中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

杨永利; 付鹏钰; 胡东生; 张卫东; 张梅喜; 王重建; 平智广

Abstract

杨永利,付鹏钰,胡东生,张卫东,张梅喜,王重建,平智广.中国成年人高血压患病区域聚集性及危险因素的多水平模型分析[J].Chinese journal of Epidemiology,2009,30(7):716-719

中国成年人高血压患病区域聚集性及危险因素的多水平模型分析

Mulfilevel regression analysis on region duster and risk factors of hypertension in the Chinese adult population

Received:March 04, 2009

DOI：10.3760/cma.j.issn.0254-6450.2009.07.018

KeyWord: 高血压危险I翊素区域聚集性二水平logistic回归模型方差成分系数

English Key Word: Hypertension msk factor Region cluster Two—level logistic regression model Variance portion coefficient

FundProject:亚洲心血管健康多中心合作研究

Author Name	Affiliation	E-mail
YANG Yongli	450001,郑州大学公共卫生学院卫生统计学教研室
FU Pengyu	河南省疾病预防控制中心
HU Dongsheng	450001,郑州大学公共卫生学院流行病学教研窜	dongsheng_hu@hotmai.com
ZHANG Weidong	450001,郑州大学公共卫生学院流行病学教研窜
ZHANG Meixi	450001,郑州大学公共卫生学院流行病学教研窜
WANG Chongjian	450001,郑州大学公共卫生学院流行病学教研窜
PING Zhiguang	450001,郑州大学公共卫生学院卫生统计学教研室

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Abstract:

目的分析中国成年人高血压的区域聚集性及危险因素, 探讨多水平模型在高血压危险因素研究中的应用。方法采用多阶段随机抽样方法 , 于2000--2001年从中国10地区共抽得年龄在35—74岁之间的15 540人作为研究对象, 采用MLwiN 2.02软件对数据进行二水平logistic回归模型拟合。结果高血压的患病存在地区聚集现象, 方差成分系数为3.1％。在调整了年龄和性别的影响后, 全身型肥胖人群(BMI≥28 kg/m²)和超重人群(BMI 24—27.9 kg/m²)分别为BMI正常人群(18.5～23.9 kg/m²)患高血压险的4.50(95％CI：4.00～5.06)和2.26(95％C1：2.07～2.46)倍;中心型肥胖人群(男性腰围≥85 cm或女性≥80 cm)为正常腰围人群患高血压风险的2.62(95％CI：2.42～2.83)倍;甘油i酯、总胆固醇、血糖、低密度脂蛋门胆同醇含量升高或者高密度脂蛋白胆固醇含量降低者患病风险分别为正常者高血压患病风险的2.10(95％CI：1.89—2.33)、2.08(95％CI：1.84～2.35)、1.85(95％CI：1.60～2.14)、1.58(95％CI：1.38～1.81)和1.49(95％CI：1.32一1.69)倍, 饮酒人群为不饮酒人群患高血压风险的1.15(95％CI：1.05～1.27)倍。结论高血压的发生不仪与个体肥胖、血糖升高、血脂异常和饮酒等危险渊素有关, 还受所居住区域环境因素的影响;在高血压的一级预防中, 既要关注高危人群, 还要重视以一般人群为基础的群体预防控制工作。

English Abstract:

Objective To analyze the region cluster and risk factors ofhypertension in the Chinese adult population and to explore the application of multilevel regression modeI in the risk factors of hypertension.Methods Multi-stage mndom sampling technique was used to choose l 5 540 individuals aged 35-74 years from 10 regions in China.Two.1evel logistic regression models were fitted under MLwiN 2.02 software.Results The region cluster of hypertension existed and variance portion coefficient was 3.1%.Atier atiusting for the age and gender.overall obese people(BMI≥28 kg/m²)were 4.50(95%CI： 4.OO-5.06)times.overweight people(BMI=24-27.9 kg/m²)were 2.26(95%CI：2.07-2.46)times more likely to be hypertensive as compared with those of normal BMI(18.5-23.9 kg/m²), and those centrally obesive people(Waist circumference≥85 cm in male or 80 cm in female)were 2.62(95%CI：2.42-2.83) times more likely to be hypertensive as compared with those of normal WC.The age-and genderadjusted odds ratios(0Rs)of triglyceride(TG), serum total cholesterol(TC), glucose, low-density lipoprotein cholesterol(LDL-C).high.density lipoprotein cholesterol(HDL-C)and drinking alcohol were 2.10(95%CI：1.89-2.33), 2.08(95%CI, ：1.84-2.35), 1.85(95%CI：1.60-2.14), 1.58(95%CI：1.38-1.81), 1.49(95%CI：1.32-1.69)and 1.15(95%CI：1.05-1.27), respectively. Conclusion The prevalence of hypertension was not only affected by individual risk factors, such as obesity。drinking alcoh01.abnormal glucose and serum lipids profile.but also affected by the geographic environment where people resided in.Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.

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