社区中老年人原发性高血压患病调查

目的：了解社区中老年人原发性高血压的流行现状和主要危险因素，以制定合理的预防措施。方法：对南海市桂城区4个居委会3699名50岁以上中老年人进行高血压患病调查，并对429例高血压患者和481名非高血压者进行葡萄糖耐量试验和心电图检查。结果：中老年人高血压患病率为43．39％；男性高于女性(P＜0．005)；单纯收缩期高血压患病率为12．9％，随年龄增加而增加(P＜0．005)。分析相关因素显示，体重指数与高血压密切相关；有48．35％否认或不知道有高血压病；高血压病人组伴发糖尿病、糖耐量减低和冠心病患病率明显高于非高血压组(P＜0．005)。结论：高血压是危害社会中老年人健康的主要疾病之一，需加强社区高血压的管理和教育。     

某社区老年人支气管哮喘流行病学调查

目的　了解社区老年人支气管哮喘的患病情况 ,为哮喘防治奠定基础。　方法　采用整群抽样 ,对南海市桂城社区 2 481名 60岁以上老年人进行哮喘的流行病学调查。　结果　确诊老年人哮喘 98例 ,患病率为 3 .95 % (男4.91%、女 2 .92 % ) ,男性高于女性 (P <0 .0 5 ) ;工业区老年人哮喘的患病率高于文化区 (患病率分别为 5 .12 %、3 .2 6% ,P<0 .0 5 ) ;有遗传家族史者 45例 ,占 45 .92 % ;78%的患者发病年龄 >14岁 ;诱发因素前 3位分别是上呼吸道感染、气候变化和刺激性气体 ;合并COPD2 5例 ,占 2 5 .5 1%。　结论　老年人哮喘是不容忽视的疾病 ,需加强对社区哮喘的管理和教育。     

北京酒仙桥地区中老年人群心血管病发病相关因素的调查和分析

目的　了解北京酒仙桥地区中老年人群心血管病发病的相关因素 ,以制定合理的预防措施。方法　于 1996年 6～ 12月对该地区 9个居委会抽样调查了 5 87名 5 0岁以上中老年人的健康状况 ,主要包括身高、体重、血压、空腹血糖和血脂、75 g葡萄糖耐量试验和心电图检查 ,并抽样检查了 30 4人的空腹胰岛素。结果　发现超重及肥胖在小学文化程度及文盲者中所占比例最大(P <0 .0 1) ,同时女性超重及肥胖所占比例高于男性 (P <0 .0 5 ) ,但不同年龄间超重及肥胖与非超重间构成比差异无显著性 (P >0 .0 5 )。在超重及肥胖者中高脂血症、高血压、冠心病、糖耐量低减和糖尿病的患病率明显高于非超重者 (P <0 .0 1) ,超重及肥胖者中空腹血糖、胰岛素、总胆固醇和甘油三酯水平明显高于非超重者 (P <0 .0 1)。结论　对中老年人群进行以预防肥胖为重点的健康教育 ,以降低心血管病的发病率是当前一件十分迫切和非常有益的事     

昆明市高血压患者医疗保健服务分析

目的　了解昆明市高血压患者对高血压知识的知晓率、患病后的治疗率及其医疗保健情况 ,为高血压的防治对策提供依据。方法　对昆明市 14县区的 15岁以上长住居民采用多阶段分层随机抽样方法进行入户问卷调查。结果　①样本人群高血压患病率为 13 0 % ,其中男性患病率为 10 3% ,女性患病率为 14 9% ,女性高于男性 (p <0 0 0 1) ;②高血压患者对正常血压值的知晓率为 30 8% ,规律服药率为 6 5 4 % ;③定期进行血压测量等社区健康体检项目开展不足 ;④高血压患者的医疗保健服务需求和利用均远远高于非高血压患者 (p <0 0 0 1)。结论　昆明市高血压患病率已处于较高水平 ,高血压患者知晓率、治疗率低 ,医疗保健服务不完善 ,患者医疗保健服务需求高、但利用不足 ,需采取社区综合防治手段加以改善。     

广东省居民单纯收缩期高血压流行病学特征分析

目的　了解广东省居民单纯收缩期高血压 (ISH)的流行病学特征。方法　利用 2 0 0 2年广东省居民营养与健康状况调查资料 ,进行ISH描述性流行病学分析。结果　广东省 1 5岁及以上居民ISH粗患病率为 8 1 % (标化率为 5 3% ) ,其中男性为 7 6 % (标化率为 4 7% ) ,女性为 8 4 % (标化率为 5 9% ) ,男女性标化患病率差异有显著性 (u =2 97,P <0 0 1 ) ;35岁以前男性ISH患病率高于女性 ,35～ 74岁则女性高于男性 ;ISH总患病率随年龄增长而迅速增高 ;低收入、高文化程度者、学生、干部的ISH患病率较低 ,ISH患病率随着体质指数、腰围的增加而增高 ;与 1 991年相比 ,ISH标化患病率总体差异无显著性 (u =1 94 ,P >0 0 5 )。结论　ISH以老年人多见 ,随年龄增长而迅速增高 ;预防控制ISH要从早期开始并以控制肥胖为主     

社区老年人高血压现况调查

目的分析2004~2005年吉林市部分社区60~74岁老年人群高血压患病率及有关特点。方法以4个社区60~74岁1258例心血管病危险因素横断面调查结果为研究样本,对老年人高血压的患病率、高血压的类型、高血压患者合并其他心血管病危险因素等情况进行分析。结果(1)该地区60~74岁人群患病率、治疗率和控制率分别为62.7%、55.8%和20.9%;(2)随着年龄增长,男女两性高血压患病率呈持续上升趋势(P<0.05);与60~65岁组相比70~74岁组男性高血压患病率增加28.7%,女性高血压患病率增加22.4%;(3)老年人单纯收缩期高血压患病率为27.0%,占老年人高血压患者的43.1%;(4)老年人高血压患者合并至少一个其他心血管病危险因素的比例为81%。结论高血压是吉林市部分社区60~74岁老年人群常见的心血管疾病,单纯收缩期高血压是老年高血压的常见类型,老年人高血压患者绝大多数合并有其他心血管病危险因素。     

北京市895名老年人慢性病现状及其影响因素分析

目的探讨老年人慢性病现状及其影响因素。方法对北京市朝阳区社区和中关村社区 90 0名 6 0岁及以上老年人进行社区卫生服务问卷调查。结果北京市 895名老年人各种慢性病的患病率达 91.7% ,患有一种慢性病者 15 .2 % ,患有两种慢性病者 2 1.6 % ,患有三种及以上慢性病的老年人占 5 4 .9% ;慢性病患病率位于前五位的依次为高血压病4 2 .3%、白内障 35 .1%、冠心病 35 .0 %、颈椎病 2 5 .0 %、脑血管病 2 2 .0 % ;前五位主要慢性病自报患病率的影响因素为年龄、性别、文化程度、工作类型、月收入、医疗保障形式。结论老年人慢性病患病率高 ,年龄、性别、文化程度、工作类型、月收入和医疗保障形式是老年人慢性病自报患病率的重要影响因素     

焦作市解放区社区慢性非传染性疾病流行状况调查

目的　了解焦作市解放区社区人群的慢性病流行状况 ,为确定中西医结合防治策略提供依据。方法　对随机抽取的4 2 98名居民进行慢性病及相关因素的问卷调查 ,对慢性病的分布状况进行分析。结果　解放区社区人群的慢性病患病率为 :高血压 1 0 7% ,冠心病 3 2 % ,糖尿病 2 5 % ,脑卒中 1 7% ,结缔组织病 0 96 % ,肿瘤 0 6 7% ;吸烟、饮酒量及时间增加 ,高血压、冠心病、糖尿病的患病率明显升高 ;6 0岁以上的老年人慢性病患病率显著高于其他年龄组人群。结论　高血压问题应列入解放区社区慢性病防治的首要位置 ,吸烟、饮酒过量是高血压等慢性病的危险因子 ,老年人是慢性病防治的重点对象     

云南省农村老年人五种常见慢性病及共病的流行现状及与社会经济地位的关系

  目的  分析云南省农村老年人高血压、糖尿病、脑卒中、冠心病、慢性阻塞性肺疾病(chronic obstructive pneumonia diseases，COPD)及共病的流行现状及与社会经济地位的关系。  方法  采用多阶段分层随机抽样的方法抽取云南省4 833名60岁及以上农村老年人进行问卷调查和体格检查，采用主成分分析法构建社会经济地位。  结果  云南农村老年人高血压、糖尿病、脑卒中、冠心病、COPD和共病的患病率分别为50.6%、10.2%、6.4%、5.5%、5.4%和16.1%。女性高血压和糖尿病的患病率均高于男性(均有P < 0.05)，而男性COPD的患病率高于女性(χ2=5.499，P=0.019)；高血压、冠心病、脑卒中、COPD和共病的患病率均随年龄的增长而增加(均有P < 0.05)；少数民族高血压、冠心病、COPD和共病的患病率均高于汉族(均有P < 0.05)。多因素Logistic回归分析结果显示，社会经济地位越低的老年人，其患高血压、冠心病、脑卒中、COPD和共病的风险越高(均有P < 0.05)。  结论  云南省农村老年人五种慢性病及共病的患病存在明显的社会经济差异，低社会经济地位的老年人是慢性病防控的重点人群。     

社区老年人痴呆流行病学调查

目的 :了解社区老年人痴呆的流行现状。方法 :采用整群抽样 ,以简易精神状态量表 (MMSE)法 ,对南海市桂城社区 14 18名 6 0岁以上老年人进行痴呆的流行病学调查。结果 :符合美国精神障碍诊断统计手册第 4版 (DSM- IV)和美国国立神经和语言障碍和卒中——老年性痴呆及相关疾病学会 (NINCDS- ADRDA)痴呆诊断标准者 6 5例 ,痴呆患病率 4 .5 8%。其中 Alzheim er病痴呆 (AD) 5 1例 ,患病率 3.6 0 % ,占 78.4 6 % ;血管性痴呆 (VD) 14例 ,患病率 0 .99% ,占2 1.5 4 %。痴呆及 AD患病率女性明显高于男性 (P<0 .0 1) ,而 VD患病率男女间差异无显著性 (P>0 .0 5 )。痴呆、 AD及 VD的患病率均随年龄的增长而增高 (P<0 .0 1)。文化程度越低 ,痴呆、 AD及 VD的患病率越高 (P<0 .0 5 )。结论 :社区痴呆患病率与世界各国报道相似 ;AD为主要类别 ;高龄、女性、低文化水平可能是痴呆的危险因素。     

上海市社区高血压人群左室肥厚的患病率及影响因素

目的：了解社区人群左室肥厚的患病率及其影响因素，方法：对上海市南市区高血压人群进行横断面调查。结果：调查高血压人群1686人，其中男性978人，女性708人，左室肥厚患病率为29．2％，男女性分别为25．4％和34．5％，女性明显高于男性（X^2＝16．17，P＜0．01），且患病主在两性均随年龄而增加，在45－、55－、65－岁年龄段男女性别之间左室肥厚的患病率差异均有显著性（P＜0．05）。单因素及多因素分析结果表明性别、年龄，文化程度，体重指数，收缩压均是左室肥厚度的影响因素，其中文化程度为保护性因素。结论：社区中老年人左室肥厚度的患病率高，与多种复杂因素有关。应从多方面对这些因素进行针对性防治。     

An inconsistent relationship between insulin and blood pressure in three Pacific Island populations

The evidence linking insulin to blood pressure is controversial, and results for groups similarly categorized by body mass, ;glucose tolerance and hypertensive status are often contradictory. We have investigated the relationship in three. population-based samples of Micronesian (Nauru), Polynesian (Western Samoa) and Melanesian (New Caledonia) Pacific islanders, who are known to be susceptible to obesity, non-insulin-dependent diabetes mellitus (NIDDM), hyperinsulinaemia and hypertension. After controlling for age and body mass index (BMI); mean fasting and 2-hr (post 75 g glucose) insulin levels were not significantly different between hypertensive and non-hypertensive subjects, in any population or glucose tolerance sub-group, excepting 2-hr insulin in New Caledonians with normal glucose, tolerance. Similarly, there were no strong trends for a higher prevalence of hypertension amongst those with insulin levels in the upper quartile of the distribution for each population, although it was apparent in some BMI/glucose tolerance sub-groups of two populations. Multiple linear regression analyses also showed an inconsistent and where: present, weak, independent association between insulin and blood pressure in models predicting, both systolic and diastolic blood pressures. We therefore conclude that the hypothesis implicating insulin as a major determinant of blood pressure and as the pathophysiological link between obesity, NIDDM and hypertension is not strongly supported either by the literature or the present data.     

Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study

ABSTRACT: BACKGROUND: Childhood obesity and associated hypertension are major public health concerns globally. This study aimed to determine the prevalence of obesity and the associated risk of high blood pressure among Nigerian adolescents. METHODS: A cross-sectional school-based study of 885 apparently healthy adolescents was performed. Weight, height and blood pressure (BP) were measured using standard methods. Body mass index (BMI) was calculated and categorized by age, sex and percentile. Obesity and overweight were defined as: [greater than or equal to] 95th and 85th to < 95th percentiles, respectively, for age, sex and height. Subjects were sub-categorized into age 10-13 years (A) and 14-17 years (B). The odds ratio for pre-hypertensive and hypertensive range BP by age and BMI were generated. Significance was set at P < 0.05. RESULTS: The prevalence of overweight and obesity were 13.8% and 9.4%, respectively. The prevalence of hypertensive range systolic BP and diastolic BP in obese subjects was 16% compared with 2.3% in normal BMI subjects (P = 0.00), and was 12.1% for females versus 6.4% in males (P = 0.27). The prevalence of hypertensive range diastolic BP was 15.2% in obese subjects versus 3.5% in normal subjects (P = 0.01), and 12% in females versus 1.4% in males (P = 0.00). BMI in group B was significantly associated with pre-hypertensive and hypertensive range systolic BP in overweight (P = 0.01, P = 0.002) and obese subjects (P = 0.00, P = 0.00) and with hypertensive range diastolic BP (P = 0.00) only in obese subjects. The only significant association in group A was between obesity and pre-hypertensive range diastolic BP (P = 0.00). CONCLUSION: The prevalence of hypertensive range BP among obese Nigerian adolescents was high. Screening for childhood obesity and hypertension, and long-term follow-up of obese adolescents into adulthood are recommended.     

Relation of somatic and psychosocial factors to systemic pressure in hypertensive and normotensive workers]

A cohort of 900 workers aged 35-59 years underwent clinical, electrographical and psychological examinations. The prevalence of arterial hypertension was 15.2%. Family history of hypertension was positive in 87 (63.5%) hypertensive and 41 (29.9%) normotensive workers (P less than 0.01). The mean body index and the mean resting heart rate were significantly higher in the hypertensive than in the normotensive group (P less than 0.01). In the former group 96 (70.1%) persons and in the latter 89 (65%) persons belonged to type A behavior (P greater than 0.05). No significant difference in the intensity of eight basic emotions was found between the hypertensive and normotensive persons (P greater than 0.05). According to multiple regression analysis the most predictive variables of systolic blood pressure in both groups were age and resting heart rate. The two variables were more significant predictors in the hypertensive than in the normotensive group. The most predictive variable of diastolic blood pressure among the normotensive workers was body index. For the hypertensive workers this variable was not a significant predictor of diastolic blood pressure. The eight basic emotions according to Plutchik and the life need satisfaction were not significant predictors of systemic blood pressure either with the hypertensive or normotensive workers.     

郑州某高校教职工代谢综合征及相关因素分析

目的了解郑州某高校教职工中代谢综合征(MS)的发病趋势及MS相关因素的特征。方法采用病例-对照研究,依据2004年中华医学会糖尿病学分会提出的MS诊断标准对3481名郑州大学教职工的体质指数(BMI)、血压、血糖、血脂等体检结果进行统计分析。结果教职工中MS患病率为10.3%(358/3481),随年龄增长逐步升高(χ2=110.008,P<0.05)。男性MS患病率是13.1%(255/1954)显著高于女性患病率6.7%(102/1527)(χ2=36.929,P<0.05),男性的收缩压、舒张压、血糖和甘油三酯显著高于女性(P<0.05)。MS的5种类型,同时患肥胖、高血压、高血脂的比例最高,占48.3%。Logisitic回归分析显示年龄、收缩压、舒张压、BMI、血糖、甘油三酯为危险性因素,高密度脂蛋白为保护性因素。结论该高校教职工男性患病率较高,年龄、性别、BMI、血压、血糖、血脂与MS密切相关,50岁以上人群易患MS,应注意防治。     

Hypertension in Oman: distribution and correlates

BACKGROUND: International studies have reported increased prevalence of hypertension and other cardiovascular risk factors, Our aim was to study the distribution and the correlates of hypertension (HTN - systolic or diastolic) in a community based survey (National Health Survey, 2000). METHODS: A cross-sectional survey of the health status of Omani community was designed. Face to face interview including demographic data, blood pressure measurement, fasting blood glucose and serum cholesterol, weight, height, waist and hip measurement for 7011 Omani subjects with a response rate ranging between about 83% (for fasting blood glucose) to about 91% (for blood pressure measurement). RESULTS: The crude prevalence of HTN was 33.1%, while the age-adjusted prevalence was 38.3%. Older age groups, male gender, lower level of education, non- working, hypercholestremia, being married, obese, smoker, or having abnormal Waist Hip Ratio (WHR), or Total Impaired fasting glucose (TIFG) were found to be associated with hypertension in bivariate analysis. Logistic models were run to identify the adjusted Odds Ratio for the overall sample, for separate genders and age groups. For the overall sample, subjects aged 60 and above were 5.4 times more likely to be hypertensive than those below forty. Female gender was a protective factor in the overall sample, while it increased the risk by 1.4 times among those aged 60+. Obese or centrally obese subjects were also more likely to be hypertensive. Subjects with impaired fasting glucose, diabetes, or hyperchlosteremia were more likely to have hypertension than others in the majority of the logistic regression models. CONCLUSION: Hypertension is considered a major public health problem in Oman. Increasing the awareness of both health care providers and the community is crucial.     

江苏省常熟市农村居民高血压危险度评估及治疗现状分析

目的 了解常熟市农村居民高血压危险度及治疗现状。方法 随机抽取常熟市农村社区1个村,年龄35～74岁的常住居民约800人,测量血压、身高、体重,检测空腹血糖、血清总胆固醇并收集其他相关资料。结果 常熟市农村居民高血压患病率为32.01％,高血压患病率随着年龄增长而显著上升(P<0.01);女性高血压患者收缩压水平与年龄高度正相关(P<0.01),而男、女高血压患者舒张压水平与年龄高度负相关(P<0.01);高血压患者并存的心血管病危险因素如高龄、高胆固醇、早发心血管病家族史和超重所占百分率,显著高于非高血压患者(P<0.01);高血压患者中,中、低危占85.72％,高危及以上占14.28％;既往高血压患者的单纯药物治疗率、单纯非药物治疗率、综合治疗率和总治疗率分别为42.05％、2.84％、14.20％和59.09％,相应的血压控制率分别为35.14％、40.00％、36.00％和39.77％。结论 常熟市居民高血压危险度评估以中、低危为主,其药物治疗率和非药物治疗率处于较低水平,应加强对高血压患者的综合干预力度。     

血压晨峰现象的社区干预措施探讨与实践

目的探讨血压晨峰现象的社区干预措施。方法对入选132位的晨峰高血压患者随机分为干预组和非干预组。其中非干预组64例,予以一般的高血压管理,干预组68例,予以一般的高血压管理以外,并予以我们慢性病管理组牵头的全科团队模式下的社区综合干预措施包括生活方式的调整、心理干预、药物调整、血脂血糖管理等多层面的干预。两组都进行为期3年的随访。结果干预组24小时的平均收缩压、白昼平均收缩压、夜间平均收缩压、收缩压晨峰变异幅度与非干预组相比有显著差异(P<0.01),并且心脑血管事件的发生率也有明显的差异(P<0.01)。结论经过我们慢性病管理组牵头的全科团队模式下的社区综合干预,血压的晨峰现象完全可以得到良好控制,从而减少和避免心脑血管并发症的发生。