高血压患者脑卒中发病影响因素Cox回归分析

目的 了解高血压患者脑卒中发病影响因素,为脑卒中的预防控制提供参考依据。方法 采用前瞻性队列研究方法于2010年1月,在江苏省5个高血压社区规范化管理基地随机抽取12 893例高血压患者进行问卷调查、体格检查和实验室检测,并就高血压患者的血压控制情况、脑卒中发生情况和死亡情况于2011-2014年每年进行1次随访,采用单因素和多因素Cox回归分析方法分析高血压患者脑卒中发病的影响因素。结果 江苏省随访的12 893例高血压患者随访时间为0.7~58.1个月,平均随访时间为(43.4±10.2)个月,共失访554例,失访率为4.30%;随访结束时高血压患者脑卒中发病331例,脑卒中发病率为2.68%;多因素Cox回归分析结果显示,年龄≥45岁、高血压病程 > 5年、有脑卒中家族史、收缩压≥180 mm Hg 和左心室肥厚为高血压患者脑卒中发病的危险因素,女性和文化程度初中及以上为高血压患者脑卒中发病的保护因素。结论 性别、年龄、文化程度、高血压病程、脑卒中家族史、收缩压和左心室肥厚是高血压患者发生脑卒中的主要影响因素。

Influencing factors of stroke in adult hypertension patients:a Cox regression analysis

Objective To explore influencing factors of stroke incident in hypertension patients and to provide references for stroke prevention.Methods A total of 12 893 hypertension patients were recruited randomly from 5 communities covered by national standardized hypertension management project in districts or counties of 5 municipalities of Jiangsu province and surveyed with questionnaire interview,physical examination,and laboratory measurement in January 2010;then the hypertension patients were followed up at least once a year for 4 years continuously to collect information on hypertension control,incidents of stroke and death.Univariate and multivariate Cox regression were used to analyze influencing factors of stoke among the patients.Results For all the patients,the follow-up time ranged from 0.7 to 58.1 months and the mean time was 43.4±10.2 months.Totally 554(4.30%)patients were lost to follow-up and 331(2.68%)had their first stroke incident by the end of the study.Multivariate Cox regression analysis revealed that aged 45 years or older,with a hypertension course of >5years,familial stroke history,systolic blood pressure ≥180 mm Hg,and left ventricular hypertrophy were risk factors of stroke;whereas female gender and an education level of junior high school or above were protective factors for stroke incident.Conclusion Gender,age,education level,hypertension course,familial history of stroke,systolic blood pressure,and left ventricular hypertrophy are main influencing factors of stroke incident among adult community hypertension patients.