The epidemiology of hypertension and its associated risk factors in the city of Debrecen,Hungary

The purpose of this work was to estimate the prevalence of hypertension and cardiovascular risk factors and its association with sociodemographic, behavioural and lifestyle characteristics among the adult population of the city of Debrecen, Hungary.A cross-sectional study was conducted in 1996. Amongst 21 800 inhabitants aged 30-65 y risk screening for cardiovascular disease (CVD) was estimated by a questionnaire that included sociodemographic, lifestyle characteristics, family history of CVD and results of self-reported data of body weight, height and blood pressure.Of the total of 19 961 surveyed sample, 37.02% were considered to be hypertensive, 53.73% were overweight, 32.18% were current smokers and 58.85% were physically inactive. Hypertensives were older than normotensives (50.81+/-9.01 vs 44.78+/-8.97 y, P<0.001). The prevalence of various risk factors amongst hypertensives as compared to normotensives were overweight (68.49 vs 45.06%, P<0.0001), current smoking (28.38 vs 34.41%, P<0.0001), physical inactivity (64.78 vs 55.36%, P<0.001), and high alcohol consumption (1.91 vs 1.06%, P<0.01). Of the hypertensives 37.11% were on drug therapy. Of those on therapy, only 17.03% had normal blood pressure. Being overweight and having low physical activity was positively associated with hypertension (OR=2.25, CI=2.11-2.40) and (OR=1.26, CI=1.15-1.38). Manual work, a family history of CVD, low education, and the male gender were also associated with hypertension and more CVD risk factors.These findings illustrate a very high prevalence of hypertension and CVD risk factors in Debrecen, indicating the importance of the need for more effective prevention programmes and control of hypertension in Hungary.     

Nutrition,antioxidants, and risk factor profile of nonsmokers,passive smokers and smokers of the Prevention Education Program (PEP) in Nuremberg,Germany

BACKGROUND: An elevated risk for coronary artery disease and lung cancer was reported for smokers and nonsmokers exposed to environmental tobacco smoke. Particularly in nonsmokers, in addition to the adverse effects of tobacco smoke, other factors which are associated with the exposure to environmental tobacco smoke may contribute to the health risks. We investigated both by questionnaires and biochemical analyses whether smokers influence the dietary habits of nonsmokers living in the same household. METHODS: The study population was a subgroup of the Prevention Education Program in Nuremberg: 817 adults aged 27-66 years were allocated to one of the four groups: Nonsmokers living with a nonsmoker (Group 1), nonsmokers living with a smoker (Group 2), smokers living with a nonsmoker (Group 3), and smokers living with a smoker (Group 4). RESULTS: The four groups did not differ in the body mass index, the concentration of lycopene, all-trans-retinol, and selenium in plasma. Plasma concentrations of high-density lipoprotein cholesterol, triglycerides, homocysteine, cobalamin, folate, beta-carotene, and alpha-tocopherol showed a gradient to unfavorable levels from Group 1 to Group 4. This trend was also reflected in the reported dietary intake of beta-carotene, alpha-tocopherol, ascorbic acid, fiber, and linoleic acid. CONCLUSIONS: Our data show that nonsmokers living with smokers indulge in less healthy dietary habits than nonsmokers living with nonsmokers. This has to be considered when evaluating the health risks of exposure to environmental tobacco smoke.     

昆明市居民糖尿病患病情况及危险因素分析

目的 了解云南省昆明市城乡居民糖尿病(DM)患病情况及其危险因素,探讨制订昆明市糖尿病预防控制对策和措施.方法 2008年1-4月,采用多阶段分层随机抽样方法,对抽中的居民进行糖尿病流行病学调查.结果 调查20岁~居民5 185人,糖尿病患病率为5.76%,标化患病率为3.99%;其中,男性患病率为5.88%,标化率为4.62%;女性患病率为5.26%,标化率为3.69%;男女性患病率比较差异无统计学意义(χ²=0.871,P=0.351);高血脂史、DM家族史、向心性肥胖、超重肥胖、年龄、高血压史是糖尿病的危险因素,OR值分别为2.756,2.630,1.890,1.514,1.493,1.467;常吃水果和食用植物油是糖尿病的保护因素,OR值分别为0.459和0.583.结论 糖尿病已成为影响昆明市城乡居民健康的主要疾病,应针对主要危险因素开展糖尿病社区预防控制工作.     

南宁市中老年人心血管健康状况危险因素分析

目的：对南宁市中老年人心血管健康状况及其危险因素进行分析。方法：采用随机抽样方法，对南宁市35－74岁之间居民进行心血管健康状况调查，分析发病水平及有关影响因素。结果：（1）样本人群高血压患病率为22．06％，随年龄增长而升高，超重率为27．45％，其中男性的为31．28％，女性为23．66％，男性超重率高于女性（P＜0．05）。（2）心肌梗塞、脑卒中，心力衰竭患病率分别为0．98％，2．20％，1．71％。（3）高血糖、高总胆固醇、高甘油三脂患病率分别为17．35％，56．67％，30．94％，男、女性别均有显性差异（P＜0．05）。（4）多因素回归分析显示：BMI、喝酒、吸烟、高血压、年龄、化程度、家族中有慢性病史等是心血管病的主要影响因素。结论：南宁市中老年人心血管健康状况不容乐观，其危险因素处于较高水平，心血管健康预防控制策略和措施有待进一步加强。     

A classification and regression tree analysis for the evaluation of the role of nutritional services on cardiovascular disease risk status of older people living in Greek islands and Cyprus

Introduction: The purpose of this study was to evaluate, with classification–regression tree analysis, the structure of the associations between nutritional and health care services and the cumulative prevalence of the classical cardiovascular disease (CVD) risk factors of older individuals living in Greek islands and Cyprus. Methods: During 2005–2009, 744 men and 742 women (>65 years) from nine Greek islands and Cyprus Republic were voluntarily enrolled in the Mediterranean Islands study; various socio-demographic, clinical and lifestyle characteristics were recorded. Moreover, information regarding practising dieticians (n = 88) and nutritional services provided in these islands was also recorded. Results: Both medical and nutrition services act more effectively to elders' cardiovascular health. For example, older individuals living in areas with nutritional services' support for at least five years, with collaboration between dieticians and physicians, reduced the CVD risk factors (CVD RF) burden by 42%. Whereas, in areas with dietetic support less than five years, but more than two, the presence of advanced health care system seemed to control the CVD RF burden to the population average. Conclusions: Despite the fact that the present work shares some limitations mainly because of its cross-sectional design, the classification and regression tree approach has clearly demonstrated the interrelation between nutritional services and the health care system towards achieving benefits among the elders' quality of life.     

Ethnic group differences in cardiovascular risk assessment scores: national cross-sectional study

Objectives. There are marked inequalities in cardiovascular disease (CVD) incidence and outcomes between ethnic groups. CVD risk scores are increasingly used in preventive medicine and should aim to accurately reflect differences between ethnic groups. Ethnicity, as an independent risk factor for CVD, can be accounted for in CVD risk scores primarily using two methods, either directly incorporating it as a risk factor in the algorithm or through a post hoc adjustment of risk. We aim to compare these two methods in terms of their prediction of CVD across ethnic groups using representative national data from England.

Design. A cross-sectional study using data from the Health Survey for England. We measured ethnic group differences in risk estimation between the QRISK2, which includes ethnicity and Joint British Societies 2 (JBS2) algorithm, which uses post hoc risk adjustment factor for South Asian men.

Results. The QRISK2 score produces lower median estimates of CVD risk than JBS2 overall (6.6% [lower quartile–upper quartile (LQ-UQ) = 4.0–18.6] compared with 9.3% [LQ-UQ = 2.3–16.9]). Differences in median risk scores are significantly greater in South Asian men (7.5% [LQ-UQ = 3.6–12.5]) compared with White men (3.0% [LQ-UQ = 0.7–5.9]). Using QRISK2, 19.1% [95% confidence interval (CI) = 16.2–22.0] fewer South Asian men are designated at high risk compared with 8.8% (95% CI = 5.9–7.8) fewer in White men. Across all ethnic groups, women had a lower median QRISK2 score (0.72 [LQ-UQ = ? 0.6 to 2.13]), although relatively more (2.0% [95% CI = 1.4–2.6]) were at high risk than with JBS2.

Conclusions. Ethnicity is an important CVD risk factor. Current scoring tools used in the UK produce significantly different estimates of CVD risk within ethnic groups, particularly in South Asian men. Work to accurately estimate CVD risk in ethnic minority groups is important if CVD prevention programmes are to address health inequalities.     

企业退休人员正常高值血压及危险因素分析

目的了解浙江省杭州市区企业退休人员正常高值血压的发生率及相关的危险因素,为高血压和相关的心脑血管疾病在社区的防治提供依据。方法用整群抽样方法随机抽取4个社区的企业退休人员1 959人,进行问卷调查、体格检查以及实验室检查。结果杭州市区企业退休人员正常高值血压率为30.6%;多元Logistic回归分析发现,正常高值血压的危险因素主要是超重(OR=1.874,95%CI=1.376~2.553)、肥胖(OR=2.211,95%CI=1.034~4.726)、饮酒(OR=1.420,95%CI=1.001~2.015)、血糖异常(OR=1.760,95%CI=1.050~2.949)、甘油三酯异常(OR=1.358,95%CI=1.045~1.765)及年龄增高(60岁~OR=1.576,95%CI=1.179~2.106;70岁~OR=1.957,95%CI=1.375~2.786)。结论企业退休人员正常高值血压率较高,存在多种危险因素。应提倡健康的生活方式,防止高血压和心脑血管疾病的发生。     

Serum selenium and precursors of cardiovascular risk factors in adolescents

The aim of this study was to determine, in a population of Italian adolescents, the association of serum selenium levels with precursors of biochemical and anthropometric variables known as being among the major risk factors for cardiovascular diseases in the adult population. The following measurements were taken in a school sample of 627 adolescents (aged 12–13 years): serum selenium, total cholesterol, high density lipoprotein cholesterol, non-HDL cholesterol, height, weight, body mass index, systolic blood pressure and diastolic blood pressure.The serum selenium levels were slightly higher in males (83.1 ± 10.1 g/1) than in females (81.7 ±- 11.0 g/1), but the difference was not statistically significant. Serum selenium was positively correlated with total cholesterol, diastolic blood pressure and HDL cholesterol in both sexes; moreover it was positively correlated with non-HDL cholesterol and negatively correlated with height in males only.Corresponding author.     

亚健康状态与心血管疾病危险因素关系

目的探讨亚健康状态与血清皮质醇以及血压、血糖和血脂等心血管疾病危险因素的关系。方法选取首都医科大学附属宣武医院体检中心的健康体检者,进行一般情况和亚健康状态问卷(SHSQ-25)调查,采集静脉血检测血清皮质醇、血糖和血脂相关指标并测量血压;共获得资料完整者812人,以亚健康状态问卷总分≥35分为亚健康组,<35分作为对照组,比较2组人群各检测指标差异,并采用结构方程模型分析亚健康状态与心血管疾病危险因素的关系。结果亚健康组收缩压、空腹血糖、总胆固醇、低密度脂蛋白以及血清皮质醇水平均高于对照组(P<0.05);结构方程模型分析结果表明,亚健康人群应激水平与心血管疾病危险因素存在相关性,拟合指数(GFI)=0.998 8,调整拟合指数(AGFI)=0.993 6,平均残差率的根(RMSR)=0.429 8(95%CI=0.388 3～0.472 8),模型中各通径系数均有统计学意义(P<0.05)。结论亚健康状态与应激及心血管疾病危险因素相关。     

Changes in cardiovascular risk factors among adolescents from 1995 to 2004 in the Republic of Karelia, Russia

BACKGROUND: In Russia, cardiovascular mortality is among the highest in the world. Behaviours related to the development of cardiovascular disease are usually adopted in childhood and adolescence. Very little information exists on prevalence and trends of risk factors among Russian youth. This study aims to investigate changes in the prevalence of cardiovascular risk factors among adolescents in the Republic of Karelia, Russia, from 1995 to 2004. METHODS: Cross-sectional surveys on chronic disease risk factors were carried out among 15-year-old adolescents in Pitk?ranta region, in the Republic of Karelia. The surveys were conducted in all 10 secondary schools in the Pitk?ranta region. All ninth-grade students in 1995 (N = 385, response rate 95%) and in 2004 (N = 395, response rate 85%) were included in the survey samples. RESULTS: Systolic blood pressure decreased statistically significantly among boys (from 119 to 116 mmHg). Diastolic blood pressure decreased statistically significantly among both girls (from 64 to 59 mmHg) and boys (from 62 to 59 mmHg). Total cholesterol increased statistically significantly only among girls (from 3.9 to 4.1 mmol/l). Body mass index did not exhibit any significant changes in both genders. Daily smoking rate doubled statistically significantly among girls from 7% to 15%. CONCLUSION: The study results show changes in the prevalence of cardiovascular disease risk factors among adolescents in the Republic of Karelia occurring over the last decade. Active measures need to be taken to prevent the increase in smoking prevalence, especially among girls, and to avert the unfavourable development of other risk factors in the future.     

Changes in cardiovascular risk factors and health behaviours from 1992 to 1997 in the Republic of Karelia, Russia

BACKGROUND: In Russia rapid changes have taken place both in total and chronic disease mortality during recent years. Little reliable information is available on the trends in conventional risk factors in Russia. METHODS: Chronic disease risk factors and health behaviours were studied in the Republic of Karelia, Russia in 1992 and 1997, in population surveys connected with the National FINRISK Study in Finland. Independent random population samples (n = 1000) of people aged between 25 and 64 years were drawn in both survey years. Surveys included a self-administered questionnaire, physical measurements and laboratory analyses. RESULTS: The levels of systolic blood pressure, total serum cholesterol, and high-density lipoprotein cholesterol decreased among both genders from 1992 to 1997, but the difference between the survey years was statistically significant only among women. Both self-reported alcohol consumption and serum gamma-glutamyl transferase levels increased significantly in both men and women. There was a significant shift in the type of fat used on bread and in cooking, from butter use to use of margarine and vegetable oil, among both genders. CONCLUSIONS: As a whole the risk factor levels in the Republic of Karelia are high. However, some slight improvement in risk profile was seen. Positive changes in dietary habits, such as change in the quality of fat and associated reduction in serum cholesterol levels may have contributed to the decline in cardiovascular disease mortality seen in Russia since 1995. However, since smoking and elevated blood pressure levels as well as alcohol consumption are still highly prevalent, there is a great need for effective interventions.     

湖南省长沙市痛风患者危险因素流行病学调查

目的 调查湖南省长沙市痛风患者的危险因素特点,为痛风的临床防治提供科学依据。 方法 随机选择2017年7月－2018年10月湘雅医院风湿免疫科确诊的长沙市痛风患者102例(痛风组)及湘雅医院就诊的长沙市非痛风患者105例(对照组)为研究对象,进行问卷调查,用单因素和多因素方法分析各因素与痛风发病的相关性。 结果 痛风组、对照组的男女性别构成(男性:95.10% vs.42.86%)、年龄[(46.02±14.49)岁 vs.(36.88±13.40)岁]、BMI[(24.70±0.28)kg/m² vs.(22.95±0.46)kg/m²]、劳动强度构成(较大强度:54.90% vs.7.62%)、饮白酒史占比(52.94% vs.14.29%)、吸烟史占比(36.28% vs.15.24%)、高血压史占比(28.43% vs.8.57%)、高血脂史占比(42.16% vs.9.52%)、肾脏疾病史占比(21.57% vs.1.91%),差异有统计学意义(P＜0.05)。以是否患痛风为因变量的多因素非条件logistic回归分析表明,男性(OR=6.245,95%CI:1.647~23.669)、饮白酒史(OR=2.404,95%CI:1.231~7.039)、肾脏疾病史(OR=12.669,95%CI:1.609~99.737)、劳动强度较大(OR=4.415,95%CI:1.605~12.148)是痛风发病的独立危险因素。 结论 男性、高龄、BMI高、劳动强度较大、饮白酒、吸烟,以及有高血压、高血脂、肾脏疾病史者需高度警惕痛风的发生     

Health education pamphlets about smoking—their benefit to smokers and non-smokers

The aim of this present study was to compare the use by smokers and non-smokers of pamphlets about smoking as delivered from different settings. The study was a nation-wide cross-sectional survey of 1924 randomly selected, Danish men and women, aged 14–77 y, who had answered a mailed questionnaire in 1994. Of these 71% also participated in a telephone interview enquiring about the use of health education material, smoking status and socio-demographic variables, 39% of readers of household-delivered anti-smoking pamphlets reported having gained information from them and 22% reported having made changes in their own smoking behaviour such as avoiding smoking in the presence of non-smokers. In general practice settings, these percentages were higher among smokers. Smokers who were thinking of stopping smoking in the near future were in addition more likely to take and to read smoking related health education materials from other places. Non-smokers received (3–49%) and read pamphlets about smoking as frequently as did smokers who did not intend to quit. In conclusion, written health education material was well received by readers, but, when distributed in a more open setting it needs to be targeted towards smokers who are considering stopping smoking. In general practice, smokers not thinking of stopping were open to health education, and pamphlets used in this setting should also target this group. Non-smokers contribute indirectly to smokers quitting by providing support to smokers and pamphlets for non-smokers need to be more targeted towards this social role.     

柳州市7 660名成人心血管病危险因素调查

目的了解柳州市人群心血管疾病危险相关因素.方法整群抽样柳州市常住居民10 408例,进行人口学资料调查.7 660人,男性3 894人,女性3 766人,平均年龄(39.5±11.0)岁,进行血压、身高、体重、腰围、空腹血糖、血脂等心血管病危险因素检测和统计分析.结果高血压、空腹血糖受损、糖尿病(DM)、高胆固醇(TC)、高甘油三酯(TG)、超重、肥胖及腰围增大的总检出率分别为16.64%,6.50%,2.51%,20.76%,26.37%,31.44%,7.92%及23.75%.危险因素检出率男性高于女性(P＜0.001).高血压、DM、高TG、高低密度脂蛋白(LDL)的检出率随年龄增长而升高.结论柳州市人群中心血管病危险因素检出率较高,应采取积极综合干预措施减少危险因素,降低其心血管病的发生或发展.     

重庆市成年居民高血压前期患病及影响因素

目的 调查重庆市高血压前期患病率及相关因素,为高血压的早期预防提供科学依据。方法 采取问卷调查方法,选择重庆市沙坪坝区>18岁常住居民59264人,计算人群中高血压前期患病率,应用Logistic回归模型进行危险因素分析。结果 高血压前期患病率为64.72%;35～44岁高血压前期患病率最高,为71.11%;其次为25～34岁为70.52%;与正常血压组比较,高血压前期组的平均年龄、吸烟率、饮酒率、体质指数(BMI)、腰围(WC)及腰臀比(WHR)等增高;多因素Logistic回归分析表明,与高血压前期相关的因素有年龄、吸烟、WHR、WC和BMI;无论男女,肥胖是其重要高危险因素。结论 重庆市居民高血压前期患病率较高,应尽早针对相关危险因素采取预防控制措施,对居民进行防治知识的宣传教育。     

海岛居民Hs-CRP水平与心血管病危险因素关系

目的 了解海岛居民血清高敏 C反应蛋白(Hs-CRP)水平与心血管疾病危险因素的关系,为心血管病的预防控制提供参考依据。方法 采用随机分层抽样方法对在辽宁省大连市长海县抽取的395名≥30岁常住居民进行问卷调查、体格检查和血液生化学检查。结果 海岛居民血清Hs-CRP P₅、P₁₀、P₂₅、P₅₀、P₇₅、P₉₀、P₉₅水平分别为0.01、0.02、0.05、0.11、0.24、0.43、0.83 mg/L;不同特征居民比较,不同年龄、居住年限、是否患高血压和是否有心血管病史居民Hs-CRP分布间差异均有统计学意义(P<0.05);海岛居民血清ln(Hs-CRP)与年龄(r=0.26)、体质指数(r=0.32)、腰围(r=0.30)、胆固醇(r=0.18)、甘油三酯(r=0.28)、低密度脂蛋白胆固醇(r=0.21)、空腹血糖(r=0.29)、血肌酐(r=0.11)、血尿酸(r=0.21)均呈正相关(P<0.05),与高密度脂蛋白胆固醇呈负相关(r=-0.11,P<0.05);多元线性回归分析结果表明,在调整其他因素后,年龄、体质指数、空腹血糖、高密度脂蛋白胆固醇、胆固醇和吸烟是海岛居民血清Hs-CRP水平的主要影响因素。结论 海岛居民的Hs-CRP水平受年龄、体质指数、空腹血糖、高密度脂蛋白胆固醇、胆固醇和吸烟的影响;控制体重、减少肥胖有利于维持血清Hs-CRP在正常范围内。     

Rural community pharmacy: a feasible site for a health promotion and screening service for cardiovascular risk factors

ABSTRACT: A pharmacist-delivered health promotion and screening service for cardiovascular risk factors in rural community pharmacy was implemented in the Upper Hunter Valley, New South Wales (NSW). We describe the development of the service and profile 204 participants at their initial screening. A standardised clinical protocol guided the pharmacist through delivery of the service. The mean age of participants was 44 years ( SD ± 13 ). Over half (54%) had a Body Mass Index (BMI) > 25, 54% had cholesterol > 5.0 mmol L^-1 and 18% a systolicBP > 140 mmHg and/or diastolicBP > 90 mmHg. Most (80%) received lifestyle information (dietary, exercise or smoking cessation). One third required referral to a general practitioner. Provision of the service through community pharmacy increased the community's access to screening, 28% reported that they had never had their cholesterol measured. Since this new service was able to identify, educate and refer people at risk of cardiovascular disease in a rural community, we recommend a broader adoption through rural pharmacies.     

护理干预对围绝经期妇女心血管危险因素的影响

目的探讨护理干预措施对围绝经期妇女心血管功能的影响。方法将2012年1月-2013年1月来深圳妇幼保健院妇科门诊就诊,并诊断为围绝经期综合征200例患者随机分为常规口头宣教的对照组和进行围绝经健康教育、运动指导、饮食指导、心理护理等护理干预的实验组。干预前后测定两组患者的体质指数（BMI）、绝经症状评分、缺血性心血管疾病（ICVD）10年发病危险评估、踝肱指数（ABI）、总胆固醇、甘油三脂、血压的变化。结果实验组患者在护理干预治疗1年后绝经症状评分、ICVD评分、血压、总胆固醇等指标明显低于对照组及治疗前,差异均有统计学意义（P〈0．05）,其他指标没有明显改变。结论通过对围绝经期妇女采取护理干预措施,不仅能减轻患者的围绝经期症状,同时使ICVD评分、血压、总胆固醇均下降,从而降低围绝经妇女心血管疾病的发生率。     

上海市杨浦区居民中心型肥胖与心血管疾病危险因素及聚集性的关系

【目的】探讨上海市杨浦区居民中心型肥胖与心血管疾病危险因素及聚集性的关系,为制定心血管疾病预防控制措施和策略提供科学依据。【方法】以社区为单位,对35~75岁居民进行问卷调查、体格检查和血生化检测,对其中资料完整的11321人进行数据分析。【结果】杨浦区居民中心型肥胖率为60.50%,标化率为56.09%。不同腰围人群的收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白和高密度脂蛋白的差异均有统计学意义(均P<0.01)。随着腰围的增加,高血压、糖尿病、血脂异常及心血管病危险因素聚集比例均呈上升趋势(均P<0.01)。多因素logistic回归结果显示,轻度、重度中心型肥胖组发生高血压、糖尿病、血脂异常和危险因素聚集的风险是正常组的1.78(OR=1.78,95%CI:1.63~1.94)和3.36倍(OR=3.36,95%CI:3.00~3.75)、1.67(OR=1.67,95%CI:1.49~1.88)和2.67倍(OR=2.67,95%CI:2.34~3.03)、1.68(OR=1.68,95%CI:1.54~1.82)和2.20倍(OR=2.20,95%CI:1.97~2.44)、2.04(OR=2.04,95%CI:1.86~2.24)和3.62倍(OR=3.62,95%CI:3.23~4.04)。【结论】上海市杨浦区居民中心型肥胖患病率高,肥胖程度与心血管疾病危险因素及其聚集风险有关,应当及时采取控制肥胖的干预措施。