广州市社区中老年人血压健康与血糖、健康相关行为关系分析

 【目的】探讨社区中老年人血压升高与血糖、健康相关行为的关系及影响因素的交互作用。【方法】采用现况研究设计，整群抽取广州市两个居委会50~79岁的居民进行调查，内容包括问卷调查研究对象的健康相关行为，测量血压、空腹血糖和体质指数。实际有效调查474人，男性166人，女性308人，根据美国高血压预防、检测、评估和治疗委员会第七次报告的血压分类方法将研究对象血压分为正常、高血压前期和高血压三类，分别有97、183和194人。采用单因素分析比较三类人群的血糖、健康相关行为特征；应用有序多分类logistic回归分析血压升高的影响因素，相加效应模型分析影响因素间的交互作用。【结果】高血压组的空腹血糖、体质指数和每天盐、食油摄入量平均水平均高于正常和高血压前期组，积极应对均分则低于后两组；高血压前期组的空腹血糖平均水平高于正常组；血压和空腹血糖水平呈正相关（rs=0.304，P<0.001）；多因素分析显示，调整性别、年龄和家族史后，血压升高与相关影响因素的OR值（95%CI）为：肥胖4.043（1.962~8.331）、空腹血糖受损2.016（1.259~3.228）、糖尿病3.647（1.986~6.700）、盐摄入过量2.430（1.557~3.792）、食油摄入过量1.624（1.101~2.396）、积极应对方式0.532（0.389~0.726）；调整相关混杂因素后，年龄与盐摄入量间交互作用的相对超额危险度、交互作用归因比和交互作用指数（95%CI）分别为2.952（0.898~5.006）、0.640（0.437~0.844）和5.493（1.161~25.950）。【结论】空腹血糖异常、肥胖、盐、食油摄入量和积极应对方式与中老年人血压升高有关；年龄与盐摄入量对血压升高的影响可能存在正交互作用，值得进一步研究。

Analysis on Relationship between Blood Pressure and Fasting Glucose, Health-related Behavior among Middle Aged Residents in Guangzhou

【Objective】 To explore the association of elevated blood pressure(BP) with blood glucose,health-related behavior,as well as the interaction between BP influencing factors.【Methods】 A cross-sectional cluster sampling survey was carried out for the population aged from 50 to 79 years old,living in two communities of Guangzhou.Data about health-related behavior,BP,fasting plasma glucose(FPG) and body mass index(BMI) of participants were collected.Among the 474 valid subjects(166 males and 308 females),97 were classified as normal,183 were prehypertension(preHT) and 194 were hypertension(HT) according to the BP classification in the Seventh Report of the Joint National Committee on Prevention,Detection,Evaluation,and Treatment of High Blood Pressure(JNC 7).The characteristics of FPG and health-related behaviors among three BP groups were compared by using the univariate method.Influencing factors for elevated BP were analyzed by ordinal multinomial logistic regression,and the interaction analysis was conducted by use of an additive effect model.【Results】 The mean levels of FPG,BMI,daily salt and cooking oil intake in the HT groups were higher than the normal and preHT groups,but for a lower mean score of positive coping style.And the perHT group had a higher mean FPG level compared with the normal one.Status of BP positively correlated with FPG(rs = 0.304,P < 0.001).In multivariate analysis,after adjusting for sex,age and history of HT,factors associated with elevated BP and their odds ratios(95% confidence intervals,CI) were: obesity 4.043(1.962 ～ 8.331),impaired fasting glucose 2.016(1.259 ～ 3.228),diabetes mellitus 3.647(1.986 ～ 6.700),excessive salt 2.430(1.557 ～ 3.792) and cooking oil 1.624(1.101 ～ 2.396) intake,positive coping style 0.532(0.389 ～ 0.726).After adjustment of the confounding factors,positive interaction was observed between age and salt intake;its relative excess risk due to interaction,attributable proportion due to interaction and synergy index(95%CI) were 2.952(0.898 ～ 5.006),0.640(0.437 ～ 0.844),and 5.493(1.161 ～ 25.950),respectively.【Conclusions】 The abnormality of FPG,obesity,excessive salt and cooking oil intake and positive coping style were significantly associated with elevated BP in middle aged residents.There might be positive interaction between age and salt intake on the effect of elevated BP,which was worth further study.