北京市公务员超重、肥胖及生活方式调查

目的了解北京市公务员的超重、肥胖及生活方式状况,为相关干预措施的开展提供理论依据。方法本调查采取普查的方式,对49家北京市机关在编的全体公务员进行自填式问卷调查。结果被调查公务员中,超重率为37.3%,肥胖率为9.1%。超重肥胖者的总吸烟率是55.3%,其中男性吸烟率66.8%,女性吸烟率5.2%,51~60岁人群吸烟率最高;超重和肥胖者中几乎每天都饮酒的占9.6%,男性饮酒的频率高于女性,年龄较大者高于年龄较小者。在体育锻炼方面,超重和肥胖的调查者中仅有23.0%进行规律的体育锻炼,年长者进行规律锻炼的比例明显高于年轻者;公务员中超重肥胖者每天静坐6小时以上者占42.2%,女性、年龄较小者静坐时间长;其平均睡眠时间为6.8小时;25.2%的被调查者最近两周有不能排解的心理压力,年龄越小者报告最近两周有不能排解的心理压力的比例越大。多因素Logistic回归分析显示:吸烟、高频率饮酒和高频率油炸食品的摄入是超重/肥胖的危险因素,而常进行体育锻炼、新鲜水果的摄入则是保护因素。结论北京市公务员中超重、肥胖患病率较高,普遍存在着行为、饮食方面的不良习惯,应该尽快采取综合措施,开展针对性干预措施。     

肥胖人群生活行为方式对高血压患病风险影响

目的探讨不同生活方式对肥胖人群高血压患病风险的影响。方法通过多级抽样方法,随机抽取天津市18～80岁社区居民21 951人,调查其生活方式及健康状况。结果社区居民平均年龄为(47.5±15.8)岁,其中男性10 689人,占48.7%;女性11 262人,占51.3%;吸烟率为29.4%(6 446人),饮酒率为28.3%(6 203人),高血压现患率为22.0%(4 797人),超重与肥胖率分别为34.8%(7 642人)、10.0%(2 192人),被调查者高血压患病风险随BMI水平上升而增高;各种生活方式中吸烟、盐摄入>6 g/d者患病风险较高;超重、肥胖者在吸烟、饮酒、盐摄入>6 g/d、不积极运动的情况下更易患高血压。结论虽然肥胖人群有较高的患高血压病风险,但如果能采取戒烟、限酒、低盐摄入和积极运动的健康生活方式,患病可能性将会降低。     

蓬莱市成人慢性病相关危险因素调查

目的 了解蓬莱市成人慢性病相关危险因素的流行现状.方法 按照多阶段随机抽样的方法,随机抽取4个乡镇,抽取的每个乡镇随机抽取3个村,每个村随机抽取35户,每户抽取1名生日最接近22号的18岁以上的居民作为调查对象,进行问卷调查和体格检查.结果 18岁以上居民总吸烟率为35.24%,18.92%的现在吸烟者每天吸烟量≥21支,开始吸烟年龄≥18岁者的比例最高(46.90%),每天均被动吸烟者占28.03%;居民饮酒率为34.29%,酗酒率为19.44%;每天食用主食、蔬菜、水果、蛋类、豆制品、肉类者占总人群的比例分别为100%、95.14%、45.14%、54.86%、2.08%、36.81%;超重者占38.57%,肥胖者占24.76%;高血压患病率为32.38%.结论 蓬莱市成人吸烟率、酗酒率、高血压患病率相对较高,饮食习惯除动物性食物及豆类摄入比例较低外,其他较为合理,肥胖问题严峻.     

2004年沂源县部分成人慢性非传染性疾病相关危险因素调查

[目的]了解沂源县居民慢性病相关危险因素的现状，为以后制订干预措施提供合理可靠的依据。[方法]2004年，采用分层随机抽样方法，在沂源县抽取部分18岁以上居民进行慢病相关危险因素的调查。[结果]调查420人，吸烟率为27．86％，吸烟者开始吸烟年龄为（20．53-6．06）岁，不吸烟者被动吸烟率为37．88％；饮酒率为34．05%；超重率为34．76％，肥胖率为12．86％；高血压患病率为16．43％；每天食用蔬菜者占97．14％，每天食用水果者占48．81％，每天食用腌熏食品者占54．76％。[结论]沂源县居民的吸烟率、高血压患病率很高，膳食结构不合理，肥胖问题严峻。     

集安市慢性病及其危险因素调查分析

目的全面掌握集安市不同地区居民慢性病危险因素及主要慢性病的流行状况和发病趋势,为慢性病干预策略和措施提供科学依据。方法通过问卷调查、身体测量、实验室检测等方法进行调查研究。结果主要慢性病患病情况高血压患病率24.16%、糖尿病9.83%。在主要慢性病危险因素中,男性吸烟率50.88%、女性吸烟率27.66%;男性饮酒率21.20%、女性饮酒率13.00%。结论集安市男性吸烟率未见明显下降,总体烟民规模仍呈扩大态势;青壮年人群饮酒行为不容乐观;18岁以上居民中接近一半的人蔬菜水果摄入不足,特别是60岁以上的老年人;成人超重与肥胖处于高流行水平;成人高血压患病率较高;糖尿病男性发病高于女性,并随年龄增长增高。     

南通市成人主要慢性病相关危险行为特征分析

摘要:目的　了解南通市18周岁以上居民主要慢性病危险因素的流行情况,为慢性病综合防控提供科学依据。方法　采用分层整群抽样的方法,随机抽取57388名成人作为调查对象,进行问卷调查、体格检查,获得主要慢性病危险因素的流行情况。结果　调查人群超重率35.0%,肥胖率11.2%,男性和女性的超重率分别为37.8%和32.3%（χ2＝190.512,P＜0.05）,肥胖率分别为9.7%和12.7%（χ2＝129.348,P＜0.05）,中年组超重、肥胖均明显高于其他2个年龄组,城市和农村超重率分别为32.2％和35.7％（χ2＝53.145,P＜0.05）,肥胖率分别为9.9％和11.6％（χ2＝28.822,P＜0.05）。成人现在吸烟率为20.1％（11613名）。男性远远高于女性（χ2＝8611.920,P＜0.05）。中年组现在吸烟率为23.1％（7674名）,高于青年组和老年组（χ2＝943.395,P＜0.05）,城市（15.3%,1839人）现在吸烟率低于农村（21.6%,9792人）（χ2＝236.669,P＜0.05）。平均饮酒率为27.2%（15593人）,男性高于女性（χ2＝20625.71,P＜0.05）,农村饮酒率高于城市（χ2＝17487.136,P＜0.05）,过量饮酒人数占调查总人数的25.7%,其中11.5%每月至少有1次大量饮酒。从不锻炼比例高达74.3％（42639名）。调查人群食盐、食油摄入超标比例分别为54.3%和71.9%,奶类、蔬菜、水果摄入不足比例分别为64.4%、57.1%、87.2%。结论　南通市成人主要慢性病危险因素高度流行,应采取积极有效的措施加以控制。     

上海市城区居民慢性病相关危险因素调查

目的研究心脑血管疾病、糖尿病等慢性非传染性疾病相关行为危险因素在上海市城区居民中的流行规律及其影响因素。方法采用多阶段随机抽样方法,抽取上海市某城区的480名年龄在18～69岁的常住居民进行问卷调查。结果上海市城区居民慢性病的行为危险因素流行率较高,其中吸烟率、饮酒率、苯丙类致癌物质及高钠食品摄入率、高脂摄入率、缺少体育运动率和超重率分别为27.14%,28.39%,9.60%,17.75%,57.62%和29.02%。调查对象自报高血压患病率为19.62%,自报高血脂患病率为10.86%,自报糖尿病患病率5.64%。Logistic多元回归分析表明,行为危险因素有其存在的广泛性和相互强化。结论吸烟、不合理膳食、缺少体育运动以及高血压等危险因素普遍存在,且具有不同的人群分布特性和影响因素,必须及时采取针对性的干预措施、加强控制。     

北京市城区居民慢性病行为危险因素监测

目的 研究心脑血管病等慢性非传染性疾病相关行为危险因素在北京市城区居民中流行规律及其影响因素。方法 1996－1999年,每月采用随机抽样方法,对全市城区抽取的11084名年龄在15－69岁的常住居民进行问卷监测调查。结果 北京市城区居民中慢性病的行为危险因素流行率较高,其中现在吸烟率、酗酒率、咸食摄入率、高脂摄入率、缺少体育运动率和体重超重率分别为23．25％、8．95％、43．57％、26．89％、14．97％和32．15％。调查对象自报高血压患病率为19．22％。随着监测次数的增加,现在吸烟率出现明显下降的趋势,而其他行为危险因素的流行率无明显变化。logistic多元回归分析表明,行为危险因素在同一人群中常伴随出现。结论 人际交往、社会及家庭环境、患病和健康意识是行为改变的主要影响因素。尽管现在吸烟率几年来出现显下降的趋势,但吸烟、不合理膳食、缺少体育运动以及高血压等危险因素严重,必须及时采取干预措施,加强控制。     

社区居民心脑血管疾病的知信行调查与干预策略探讨

抽取上海市卢湾区某街道的两个里委。对１４８６名社区成年居民的调查发现：心脑血管疾病的危险因素普遍存在,吸烟率１７６％,男性吸烟率３３５％;饮酒率１１１％;超重和肥胖占２５８％;６３０％缺乏锻炼;５０％左右的高血压患者不定期看医生,不经常量血压和不遵医嘱服药。仅１３７％的调查对象知道高血压、冠心病和中风,１８６％对心脑血管病的危险因素全然不知。６７４％的成年社区居民认为预防是控制心脑血管病的关键,但愿意参加防治活动者仅１／３,尤其是心脑血管病知识缺乏者。因此,开展社区健康教育干预极为迫切。     

广州市白云区慢性非传染性疾病社区诊断报告及健康教育策略探讨

目的了解白云区常住居民主要慢性病患病情况,探讨居民慢性病预防与控制策略。方法采用多阶段整群随机抽样方法,对居住满半年以上的常住居民进行问卷调查和一般体格检查。结果实际调查居民17313人,总患病率为19.82%。15岁以上人群现场高血压检出率为10.05%,平均体重指数为23.45kg/m2,总超重肥胖率为20.24%,吸烟率为20.92%,饮酒率为8.91%,主动锻炼率为82.96%。结论低年龄组女性超重肥胖率高于男性,到18岁年龄段以后,女性超重肥胖率均低于男性,随着年龄增长而上升的趋势不明显。60岁以上老年人口的戒烟比例最高,原因可能是因患病而被动戒烟。锻炼模式多为老年人在退休后开展体育锻炼,而青、中年则较少进行体育锻炼。     

职业人群不健康行为生活方式与高尿酸血症的关系及高血压、血脂异常的效应修饰作用

目的 探索不健康行为生活方式与高尿酸血症的关系,以及高血压、血脂异常的效应修饰作用,为预防高尿酸血症提供理论依据。方法 采用横断面调查研究设计,基于2021年10-12月来自四川省、贵州省28个地级市和重庆市33个区（县）中国铁路成都局集团有限公司的西南职业人群队列基线数据,通过问卷调查、体格测量及实验室生化检测收集研究对象的人口学特征、行为生活方式、慢性非传染性疾病患病情况。不健康行为生活方式得分根据吸烟、饮酒、膳食模式、体力活动和低体重/超重状况进行评分,分值越高不健康行为生活方式越多。采用多因素logistic回归模型分析不健康行为生活方式评分、吸烟状况、饮酒状况等与高尿酸血症的关系,采用分层分析探索高血压等疾病对不健康行为生活方式与高尿酸血症之间关系的修饰效应。结果 共纳入11 748名研究对象,高尿酸血症患病率为34.4%。多因素logistic回归分析显示,现在吸/既往吸烟、现在饮/既往饮酒及BMI异常是高尿酸血症患病的危险因素,不健康行为生活方式对高尿酸血症患病风险呈现累积效应,随着得分的升高,高尿酸血症患病风险升高,OR值由1.64（95%CI：1.34~2.00）上升至2.89（95%CI：2.39~3.50）。分层分析结果显示,在高血压及血脂异常人群中,不健康行为生活方式对高尿酸血症患病风险影响更大。结论 多种不健康行为生活方式的共存会升高高尿酸血症患病风险,这一效应在高血压、血脂异常人群中更明显。及时纠正不健康行为生活方式,并控制高血压和血脂异常,降低患高尿酸血症的风险。     

Association of adherence to the seventh report of the Joint National Committee guidelines with hypertension in Korean men and women

Whether the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) guidelines can be applied to the Asian population remains unclear. We aim to test the hypothesis that adherence to the JNC-7 guidelines is associated with hypertension in a representative sample of the Korean population in the fourth Korea National Health and Nutrition Examination Survey. Participants completed a non-quantitative food frequency questionnaire and 24-hour diet recall through interviews. Blood pressure, height, and weight were directly measured, and questions about physical activity and other lifestyle factors were administered. A total of 500 hypertensive and 4567 normotensive participants were identified. We estimated the odds ratio and 95% confidence intervals using a multivariate logistic regression. The following components of the JNC-7 guidelines were considered: dietary approaches to stop a hypertension style diet, moderate consumption of alcohol, adequate physical activity, and a normal body mass index. Those individuals who fell in the low-risk category for all 4 lifestyle components had an odds ratio of 0.48 (95% confidence interval, 0.30-0.78) compared with the remainder of the participants. In conclusion, we found an inverse association between adherence to the JNC-7 guidelines and hypertension prevalence among Korean adults, suggesting the importance of lifestyle modification for the prevention and management of hypertension.     

Management of hypertension in low and middle income countries: Challenges and opportunities

Hypertension is one of the most important risk factors for cardiovascular morbidity and mortality. More than a quarter of the global adult population (972 million) is currently hypertensive and almost three quarters (639 million) live in developing countries. Hypertension management therefore is of great public health importance in the developing world. In this paper, we review screening, diagnosis and management using lifestyle measures and pharmacotherapy given the resources of developed nations. We then discuss the barriers and challenges to implementing this approach and what can be done regarding prevention, screening, lifestyle modification and pharmacotherapy in developing countries. By adopting a comprehensive population based approach including policy level interventions directed at promoting lifestyle changes; a healthy diet (appropriate calories, low in saturated fats and salt additives and rich in fruits and vegetables), increased physical activity, and a smoke free environment, properly balanced with a high risk approach of cost effective clinical care, developing countries can effectively control hypertension and improve public health. Existing scientific knowledge regarding prevention, treatment and management should be harnessed as a health priority to reduce the disease burden associated with uncontrolled hypertension.     

Higher adherence to the Mediterranean diet is inversely associated with having hypertension: is low salt intake a mediating factor?

Blood pressure (BP) is a major risk factor for population health worldwide and a preventable disease through lifestyle modification. The aim of this study was to assess the association between adherence to the Mediterranean diet (MD) and occurrence of hypertension in a Mediterranean cohort. Demographic and dietary data of 1937 adults were collected in 2014–2015 from the general population of Catania, Sicily (Italy). Food frequency questionnaires and a MD adherence score were used to assess exposure variables. Higher adherence to the MD was inversely associated with hypertension. However, this association was no more significant after adjustment for sodium and potassium intake. These results suggest that salt may exert a mediating effect of high adherence to the MD towards hypertension.     

The treatment of adults with essential hypertension

Hypertension is arbitrarily defined as diastolic blood pressure (DBP) of 90 mm Hg or higher, systolic blood pressure (SBP) of 140 mm Hg or higher, or both, on 3 separate occasions. Essential hypertension is hypertension without an identifiable cause. Essential hypertension, also known as primary or idiopathic hypertension, accounts for at least 95% of all cases of hypertension. According to the third National Health and Nutrition Examination Survey (NHANES III), approximately 60% of the 50 million Americans with hypertension are at increased risk for cardiovascular disease resulting from uncontrolled hypertension. This is because only 53% of hypertensive patients are being treated and only 24% have their hypertension under control. Physicians must play an active role in identifying and treating hypertension. In an earlier Applied Evidence article, an approach to the diagnosis of hypertension was presented. This article reviews the treatment of essential hypertension in adults and the prognosis of untreated hypertension. Risk stratification, alternative therapies, lifestyle modification, drug therapy, and prognosis will each be reviewed sequentially.     

An update on medical therapy for obesity.

Obesity is a risk factor and exacerbates many chronic conditions, particularly diabetes, but also hypertension, hyperlipidemia, heart disease, stroke, certain cancers, arthritis, and obstructive sleep apnea. Despite increased awareness within the public and healthcare system, there has still been a persistent rise in the prevalence of obesity over the past half-century. Failure to halt this epidemic is related to difficulties in adherence to lifestyle changes, forceful counter-regulatory mechanisms opposing weight loss, and the lack of efficient long-term therapy for obesity. This article summarizes the current medical approach to the treatment of obesity, reviewing strategies for lifestyle modification, available pharmacotherapy both as an adjunct to diet and exercise and to ameliorate comorbidities, and an overview of new pharmaceutical agents being developed.     

某客运段厨师高血压患病情况分析

目的了解某客运段列车厨师的高血压患病率,为职业人群高血压防治提供科学依据。方法选取某客运段列车厨师317名为观察组,同单位列车乘务员362名为对照组,采用汞柱式血压计测量血压,用1999年WHO/国际高血压联盟推荐的高血压分类标准,并进行x~2检验。结果 317名厨师高血压患病率19.9%,明显高于对照组8.8%,差异有统计学意义（P〈0.01）。各工龄段比较差异有统计学意义。结论列车厨师高血压不容忽视,应采取改变生活方式、合理膳食、加强锻炼、加强健康监测和劳动保护等综合防治措施。     

Experiences of and attitudes to lifestyle modification for the management of multiple sclerosis: A qualitative analysis of free‐text survey data

BackgroundGrowing evidence suggests a role of lifestyle modification in improved health outcomes for people with multiple sclerosis (pwMS); however, perspectives of pwMS who engage in lifestyle modification are lacking.ObjectiveWe explored perspectives of pwMS regarding the modification of lifestyle‐related risk factors in multiple sclerosis (MS) for disease management to understand attitudes to and experiences of lifestyle modification as part of self‐management from a patient perspective.DesignParticipants were ≥18 years and English speaking who responded to a free‐text open‐ended question in the Health Outcomes and Lifestyle In a Sample of pwMS (HOLISM), an international online survey. Responses were analysed utilizing inductive thematic analysis.ResultsUnder the exploration of lifestyle modification, themes describing the experiences and attitudes of participants included practical challenges and physical and psychological barriers, enablers of change and experienced outcomes. Although participants reported some practical and psychological challenges to adoption and maintenance of lifestyle behaviours, many expressed an ability to gain control of MS through engagement with lifestyle behaviours and the development of hope and optimism that accompanied this sense of control, at times leading to a sense of personal transformation.ConclusionFindings highlight the challenges experienced by pwMS in adopting lifestyle modifications for disease management as well as the positive benefits from following healthy lifestyle behaviours. Our findings may form the basis of more focussed qualitative explorations of the experiences and outcomes of lifestyle modification in MS in the future.Patient ContributionConsenting pwMS completed a survey capturing data on demographics, clinical course, lifestyle behaviours and health outcomes.     

中老年人群生活方式与血压水平和高血压发生风险的关联

  目的  探讨中老年人群生活方式及其变化与血压水平和高血压发生风险的关联。  方法  纳入东风-同济队列2008―2010年7 671名研究对象进行分析。分别采用线性回归和Logistic回归分析模型评估生活方式与血压水平和高血压发生风险的关联。  结果  校正混杂因素后,生活方式评分增加与血压水平和高血压风险的降低均有剂量反应关系。与基线生活方式评分0~1分组相比,＞4分组的SBP、DBP和平均动脉压分别降低4.03、2.25和2.84 mm Hg,新发高血压的OR值为0.68(95% CI: 0.52~0.88)。且每增加1分,高血压发生风险降低9%(OR=0.91, 95% CI: 0.87~0.95)。而从基线至2013年随访5年间生活方式评分维持在＞3的个体,其新发高血压风险的OR值为0.61(OR=0.61, 95% CI: 0.47~0.80),但是从基线0~2分提高至随访＞3分并不能降低高血压风险(OR=0.87, 95% CI: 0.54~1.40)。  结论  中老年人群尽早并长期坚持健康生活方式对于高血压防控效益最大。     

保定市人群高血压患者不良生活方式调查

目的了解保定市高血压患者不良生活方式状况,为政府制定高血压防治策略提供依据,为临床医生选择干预手段、制定干预策略,提高高血压患者的依从度提供资料。方法对保定市区和涿州市码头镇高血压患者不良生活方式进行调查,对基线资料进行统计分析。结果高血压患者血压控制率还很低,尤其农村不达标率达89.66%。吸烟、饮酒等不良嗜好广泛存在,城市主要是饮酒,农村主要是吸烟。城市食盐摄入量高于农村。结论高血压控制应长期性、针对性、多样化、个体化。