检出率达39.4 %。logistic回归分析结果显示,性别、年龄、婚姻状况、文化程度、职业、收入、吸烟、饮酒、高血压史、糖尿病史及各项血脂指标(甘油三酯除外)均为心血管病高危人群的影响因素(P均 < 0.001)。 结论 辽宁省心血管疾病高危人群检出率较高,需加强对心血管疾病高危人群的防治,以降低辽宁省心血管疾病的发病率和死亡率。 Abstract:Objective To explore the detection rate of populations at high risk of cardiovascular disease (CVD) among residents and its influencing factors in Liaoning province for providing evidences to effective prevention and control of CVD. Methods We conducted a survey among 35 – 75 years old residents selected with stratified multistage random sampling in 3 urban districts and 3 rural towns of Liaoning province between 2014 and 2017. The participants′ information on demography, education, income, smoking, alcohol drinking, history of hypertension, diabetes, CVD and medication relevant to the diseases were collected with a questionnaire interview; the participants′ height, weight, waist circumference were measured and their blood glucose, blood lipid, urinalysis, and lung function were detected. Results Of the 138 554 participants surveyed, 36 435 (26.3%) were identified as the individuals at a high-risk of CVD and the male participants had a significantly lower ratio of the at high CVD risk compared to the female participants (25.8% vs. 26.7%, 16 111 vs. 20 324 in number) (χ2 = 14.155, P < 0.001). Among the participants, the ratio of the individuals at a high-risk of CVD increased with the increment of their ages and the participants aged 65 – 75 had the highest ratio (39.4%). The results of logistic regression analysis revealed following influencing factors of being at a high-risk of CVD for the participants: gender, age, marital status, education, occupation, income, smoking, alcohol drinking, hypertension history, diabetes history, and all routine blood lipids indicators (except for triglyceride) (all P < 0.001). Conclusion The detection rate of individuals at high risk of cardiovascular disease is relatively high among 35 – 75 years old urban and rural residents in Liaoning province and interventions on cardiovascular disease need to be promoted among the high-risk populations. -
Key words:
- cardiovascular disease /
- high-risk population /
- influencing factor /
- survey
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表 1 初筛对象一般人口学特征
人口学特征 分类 调查人数 构成比(%) 高危检出(例) 高危检出率(%) 性别 男 62 433 45.1 16 111 25.8 女 76 121 54.9 20 324 26.7 年龄(岁) 35~ 25 815 18.6 4 151 16.1 45~ 49 681 35.9 10 935 22.0 55~ 41 186 29.7 12 721 30.9 65~75 21 872 15.8 8 628 39.4 BMI(kg/m2) < 18.5 1 230 9.0 229 17.0 18.5~ 56 667 41.5 11 327 19.5 24.0~ 60 907 44.6 17 127 27.9 ≥ 28 17 706 13.0 7 717 43.6 婚姻状况 已婚 131 898 95.2 34 586 26.2 离异或分居 2 661 1.9 563 21.2 丧偶 3 073 2.2 1 142 37.2 未婚 312 0.2 22 17.6 其他 610 0.4 89 14.6 教育程度 小学及以下 28 325 20.4 8 454 29.8 初中 62 229 44.9 16 440 26.4 高中或中专 31 965 23.1 7 513 23.5 大专及以上 15 023 10.8 3 768 25.1 其他 1 012 0.7 260 25.7 职业 农民 31 128 22.5 7 504 24.1 工人 22 137 16.0 4 734 21.4 行政 9 564 6.9 2 099 21.9 专业技术 11 001 7.9 2 291 20.8 商业、服务业 11 803 8.5 2 258 19.1 退休 29 804 21.5 11 542 38.7 无业 13 230 9.6 4 221 31.9 其他 9 887 7.1 1 986 18.1 家庭收入(元/年) < 50 000 107 952 85.9 31 929 26.4 ≥ 50 000 17 751 14.1 4 506 25.4 吸烟 是 22 406 16.2 6 969 31.1 否 116 138 83.8 29 465 25.4 饮酒 从不 108 157 78.1 27 612 25.5 每月 < 1次 8 191 5.9 1 916 23.4 每月2~4次 9 948 7.2 2 670 26.8 每周2~3次 4 592 3.3 1 429 31.1 每周 > 4次 6 188 4.5 2 519 40.7 其他 11 988 1.1 289 24.1 表 2 不同性别初筛对象各指标比较(
$\bar x \pm s$ )指标 男性 女性 t值 P值 年龄(岁) 54.03 ± 9.57 53.82 ± 9.26 4.153 < 0.001 身高(cm) 171.0 ± 5.5 160.4 ± 5.3 367.581 < 0.001 体重(kg) 72.9 ± 9.2 63.1 ± 8.5 205.510 < 0.001 BMI(kg/m2) 24.9 ± 2.8 24.5 ± 3.1 23.356 < 0.001 吸烟(支/d) 15.7 ± 8.5 12.1 ± 8.2 14.647 < 0.001 收缩压(mmHg) 139.1 ± 18.9 138.4 ± 20.9 6.133 < 0.001 舒张压(mmHg) 84.0 ± 10.6 81.7 ± 10.7 38.384 < 0.001 心率(次/min) 76.0 ± 9.5 76.5 ± 9.3 – 9.364 < 0.001 总胆固醇(mmol/L) 4.6 ± 1.0 4.9 ± 1.1 – 44.524 < 0.001 甘油三酯(mmol/L) 1.8 ± 1.1 1.9 ± 1.1 – 9.116 < 0.001 LDL-C(mmol/L) 2.5 ± 0.8 2.6 ± 0.9 – 18.087 < 0.001 HDL-C(mmol/L) 1.4 ± 0.5 1.5 ± 0.5 – 52.214 < 0.001 血糖(mmol/L) 6.30 ± 1.8 6.39 ± 1.8 – 5.017 < 0.001 表 3 辽宁省居民心血管病高危个体检出率(%)
年龄(岁) 男性 女性 合计 调查人数 高危数 检出率 调查人数 高危数 检出率 调查人数 高危数 检出率 35~ 11 790 2 121 18.0 14 025 2 030 14.5 25 815 4 151 16.1 45~ 21 875 4 904 22.4 27 806 6 031 21.7 49 618 10 935 22.0 55~ 18 385 5 359 29.1 22 801 7 362 32.3 41 186 12 721 30.9 65~75 10 383 3 727 35.9 11 489 4 901 42.7 21 872 8 628 39.4 表 4 心血管病高危人群影响因素分析
因素 参照组 B $S_{\overline x}$ Wald χ2值 P 值 OR 值 95 % CI 性别 女 男 – 0.121 0.019 42.198 < 0.001 0.886 0.855~0.919 年龄 0.030 0.001 974.647 < 0.001 1.030 1.029~1.032 BMI 0.055 0.003 441.039 < 0.001 1.056 1.051~1.062 饮酒 每月2~4次 从不 0.096 0.031 9.455 0.002 1.101 1.036~1.171 每周2~3次 0.299 0.043 49.460 < 0.001 1.349 1.241~1.466 每周 > 4次 0.523 0.037 199.496 < 0.001 1.687 1.569~1.814 高血压史 否 是 – 1.858 0.023 6 776.337 < 0.001 0.156 0.149~0.163 糖尿病史 否 是 – 0.422 0.037 128.749 < 0.001 0.656 0.609~0.705 TC 0.494 0.013 1 365.861 < 0.001 1.639 1.597~1.683 HDL-C – 1.002 0.021 2 382.182 < 0.001 0.367 0.353~0.382 LDL-C 0.210 0.014 219.713 < 0.001 1.234 1.200~1.269 婚姻 离婚或分居 已婚 – 0.274 0.058 22.028 < 0.001 0.760 0.678~0.852 丧偶 – 0.230 0.049 21.867 < 0.001 0.794 0.721~0.875 未婚 – 0.377 0.175 4.650 0.031 0.686 0.487~0.966 其他 – 0.299 0.136 4.826 0.028 0.741 0.568~0.968 教育 初中 小学及以下 0.069 0.021 11.192 0.001 1.072 1.029~1.116 大专及以上 0.117 0.034 11.897 0.001 1.124 1.052~1.201 职业 行政 农民 – 0.086 0.038 5.141 0.023 0.918 0.852~0.988 专业技术 – 0.085 0.036 5.452 0.020 0.919 0.856~0.986 退休 0.152 0.024 39.293 < 0.001 1.164 1.110~1.221 无业 0.287 0.029 101.056 < 0.001 1.333 1.260~1.410 其他 – 0.103 0.036 7.976 0.005 0.902 0.840~0.969 收入(万元) ≥5 < 5 – 1.045 0.034 919.890 < 0.001 0.352 0.329~0.376 吸烟 0.217 0.023 85.949 < 0.001 1.242 1.187~1.301 常数 – 2.757 0.114 585.665 < 0.001 0.064 -
[1] 中国心血管病报告编写组. 《中国心血管病报告2016》概要[J]. 中国循环杂志, 2017, 32(6): 521 – 530. [2] 李春燕, 简伟研. 中老年人心血管疾病经济负担 —— 基于中国健康与养老追踪调查的实证分析[J]. 中国卫生政策研究, 2017, 10(5): 75 – 80. [3] Rahman MM. Chronic non communicable diseases and its risk factors in Bangladesh[J]. Banglad J Med, 2012, 23(2): 48 – 49. [4] Welch LS, Dement J, Ringen K, et al. Impact of secondary prevention in an occupational high-risk group[J]. JOEM, 2017, 59(1): 68 – 73. [5] Khoury M, Manlhiot C, Gibson D, et al. Universal screening for cardiovascular disease risk factors in adolescents to identify high-risk families: a population-based cross-sectional study[J]. BMC Pediatr, 2015, 16(1): 11 – 16. [6] Chamnan P, Simmons RK, Khaw KT, et al. Estimating the population impact of screening strategies for identifying and treating people at high risk of cardiovascular disease: modelling study[J]. British Medical Journal, 2010, 340(7754): 1016 – 1016. [7] 孙海欣, 王文志. 从指南到临床: 谈阿司匹林在心脑血管疾病一级预防中的应用[J]. 中国实用内科杂志, 2012, 32(5): 31. [8] 殷雨天. 吉林省心血管病高危人群早期筛查与相关危险因素的研究[D]. 吉林: 吉林大学硕士学位论文, 2016. [9] Lobelo F, Rohm DY, Sallis R, et al. Routine assessment and promotion of physical activity in healthcare settings: a scientific statement from the American Heart Association[J]. Circulation, 2018, 137(18): e495 – e522. [10] Biswas T, Islam MS, Linton N, et al. Socio-economic inequality of chronic non-communicable diseases in Bangladesh[J]. PLoS One, 2016, 11(11): e0167140. [11] Wilson PW, D′Agostino RB, Levy D, et al. Prediction of coronary heart disease using risk factor categories[J]. Circulation, 1998, 97(18): 1837 – 47. [12] Talaei M, Hosseini N, Koh AS, et al. Association of "elevated blood pressure" and "stage 1 hypertension" with cardiovascular mortality among an Asian population[J]. J Am Heart Assoc, 2018, 7(8): e008911.
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