摘要/Abstract
摘要： 目的·探讨上海嘉定区高血压的控制情况，分析其影响因素，为高血压的防治提出建议。方法·嘉定区数据来源于五月血压测量月 （May Month Measurement，MMM）数据库。MMM项目在2017年5月—9月实施，对18岁及以上成年人规范测量3次坐位血压，每次测量间隔1 min，记录血压值。并采集人口学资料（包括年龄、性别、身高、体质量、烟酒史），既往病史[包括糖尿病、冠状动脉粥样硬化性心脏病（coronary artery heart disease，CHD）、脑卒中或短暂性脑缺血发作（transient ischemic attack，TIA） ]，及降压药物和调脂药物服用史等，测量腰围、臀围。采用Logistic逐步回归分析高血压未知晓、未治疗和未控制的影响因素。结果·共9 992例参与者，平均年龄（50.3±16.2）岁，男性占56.2%，平均血压水平125 mmHg/76 mmHg（1 mmHg=0.133 kPa）。高血压者3 161例（31.6%），其知晓率、治疗率、控制率分别为64.7%、59.3%、40.1%。对未知晓、未治疗、未控制的影响因素进行分析，发现：随着年龄的增长，高血压者的知晓、治疗情况更好（+10岁，未知晓：OR=0.77，95%CI 0.71～0.83，P=0.000。未治疗：OR=0.77，95%CI 0.71～0.83，P=0.000），男性的知晓、治疗及控制情况更差（vs 女性，未知晓：OR=1.42，95%CI 1.19～1.69，P=0.000。未治疗：OR=1.27，95%CI 1.06～1.52，P=0.009。未控制：OR=1.24，95%CI 1.02～1.51，P=0.034），患有糖尿病（未知晓：OR=0.36，95%CI 0.22～0.61，P=0.000。未治疗：OR=0.52，95%CI 0.34～0.80，P=0.003）、使用调脂药物（未知晓：OR=0.20，95%CI 0.11～0.36，P=0.000。未治疗：OR=0.25，95%CI 0.15～0.42，P=0.000）、患有CHD（未知晓：OR=0.27，95%CI 0.12～0.59，P=0.001。未治疗：OR=0.30，95%CI 0.15～0.58，P=0.000）以及卒中或TIA者（未知晓：OR=0.35，95%CI 0.17～0.72，P=0.004。未治疗：OR=0.38，95%CI 0.20～0.71，P=0.002），其知晓及治疗情况更好，CHD患者较非CHD者血压控制情况更好（OR=0.63，95%CI 0.42～0.95，P=0.026）。结论·上海嘉定区高血压的知晓率、治疗率和控制率不甚理想，低的知晓率和治疗率在男性和年轻人中更为显著，心脑血管疾病患者的知晓率、治疗率和控制率更高，提示高血压公众教育和血压测量的重要性。
关键词: 高血压, 知晓, 治疗, 控制
Abstract:
Objective · To investigate the hypertension control and relevant factors in Jiading, Shanghai, and make some suggestions for the management of hypertension. Methods · The data was derived from the May Month Measurement study, from May to September 2017. The seated blood pressure of adults aged 18 years or above were measured three times with 1-minute interval. All values were recorded. Demographic information, including age, gender, body height, and current smoking and alcohol intake, the presence of comorbid diseases, such as diabetes, coronary artery heart disease (CHD) and stroke or transient ischemic attack (TIA) and the use of antihypertensive and lipid lowering drugs, were collected as well as waist and hip circumferences were measured. Logistic stepwise regression was used to analyze the relevant factors of unawareness, untreated and uncontrolled of hypertension. Results · A total of 9 992 participants were included in the analysis, the mean age of whom was (50.3±16.2) years, with males accounting for 56.2%, and the mean blood pressure was 125 mmHg/76 mmHg (1 mmHg=0.133 kPa). The proportion of hypertension was 31.6%, and the rates of awareness, treatment and control of hypertension were 64.7%, 59.3% and 40.1%. The older hypertensive participants had better awareness and treatment [+10 years, unawareness: OR=0.77, 95%CI 0.71–0.83, P=0.000. untreated: OR=0.77, 95%CI 0.71–0.83, P=0.000]. The situation in male was worse (vs female, unawareness: OR=1.42, 95%CI 1.19–1.69, P=0.000. untreated: OR=1.27, 95%CI 1.06–1.52, P=0.009. uncontrolled: OR=1.24, 95%CI 1.02–1.51, P=0.034). Individuals with diabetes (unawareness: OR=0.36, 95%CI 0.22–0.61, P=0.000. untreated: OR=0.52, 95%CI 0.34–0.80, P=0.003), using lipid-lowering drugs (unawareness: OR 0.20, 95%CI 0.11–0.36, P=0.000. untreated: OR=0.25, 95%CI 0.15–0.42, P=0.000), with CHD (unawareness: OR=0.27, 95%CI 0.12–0.59, P=0.001. untreated: OR=0.30, 95%CI 0.15–0.58, P=0.000), and with stroke or TIA (unawareness: OR=0.35, 95%CI 0.17–0.72, P=0.004. untreated: OR=0.38, 95%CI 0.20–0.71, P=0.002) had better awareness and treatment, and patients with CHD were better controlled than ones without CHD (OR=0.63, 95%CI 0.42–0.95, P=0.026). Conclusion · The rate of awareness, treatment and control of hypertension in Jiading, Shanghai is not ideal, especially in male and the youngers. The rate of awareness, treatment and control in patients with cardiovascular diseases is higher, which suggests the importance of blood pressure measurement and public education.
Key words: hypertension, awareness, treatment, control
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