中国心血管病研究2024，Vol.22Issue(4) ：289-294.DOI:10.3969/j.issn.1672-5301.2024.04.001

原发性高血压患者冠心病家族史与生活方式对冠心病作用的研究

The effect of family history of coronary heart disease and lifestyle on coronary heart disease in essential hypertensive patients

曹良佳 马明艳 王淑霞 张扬 茹柯耶·亚森 许文娟 张嘉炫 金华 王馨 王增武 胡继宏
中国心血管病研究2024，Vol.22Issue(4) ：289-294.DOI:10.3969/j.issn.1672-5301.2024.04.001
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原发性高血压患者冠心病家族史与生活方式对冠心病作用的研究

The effect of family history of coronary heart disease and lifestyle on coronary heart disease in essential hypertensive patients

曹良佳 1马明艳 2王淑霞 3张扬 4茹柯耶·亚森 1许文娟 1张嘉炫 1金华 1王馨 5王增武 5胡继宏6
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作者信息

  • 1. 730000 甘肃省兰州市,甘肃中医药大学公共卫生学院
  • 2. 临夏回族自治州人民医院公共卫生管理科
  • 3. 甘肃中医药大学附属医院研究生部
  • 4. 730000 甘肃省兰州市,甘肃中医药大学敦煌医学与转化教育部重点实验室
  • 5. 中国医学科学院阜外医院国家心血管病防治中心社区防治部
  • 6. 730000 甘肃省兰州市,甘肃中医药大学教学实验实训中心
  • 折叠

摘要

目的 探讨冠心病(CHD)家族史和生活方式对原发性高血压患者患CHD的独立影响以及潜在交互作用,为具有CHD家族史的高血压患者其CHD防控提供依据.方法 依托卫生行业专项,收集2012年6月至2014年3月全国15个省份220个社区卫生中心实施心血管病危险因素监测的43769例原发性高血压患者的基线信息.采用多因素logistic回归分析分析冠心病家族史与生活方式的独立影响和相乘交互作用风险(ORs);利用相加模型,通过计算相对超额危险度(RERI)、交互作用指数(SI)和归因比(AP)判断相加交互作用风险.结果 冠心病家族史、吸烟与原发性高血压患者CHD风险增高有关(均P＜0.05);而饮酒与CHD风险降低有关(P＜0.05).冠心病家族史与吸烟对CHD患病风险有正向相乘和正向相加的交互作用(ORs=7.27,RERI=2.70,SI=1.75,AP=0.37,均P＜0.05),冠心病家族史和缺乏体育锻炼有正向相乘的交互作用(ORs=5.04,P＜0.05).冠心病家族史与饮酒有负向相乘的交互作用(ORs=3.82,P＜0.05).结论 原发性高血压患者冠心病家族史、吸烟和饮酒不仅与CHD独立相关,冠心病家族史联合吸烟及缺乏体育锻炼会增加CHD风险,联合饮酒可降低CHD风险,提示有冠心病家族史的原发性高血压患者可通过减少吸烟、增加锻炼和适量饮酒等改善生活方式降低CHD患病风险.

Abstract

Objective To explore the effect and potentially interactive effects of the family history of coronary heart disease(FHCHD)and lifestyle factors on CHD among essential hypertensive patients and to provide a basis for the prevention and control of CHD in the hypertensive patients with FHCHD.Methods Based on the health profession scientific reaserch project,the baseline data of 43,769 essential hypertension patients from the cardiovascular risk factor surveillance were clolected from June 2012 to March 2014 in China's 220 community health centers(CHCs)in 15 provinces.The multi-variables logistic regression and multiplicative model were used to evaluate the independent effects and interaction risks(ORs)of FHCHD and lifestyles for CHD;and in additive model,the relative excess risk due to interaction(RERI),synergistic effect index(SI)and attributable proportion due to interaction(AP)were calculated as the interaction indices.Result The FHCHD and smoking were significantly associated with increased risk of CHD in essential hypertensive patients(all P＜0.05),whereas drinking was associated with a decreased risk of CHD(P＜0.05).There was a positive multiplicative and positive additive interaction between FHCHD and smoking on the risk of CHD prevalence(ORs 7.27,RERI 2.70,SI 1.75,and AP 0.37,all P＜0.05).FHCHD and lack of exercise were associated with a increased risk of CHD,with ORs of 5.04(P＜0.05).Conversely,FHCHD exhibited an inverse interaction with drinking(ORs 3.82,P＜0.05)of CHD in essential hypertensive population.Conclusion The FHCHD,smoking and drinking in the essential hypertensive population are independently associated with CHD.FHCHD combined with smoking and lack of exercise has a positive interaction on CHD,but a negative interaction in the FHCHD and drinking on CHD in the essential hypertensive population.These associations suggest that reducing smoking,increasing exercise,and moderate drinking can lower the risk of CHD in the essential hypertensive patients.

关键词

冠心病/原发性高血压/冠心病家族史/生活方式/患病风险/交互作用

Key words

Coronary heart disease/Essential Hypertension/Family history of coronary heart disease/Lifestyle/Risk of Illness/Interaction

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基金项目

国家自然科学基金(81960614)

卫生行业科研专项(200902001)

甘肃省国际科技合作重点研发计划(20YF3WA020)

敦煌医学与转化教育部重点实验室开放基金(DHYX20-05)

出版年

2024
中国心血管病研究
中国医师协会，煤炭总医院

中国心血管病研究

CSTPCD
影响因子：0.878
ISSN：1672-5301
参考文献量4
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