健康体检人群高血压患病情况与ABO血型相关性研究

背景　目前全球高血压患病率正在逐步增高，而我国高血压患病人群不仅基数庞大并且在不断增加。当前对于高血压患病情况的研究多数基于临床分析，较少涉及血型分布等遗传规律。目的　分析高血压患病情况与ABO血型的相关性，为研究高血压的预防与治疗提供科学依据。方法　选择2008—2017年江西省居民健康档案中185 633例体检人群作为研究对象，根据是否确诊高血压，将其分为病例组（8 798例）和对照组（176 835例）。分别统计研究对象的性别、年龄、血型。进一步分析病例组与对照组的性别、年龄以及血型的分布情况。对性别、年龄进行亚组分析，判断不同性别、不同年龄段高血压患病情况与ABO血型是否具有相关性。结果　对照组和病例组性别分布、年龄分布比较，差异均有统计学意义（χ2=85.863，P<0.001；χ2=2 765.236，P<0.001）。对照组和病例组血型分布比较，差异有统计学意义（χ2=46.102，P<0.001）。病例组A型、B型所占比例低于对照组，O型、AB型所占比例高于对照组（P<0.001），RR值依次为0.95、0.93、1.06、1.15。男性中，对照组和病例组血型分布比较，差异有统计学意义（χ2=25.286，P<0.001）；病例组A型、B型所占比例低于对照组，O型、AB型所占比例高于对照组（P<0.001），RR值依次为0.95、0.94、1.06、1.16。女性中，对照组和病例组血型分布比较，差异有统计学意义（χ2=21.271，P<0.001）；病例组A型、B型所占比例低于对照组，O型、AB型所占比例高于对照组（P<0.001），RR值依次为0.94、0.93、1.07、1.16。少年中（0~17岁），两组血型分布比较，差异无统计学意义（χ2=2.502，P=0.475）；两组A型、B型、O型、AB型所占比例比较，差异均无统计学意义（P>0.05）。青年中（18~45岁），两组血型分布比较，差异有统计学意义（χ2=15.733，P<0.001）；病例组B型所占比例低于对照组，O型、AB型所占比例高于对照组（P<0.05），RR值依次为0.89、1.11、1.20。壮年中（46~60岁），两组血型分布比较，差异有统计学意义（χ2=15.982，P<0.001）；病例组O型、AB型所占比例高于对照组（P<0.05），RR值依次为1.07、1.20。老年中（>60岁），两组血型分布比较，差异有统计学意义（χ2=15.449，P<0.001）；病例组A型、B型所占比例低于对照组，O型、AB型所占比例高于对照组（P<0.05），RR值依次为0.95、0.96、1.05、1.11。结论　高血压患者与非高血压者在血型分布中存在差异，O型与AB型与高血压发生相关。

Prevalence of Hypertension and Its Association with ABO Blood Types in General Health Examinees

Background　Worldwide prevalence of hypertension is increasing gradually.In particular，China owns an ever-larger number of hypertensive patients.Most hypertension prevalence-related research studies are based on the clinical analysis，rarely involves blood groups and other genetic laws.Objective　This study provides a scientific basis for the prevention and treatment of hypertension by analyzing the correlation between the prevalence of hypertension and ABO blood types.Methods　The data stemmed from the electronic health records of Jiangxi residents，involving a sample of 185 633 normal individuals undergoing health screening between 2008 and 2017，including 8 798 who were found with hypertension（hypertension group） and 176 835 without（control group）．Sex，age and blood types of both groups were comparatively analyzed.Sex- and age-specific subgroup analyses were performed to examine the associations of hypertension prevalence with ABO blood types.Results　There were significant differences in sex distribution and age distribution between the two groups（χ2=85.863，P<0.001；χ2=2 765.236，P<0.001）．Both groups also showed significant difference in ABO blood types distribution（χ2=46.102，P<0.001）．Compared with the control group，the percentages of A and B blood types were lower while the percentages of O and AB blood types were higher in hypertension group（RR=0.95，0.93，1.06，1.15，P<0.001）．Sex-specific analysis showed that blood group distribution differed significantly between hypertensive and non-hypertensive men（χ2=25.286，P<0.001），and between hypertensive and non-hypertensive women（χ2=21.271，P<0.001）．Lower percentages of A and B blood types，and higher percentages of O and AB blood types were found in hypertensive men instead of non-hypertensive men（RR=0.95，0.94，1.06，1.16，P<0.001），and were found in hypertensive women instead of non-hypertensive women（RR=0.94，0.93，1.07，1.16，P<0.001）．Age-specific analysis revealed that no significant differences were found in blood group distribution（χ2=2.502，P=0.475），and in the percentages of A，B，O and AB blood types between hypertensive and non-hypertensive adolescent subgroups（0-17 years old）．However，blood group distribution differed significantly between young（18-45 years old） hypertensive and non-hypertensive subgroups（χ2=15.733，P<0.001）．Young hypertensive subgroup showed a lower percentage of blood type B，and higher percentages of blood types O and AB（RR=0.89，1.11，1.20，P<0.05）．Blood group distribution also differed significantly between middle-aged（46-60 years old） hypertensive and non-hypertensive subgroups（χ2=15.982，P<0.001）．Middle-aged hypertensive subgroup showed higher percentages of O and AB blood types（RR=1.07，1.20，P<0.05）．A significant difference in blood group distribution was also found between elderly（> 60 years old） hypertensive and non-hypertensive subgroups（χ2=15.449，P<0.001）．Elderly hypertensive subgroup demonstrated lower percentages of A and B blood types，and higher percentages of O and AB blood types（RR=0.95，0.96，1.05，1.11，P<0.05）．Conclusion　The distribution of blood types differed significantly between hypertensive and non-hypertensive health examinees.Those with blood type O or AB may be more likely to have hypertension.