摘要
目的 探讨社区65岁及以上老年人不同血压水平与其他代谢综合征指标的相关性,为社区老年人心脑血管事件的防治提供参考依据.方法 选取2022年1-10月在福建省泉州市丰泽区北峰、清源2个街道社区卫生服务中心进行健康体检的65岁及以上老年人,剔除关键变量缺失及异常值46名,最终实际纳入3 598名老年人作为研究对象.根据血压水平分为正常血压组[收缩压<120 mmHg(1 mmHg=0.133 kPa)和舒张压<80 mmHg]、正常高值血压组[收缩压120～139 mmHg和(或)舒张压 80～89 mmHg]和高血压组[收缩压≥140 mmHg 和(或)舒张压≥90 mmHg].其中高血压组又分4个亚组:1级高血压组[收缩压140～159 mmHg和(或)舒张压90～99 mmHg]、2级高血压组[收缩压 160～179 mmHg和(或)舒张压 100～109 mmHg]、3级高血压组[收缩压≥180 mmHg和(或)舒张压≥100 mmHg]、单纯收缩期高血压组(收缩压≥140 mmHg 和舒张压<90 mmHg).比较不同水平血压组的一般资料和体质量指数(body mass index,BMI)、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血肌酐、血尿素氮及脂肪肝等代谢指标的差异.结果 高血压患病率为50.64%(1 822/3 598),代谢综合征患病率为21.40%(770/3 598),超重肥胖、血脂紊乱、高血压、高血糖检出率较高.随着血压水平的升高,各组BMI、腰围、腰高比、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、血肌酐水平呈递增趋势,差异有统计学意义(P<0.05).进一步对不同血压水平分组的上述代谢指标两两比较分析,正常高值血压组高于正常血压组,各级(1、2、3级)高血压组高于正常高值血压组,单纯收缩期高血压组与各级(1、2、3级)高血压组比较,差异有统计学意义(P<0.05).线性趋势检验结果显示,年龄、BMI与血压水平之间存在线性关系,差异有统计学意义(χ2值分别为43.22,21.92,P<0.01).结论 社区65岁及以上老年人群中具有较高的高血压及代谢综合征患病率,且不同血压水平与多代谢异常存在密切联系,需早期采取综合性干预措施.
Abstract
Objective To determine the correlation between different blood pressure levels and other metabolic syndrome indicators in community elderly≥65 years of age to provide a reference for the prevention and treatment of cardiovascular and cerebrovascular events in community elderly.Methods From January 2022 to October 2022,elderly adults≥65 years of age who underwent annual physical examinations at the com-munity health service centers in Beifeng and Qingyuan(Fengze District,Quanzhou City,Fujian Province)were selected.Forty-six elderly adults with missing and abnormal values of key variables were exclusion criteria.Finally,3 598 elderly adults were included as research objects.Based on the blood pressure level,the elderly adults were divided into a normal blood pressure group[SBP<120 mmHg(1 mmHg=0.133 kPa)and DBP<80 mmHg],a normal high blood pressure group(SBP 120-139 mmHg and/or DBP 80-89 mmHg),and a hypertension group(SBP≥140 mmHg and/or DBP≥90 mmHg).The hypertension group was divided into the following 4 subgroups:grade 1 hypertension group(SBP 140-159 mmHg and/or DBP 90-99 mmHg),grade 2 hypertension group(SBP 160～179 mmHg and/or DBP 100-109 mmHg),grade 3 hypertension group(SBP≥180 mmHg and/or DBP≥100 mmHg),and simple systolic hypertension group(SBP≥140 mmHg and DBP<90 mmHg).The general data and metabolic indices,such as body mass index(BMI),fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),high-density lipoprotein choles-terol(HDL-C),low-density lipoprotein cholesterol(LDL-C),serum creatinine(Cr),hematin nitrogen(BUN),and fatty liver,in the different blood pressure groups were observed for statistical analysis.Results The prevalence of hypertension was 50.64％(1 822/3 598)and the prevalence of metabolic syndrome was 21.40％(770/3 598).The average prevalence of overweight,obesity,dyslipidemia,hypertension,and hy-perglycemia was high.As the blood pressure increased,the BMI,waist circumference,waist:height ratio,and FPG,TC,TG,LDL-C,and Cr levels in each group gradually increased;the difference between the groups was statistically significant(P<0.05).Further comparative analysis of the above metabolic indices in the different blood pressure groups showed that the prevalence of the normal high blood pressure group was greater than the normal blood pressure group,the prevalence of the hypertension group(all levels 1,2,and 3)was greater than the normal high blood pressure group,and the prevalence of the simple systolic hyperten-sion group was similar to the prevalence of the hypertension group(all levels 1,2,and 3);the difference was statistically significant(P<0.05).The results of the linear trend test showed that there was a linear relationship between age and BMI,and the blood pressure level(χ2 value was 43.22 and 21.92,respectively;P<0.01).Conclusions There is a high prevalence of hypertension and metabolic syndrome in community elderly≥65 years of age,and different blood pressure levels are closely related to multiple metabolic abnor-malities,thus early comprehensive intervention measures should be implemented.
维普
万方数据