嘉兴市某三甲医院体检中老年人群高血压患病的驱动因素模型构建

邸军军; 沈亮

doi:10.16766/j.cnki.issn.1674-4152.003248

嘉兴市某三甲医院体检中老年人群高血压患病的驱动因素模型构建

doi: 10.16766/j.cnki.issn.1674-4152.003248

邸军军^1, ,,
沈亮²

1.
中国人民武装警察部队海警总队医院心血管内科，浙江嘉兴 314000
2.
嘉兴市第一医院心内科，浙江嘉兴 314000

基金项目:

浙江省基础公益研究计划项目 LGF19H020007

详细信息

通讯作者:
邸军军，E-mail：djj13758093901@163.com

中图分类号: R544.1
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出版历程
- 收稿日期: 2022-11-15
- 网络出版日期: 2024-01-13

Construction of a driving factor model of hypertension among physical examination middle-aged and elderly people in a top three hospital in Jiaxing City

DI Junjun^{1
, ,},
SHEN Liang²

1.
Department of Hospital of the Chinese People' s Armed Police Force Maritime Safety Bureau, Jiaxing, Zhejiang 314000, China

摘要

摘要: 目的调查嘉兴市某三甲医院体检中老年人群高血压患病率现况并构建疾病发生驱动因素模型，为预防措施的制定提供依据。方法回顾性选择2019年12月—2022年6月于中国人民武装警察部队海警总队医院进行体检的5 155例中老年人群进行研究，根据研究对象高血压发生情况，将其分为高血压组(2 327例)和非高血压组(2 828例)。调查中老年人群高血压患病率现况，通过单因素分析及多因素logistic回归分析法分析中老年人群高血压发生的危险因素，建立驱动因素模型，并绘制ROC曲线分析其对中老年人群高血压发生的预测价值。结果 5 155例中老年人群中患高血压者2 327例，高血压患病率为45.14%。多因素logistic回归分析结果显示，年龄≥60岁、BMI>24、吸烟、高盐饮食、中心型肥胖、未经常运动、糖尿病、有高血压家族史为中老年人群高血压发生的危险因素(均P < 0.05)。将上述因素纳入驱动因素模型：logit(P)=-14.158+年龄≥60岁×0.542+BMI>24×0.803+吸烟×0.609+高盐饮食×0.774+中心型肥胖×0.668+未经常运动×0.794+糖尿病×0.545+有高血压家族史×0.676，绘制ROC曲线，结果显示当logit(P)>16.81时，AUC为0.855。结论嘉兴市某三甲医院体检的中老年人群高血压患病率达45.14%，高血压发生的危险因素较多，据此建立驱动因素模型预测中老年人群高血压发生的价值较高。
- 高血压 /
- 中老年 /
- 现况 /
- 危险因素 /
- 模型 /
- 受试者工作特征曲线
Abstract: Objective To investigate the prevalence of hypertension among middle-aged and elderly people in a Level A Tertiary Hospital in Jiaxing City and to build a driving factor model for the development of preventive measures. Methods A total of 5 155 middle-aged and elderly people who underwent a physical examination in Hospital of the Chinese People' s Armed Police Force Maritime Safety Bureau from December 2019 to June 2022 were retrospectively selected for this study. According to the occurrence of hypertension, the subjects were divided into the hypertension group (2 327 cases) and the non-hypertension group (2 828 cases). Hypertension in middle-aged and elderly people was investigated, through the single-factor analysis and multifactor logistic regression analysis, the risk factors of middle-aged and elderly people, construction of driving factor model was established, and draw the receiver operating characteristic (ROC) curve analysis driven model predictive value for hypertension in middle-aged and elderly people. Results There were 2 327 cases of hypertension among 5 155 middle-aged and elderly people, the incidence of hypertension was 45.14%. The results of multivariate logistic analysis showed that age ≥60 years old, BMI >24, smoking, high salt diet, central obesity, no regular exercise, diabetes, family history of hypertension were the risk factors for hypertension in middle-aged and elderly people (all P < 0.05). Including the above factors in the driver model: logit (P) =-14.158+age≥60 years old ×0.542+BMI>24×0.803+smoking×0.609+ high salt diet ×0.774+ central obesity×0.668+ no regular exercise ×0.794+ diabetes ×0.545+ family history of hypertension ×0.676. The results of the ROC curve showed that when logit (P) >16.81, the area under the curve (AUC) was 0.855. Conclusion The incidence of hypertension in physical examination middle-aged and elderly people in a top three hospital in Jiaxing City could reach 45.14%, the risk factors for hypertension include many factors, it was of high value to build a driving factor model to predict the occurrence of hypertension in middle-aged and elderly people.
- Hypertension /
- Middle-aged and old /
- Current conditions /
- Risk factors /
- Model /
- Receiver operating characteristic

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图 1 驱动因素模型预测中老年人群高血压发生的ROC曲线

Figure 1. ROC curve of hypertension in middle-aged and elderly population predicted by driver model

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表 1 中老年人群高血压发生危险因素的单因素分析[例(%)]

Table 1. factor analysis of hypertension risk factors in middle-aged and elderly population [cases (%)]

项目	高血压组 (n=2 327)	非高血压组 (n=2 828)	χ²值	P值	项目	高血压组 (n=2 327)	非高血压组 (n=2 828)	χ²值	P值
性别			0.830	0.362	中心型肥胖			168.144	<0.001
男性	1 297(55.74)	1 612(57.00)			是	1 257(54.02)	1 018(36.00)
女性	1 030(44.26)	1 216(43.00)			否	1 070(45.98)	1 810(64.00)
年龄(岁)			221.745	<0.001	上臂皮褶厚度增加			64.088	<0.001
45~59	582(25.01)	1 273(45.01)			是	1 070(45.98)	990(35.01)
≥60	1 745(74.99)	1 555(54.99)			否	1 257(54.02)	1 838(64.99)
BMI			142.437	<0.001	经常运动			364.462	<0.001
≤24	628(26.99)	1 216(43.00)			是	279(11.99)	990(35.01)
>24	1 699(73.01)	1 612(57.00)			否	2 048(88.01)	1 838(64.99)
受教育程度			0.643	0.423	糖尿病			40.037	<0.001
高中及以上	838(36.01)	1 049(37.09)			有	768(33.00)	707(25.00)
高中以下	1 489(63.99)	1 779(62.91)			无	1 559(67.00)	2 121(75.00)
吸烟			116.879	<0.001	婚姻状况			37.829	<0.001
是	1 210(52.00)	1 046(36.99)			有配偶	2 048(88.01)	2 630(93.00)
否	1 117(48.00)	1 782(63.01)			无配偶	279(11.99)	198(7.00)
饮酒			109.597	<0.001	高血压家族史			377.389	<0.001
有	791(33.99)	594(21.00)			有	1 373(59.00)	905(32.00)
无	1 536(66.01)	2 234(79.00)			无	954(41.00)	1 923(68.00)
就业状况			1.170	0.279	职业			0.534	0.970
在业	1 001(43.02)	1 259(44.52)			农民	460(19.77)	560(19.80)
未在业	1 326(56.98)	1 569(55.48)			工人	470(20.20)	565(19.98)
高盐饮食			106.688	<0.001	个体工商户	475(20.41)	570(20.16)
是	1 047(44.99)	877(31.01)			单位职工	455(19.55)	575(20.33)
否	1 280(55.01)	1 951(68.99)			退休/自由职业	467(20.07)	558(19.73)

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表 2 中老年人群高血压发生危险因素的多因素logistic回归分析

Table 2. Multivariate logistic analysis of hypertension risk factors in middle-aged and elderly population

变量	B	SE	Wald χ²	P值	OR值	95% CI
年龄≥60岁	0.542	0.253	4.589	0.032	1.719	1.047~2.823
BMI>24	0.803	0.224	12.851	<0.001	2.232	1.439~3.463
吸烟	0.609	0.294	4.291	0.038	1.839	1.033~3.271
饮酒	0.668	0.606	1.215	0.270	1.950	0.595~6.397
高盐饮食	0.774	0.226	11.729	0.001	2.168	1.392~3.377
中心型肥胖	0.668	0.317	4.441	0.035	1.950	1.048~3.630
上臂皮褶厚度增加	0.830	0.712	1.359	0.244	2.293	0.568~9.258
未经常运动	0.794	0.238	11.130	0.001	2.212	1.388~3.527
糖尿病	0.545	0.212	6.609	0.010	1.725	1.138~2.613
婚姻状况为无配偶	0.621	0.784	0.627	0.428	1.861	0.400~8.651
有高血压家族史	0.676	0.292	5.360	0.021	1.966	1.109~3.484

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参考文献(20)

[1]	马丽媛, 王增武, 樊静, 等. 《中国心血管健康与疾病报告2021》关于中国高血压流行和防治现状[J]. 中国全科医学, 2022, 25(30): 3715-3720. MA L Y, WANC Z W, FAN J, et al. Epidemiology and management of hypertension in China: an analysis using data from the annual report on cardiovascular health and diseases in China (2021)[J]. Chinese General Practice, 2022, 25(30): 3715-3720.
[2]	段力, 贺娟, 李淼晶. 成都市某社区居民高血压认知现状及影响因素分析[J]. 中华全科医学, 2022, 20(9): 1526-1530. doi: 10.16766/j.cnki.issn.1674-4152.002640 DUAN L, HE J, LI M J. Cognitive status and influencing factors of hypertension amongst residents in a community in Chengdu[J]. Chinese Journal of General Practice, 2022, 20(9): 1526-1530. doi: 10.16766/j.cnki.issn.1674-4152.002640
[3]	侯绪良, 冯永恩, 尹天露, 等. 独立自然村老年高血压人群流行病学数据获取方法的分析[J]. 中国全科医学, 2021, 24(29): 3724-3728. doi: 10.12114/j.issn.1007-9572.2021.01.305 HOU X L, FENG Y E, YIN T L, et al. Methods of obtaining epidemiological data of hypertensive elderly people in an isolated natural village: a comparative analysis[J]. Chinese General Practice, 2021, 24(29): 3724-3728. doi: 10.12114/j.issn.1007-9572.2021.01.305
[4]	常琼, 何秋黎. 重庆市社区中老年居民高血压发生情况、流行病学特征及健康管理需求调查[J]. 实用心脑肺血管病杂志, 2021, 29(11): 21-28. doi: 10.12114/j.issn.1008-5971.2021.00.218 CHANG Q, HE Q L. Investigation on the incidence, epidemiological characteristics and health management requirement of hypertension in middle-aged and elderly community residents in Chongqing[J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2021, 29(11): 21-28. doi: 10.12114/j.issn.1008-5971.2021.00.218
[5]	徐艳, 朱丽萍, 刘杰, 等. 江西省94 591名居民高血压流行病学特征分析[J]. 中国卫生统计, 2021, 38(2): 222-225. XU Y, ZHU L P, LIU J, et al. Epidemiological characteristics of hypertension in 94591 residents of Jiangxi Province[J]. Chinese Journal of Health Statistics, 2021, 38(2): 222-225.
[6]	陆再英, 钟南山. 内科学[M]. 7版. 北京: 人民卫生出版社, 2008: 23-29. LU Z Y, ZHONG N S. Internal Medicine[M]. 7th edition. Beijing: People's Medical Publishing House, 2008: 23-29.
[7]	OSTCHEGA Y, HUGHES J P, KIT B, et al. Differences in hypertension and stage Ⅱ hypertension by demographic and risk factors, obtained by two different protocols in us adults: national health and nutrition examination survey, 2017-2018[J]. Am J Hypertens, 2022, 35(7): 619-626. doi: 10.1093/ajh/hpac042
[8]	ALLAMEH M, GHANEI GHESHLAGH R, RAHMANI K. Prevalence and associated risk factors of hypertension for the middle-aged population (30-59 years) in Iran: a national cross-sectional study[J]. High Blood Press Cardiovasc Prev, 2022, 29(1): 75-80. doi: 10.1007/s40292-021-00490-6
[9]	袁姣, 武青松, 雷枢, 等. 我国中老年人群高血压流行现状及影响因素研究[J]. 中国全科医学, 2020, 23(34): 4337-4341. doi: 10.12114/j.issn.1007-9572.2020.00.285 YUAN J, WU Q S, LEI S, et al. The prevalence of hypertension and its influencing factors in middle-aged and elderly people in China[J]. Chinese General Practice, 2020, 23(34): 4337-4341. doi: 10.12114/j.issn.1007-9572.2020.00.285
[10]	赵冬. 中国成人高血压流行病学现状[J]. 中国心血管杂志, 2020, 25(6): 513-515. ZHAO D. Current epidemiology of adult hypertension in China[J]. Chinese Journal of Cardiovascular Medicine, 2020, 25(6): 513-515.
[11]	周小艳, 林先燕, 莫才云, 等. 贵州黔南瑶族中老年人群高血压流行病学特点及影响因素[J]. 中国老年学杂志, 2020, 40(10): 2206-2208. ZHOU X Y, LIN X Y, MO C Y, et al. Epidemiological characteristics and influencing factors of hypertension in middle-aged and elderly Yao people in Qiannan, Guizhou Province[J]. Chinese Journal of Gerontology, 2020, 40(10): 2206-2208.
[12]	张文, 李鑫, 孙坤, 等. 养老机构老年高血压患者衰弱与社会支持、睡眠质量的相关性研究[J]. 成都医学院学报, 2022, 17(4): 500-504. ZHANG W, LI X, SUN K, et al. A Study on the correlation between frailty, social support and sleep quality in elderly hypertensive patients in nursing homes[J]. Journal of Chengdu Medical College, 2022, 17(4): 500-504.
[13]	陈艳明, 赵茂翔, 汪驰, 等. 基层部队官兵高血压流行病学特点及危险因素分析[J]. 解放军医学院学报, 2021, 42(1): 30-33. CHEN Y M, ZHAO M X, WANG C, et al. Epidemiological characteristics and risk factors of hypertension among PLA troops[J]. Academic Journal of Chinese PLA Medical School, 2021, 42(1): 30-33.
[14]	熊筱璐, 马一鸣, 周卫红, 等. 南京某医院中青年体检人群高血压前期和高血压病流行现状及其危险因素分析[J]. 中华内科杂志, 2021, 60(4): 338-344. XIONG X L, MA Y M, ZHOU W H, et al. Prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing[J]. Chinese Journal of Internal Medicine, 2021, 60(4): 338-344.
[15]	张文博, 黄星荷, 李静. 高血压的流行趋势和治疗进展[J]. 心血管病学进展, 2019, 40(3): 331-337. ZHANG W B, HUANG X H, LI J. Epidemiology trend and progress in antihypertensive treatment of hypertension[J]. Advances in Cardiovascular Diseases, 2019, 40(3): 331-337.
[16]	武肖肖, 张琳琳, 王旭帆, 等. 安徽省40岁以上人群高血压患病情况及影响因素的地区差异分析[J]. 中华全科医学, 2022, 20(1): 68-71. doi: 10.16766/j.cnki.issn.1674-4152.002279 WU X X, ZHANG L L, WANG X F, et al. Regional differences in the prevalence and influencing factors of hypertension amongst people over 40 years old in Anhui Province[J]. Chinese Journal of General Practice, 2022, 20(1): 68-71. doi: 10.16766/j.cnki.issn.1674-4152.002279
[17]	刘玉环, 赵晶晶, 曹亚景, 等. 河北省年龄35~75岁人群高血压的流行状况及相关因素[J]. 中华高血压杂志, 2019, 27(10): 945-950. LIU Y H, ZHAO J J, CAO Y J, et al. Epidemic status and risk factors of hypertension in population aged 35-75 years in Hebei province[J]. Chinese Journal of Hypertension, 2019, 27(10): 945-950.
[18]	付朝红, 李建彬, 郭向娇, 等. 郑州市40岁及以上高血压患者血脂异常流行现状与影响因素[J]. 中国心血管杂志, 2020, 25(5): 470-475. FU Z H, LI J B, GUO X J, et al. Epidemiological status and influencing factors of dyslipidemia in hypertensive patients aged 40 and above in Zhengzhou[J]. Chinese Journal of Cardiovascular Medicine, 2020, 25(5): 470-475.
[19]	HIBINO M, OTAKI Y, KOBEISSI E, et al. Blood pressure, hypertension, and the risk of aortic dissection incidence and mortality: results from the J-SCH study, the UK biobank study, and a meta-analysis of cohort studies[J]. Circulation, 2022, 145(9): 633-644.
[20]	隋静, 高玉敏, 赵美清, 等. 社区老年人DDAH2基因多态性与高血压的相关性研究[J]. 中国循证心血管医学杂志, 2022, 14(5): 611-614, 619. SUI J, GAO Y M, ZHAO M Q, et al. Correlation between dimethylarginine dimethylamine hydrolase 2 gene polymorphisms and hypertension in old people in community[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2022, 14(5): 611-614, 619.