天津社区老年高血压患者心血管疾病危险因素分析

目的 预测老年高血压人群心血管疾病10年发病风险,为防治提供科学依据。方法 选取2016年972名老年高血压患者为研究对象并收集2017年回访资料,应用国人缺血性心血管病(ischemic cardiovascular disease,ICVD)10年发病危险评估方法对该人群ICVD 10年发病风险进行评估。结果 该人群ICVD 10年发病绝对风险2016年为12.8%、2017年为16.8%,2017年高于2016年(P＜0.01),其中高危者由59.3%升高至67.7%(P＜0.01);发病风险升高的154例患者的体质量指数、腰围、收缩压、血糖、血脂、尿素氮和肌酐均增加(P＜0.01),超重及肥胖增加,高胆固醇血症、高三酰甘油血症、糖尿病、代谢综合征、肾功能受损患病率增加(P＜0.01),提示ICVD 10年发病风险升高与这些因素的升高相关。结论 天津社区老年高血压人群心血管疾病危险因素水平较高,ICVD 10年发病风险较大,应加强对危险因素的有效干预。

Analysis of risk factors of cardiovascular disease in elderly hypertensive population in Tianjin community

Objective To predict the risk and trends of 10-year risk for cardiovascular diseases in elderly hypertensive population and to provide foundation data for the prevention and treatment of ischemic cardiovascular disease(ICVD). Methods Baseline data in 2016 and those of return visit in 2017 from 972 elderly hypertensive patients were collected and processed. Risk assessment and stratification of 10-year risk for cardiovascular disease(CVD) were conducted according to ICVD model. Results Compared with 2016, the absolute risk of 10-year risk of ICVD was much higher in 2017, raised from 12.8% to 16.8%(P＜0.01). In 2016, the proportion of the participants with high ICVD risk was raised from 59.3% to 67.7% (P＜0.01).Analysis on 154 patients with increased ICVD risk in this population revealed that body mass index (BMI), waist circumstance (WC), systolic blood pressure(SBP), blood glucose, blood lipids, blood urea nitrogen (BUN) and creatinine (Cr) were increased (P<0.01), the prevalence of overweight and obesity, hypercholesterolemia, hypertriglyceridemia, diabetes, metabolic syndrome, and impaired renal function were increased (P<0.01), suggesting that the increased 10-year risk of154 ICVD patients is related to the increase of these factors. Conclusion The level of cardiovascular disease risk factors in elderly hypertensive population in Tianjin community is relatively high, and is showing an upward trend. The risk of ICVD in the next 10 years is relatively high, and effective intervention should be strengthened according to risk factors.