安徽省农村地区老年人高血压与超重、肥胖的关联研究

发布时间：2018-04-25 03:35

本文选题：高血压 + 农村地区　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的旨在对安徽省若干个农村地区老年人高血压、超重和肥胖的流行状况进行描述,并探索BMI及腰围与血压的关联。为更好的反映超重、肥胖及中心性肥胖状况对于高血压患病的作用,同时为制定农村地区老年人群高血压、超重及肥胖状况的预防控制策略和措施提供科学依据。方法根据安徽省地理位置采用多阶段整群抽样方法,保证样本代表性及抽样的可行性原则。第一阶段,选取宿州、蚌埠、马鞍山、铜陵、池州五个地级市作为代表,在选取的5个市中再各自抽取1个或2个县/区,第二阶段在抽取的县/区中随机抽取若干个行政村,对抽取的所有行政村中的4234名年龄在60岁及以上的老年人进行问卷调查及体格检查。问卷调查及体格测量内容包括:一般情况调查(性别、年龄、文化程度、生活方式等)、体格测量(身高、体重、腰围及血压的测量)及慢性病患病情况。采用c2检验、t检验和方差分析进行单因素检验,均数间的两两比较采用Bonferroni检验,采用二分类Logistic回归分析和多重线性回归对高血压的潜在影响因素进行分析。结果调查对象中的男性为1861人(44.0%),女性为2372人(56.0%),男女性之比为1:1.27。调查对象身高、体重和腰围的平均值分别为(157.23±8.56)cm、(57.24±10.39)kg和(84.73±12.35)cm,体质指数平均值为(23.11±3.74)kg/m2,收缩压和舒张压的平均值分别为(133.20±20.17)mmHg和(80.12±11.32)mmHg。安徽省农村老年人高血压患病率为57.0%,血压正常高值检出率为14.6%,超重检出率为27.7%,肥胖检出率为9.6%。男性腹型肥胖者的比例低于女性,差异有统计学意义(57.3%vs.63.0%,P0.01)。二分类Logistic回归分析结果显示,校正性别、年龄、文化程度、婚姻状况、吸烟状况及饮酒状况后,以正常BMI/正常腰围组为参照组,正常BMI/腹型肥胖、非正常BMI/正常腰围、非正常BMI/腹型肥胖皆为患高血压病的危险因素,OR值(95%CI)分别为1.40(1.20-1.64),2.06(1.44-2.95),2.60(2.23-3.03)。安徽省农村地区老年人平均动脉压的多重线性回归分析结果显示,在校正了性别、年龄、文化程度、婚姻状况、饮酒状况和吸烟状况后,模型1中BMI的标准偏回归系数为0.243,模型2中腰围的标准偏回归系数为0.205,BMI值和腰围值对平均动脉压都有影响。结论安徽省农村地区老年人高血压患病率较高,超重、肥胖率呈快速上升趋势,两者之间关系密切。因此,评估老年人中超重、肥胖、腹型肥胖对高血压患病状况的影响,具有重要的公共卫生学意义。老年人的BMI对于平均动脉压的影响略大于腰围对于平均动脉压的影响,关注并控制农村老年人的BMI是预防农村老年人高血压的重要且有效的措施。
[Abstract]:Objective to describe the prevalence of hypertension, overweight and obesity among the elderly in some rural areas of Anhui Province, and to explore the relationship between BMI, waist circumference and blood pressure. In order to better reflect the role of overweight, obesity and central obesity on the prevalence of hypertension, and provide scientific basis for the formulation of prevention and control strategies and measures of hypertension, overweight and obesity among the elderly in rural areas. Methods according to the geographical location of Anhui Province, multi-stage cluster sampling method was adopted to ensure the representativeness of the sample and the feasibility principle of sampling. In the first stage, five prefecture-level cities, including Suzhou, Bengbu, Ma'anshan, Tongling and Chizhou, were selected as representatives, and one or two counties / districts were selected from each of the five selected cities. In the second stage, a number of administrative villages were randomly selected from the selected counties and districts. A questionnaire survey and physical examination were conducted among 4234 people aged 60 and above in all administrative villages. Questionnaires and physical measurements include general survey (sex, age, education, lifestyle, etc.), physical measurement (height, weight, waist circumference and blood pressure) and chronic disease. Single factor test was carried out by using C _ 2 test and variance analysis, Bonferroni test was used to compare the mean numbers, and potential influencing factors of hypertension were analyzed by two-classification Logistic regression analysis and multiple linear regression. Results there were 1861 males and 2372 females, and the ratio of male to female was 1: 1.27. The average height, weight and waist circumference of the subjects were 57.24 卤10.39)kg and 84.73 卤12.35 cm respectively, the average body mass index was 23.11 卤3.74 kg 路m ~ (2), the mean systolic and diastolic blood pressure were 133.20 卤20.17)mmHg and 80.12 卤11.32 mm / g, respectively. The prevalence rate of hypertension, normal blood pressure, overweight and obesity were 57.0, 14.6, 27.7and 9.6 respectively. The proportion of male patients with abdominal obesity was lower than that of females, and the difference was statistically significant (57.3vs.63.0). The results of Logistic regression analysis showed that after adjusting sex, age, education, marital status, smoking status and drinking status, normal BMI/ normal waist circumference group was used as reference group, normal BMI/ abdominal obesity group, abnormal BMI/ normal waist circumference group. The odds ratio (OR) of abnormal BMI/ abdominal obesity was 1.40V 1.20-1.64% 2.064-2.95% 2.60,2.23-3.03g respectively. Multiple linear regression analysis of the mean arterial pressure of the elderly in rural areas of Anhui Province showed that after sex, age, education, marital status, drinking status and smoking status were adjusted, The standard partial regression coefficient of BMI in model 1 was 0.243, and the standard partial regression coefficient of waist circumference in model 2 was 0.205. Conclusion the prevalence of hypertension in the elderly in rural areas of Anhui Province is high, the prevalence of overweight and obesity is rising rapidly, and there is a close relationship between the two. Therefore, it has important public health significance to evaluate the influence of overweight, obesity and abdominal obesity on the prevalence of hypertension in the elderly. The influence of BMI on mean arterial pressure in the elderly is slightly greater than that of waist circumference on the mean arterial pressure. It is an important and effective measure to pay attention to and control the BMI of the rural elderly to prevent hypertension in the rural elderly.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1;R589.2

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