上海市郊区某社区居民不同血压类型与血脂水平的相关性研究

目的:分析上海市郊区居民不同血压类型与血脂水平的相关性。方法:选取上海市郊区某社区60岁以上参加2019年居民体检的常住村民6107人作为研究对象,测定股动脉随机坐位血压,采集空腹静脉血测定甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平。并根据血压值分为4组,正常血压组(2764人),单纯收缩期高血压组(2357人),单纯舒张期高血压组(543人),双期高血压组(443人),将4组间的血脂检测指标进行比较研究,单因素及多因素分析评价血压与血脂水平的相关性。结果:男、女性一般情况对比中,老年女性收缩压、脉压差、TC、TG、LDL-C和HDL-C方面较老年男性偏高,差异具有统计学意义。在总的人群及老年男性中,高TG、LDL-C在4种类型血压中分布不同;老年女性中,高TG在4种类型血压中分布不同(χ2=19.67,P=0.000)。以血压为因变量的logistic回归分析模型显示:TG是收缩压、舒张压的危险因素;6069岁男性中HDL-C、7079岁男性中TC是收缩压的保护因素。结论:在临床治疗老年人高血压过程中,除了关注血压值外,还要关注血脂指标。除了降压药治疗外,还应同时给予调节脂质代谢的药物,更重要的是需要区别对待不同类型、不同年龄和不同性别的高血压患者,个体化治疗,才能获得更好的疗效,进而达到真正延缓高血压发展的进程。

Analysis on the Correlation between Different Types of Hypertension and Lipid Levels in Population from a Community in the Suburb of Shanghai

OBJECTIVE To explore the correlation between different types of hypertension and lipid levels in population from a community in the suburb of Shanghai.METHODS A total of 6107 residents(aged above 60)who participated in physical examination in 2019,from a community in the suburb of Shanghai were enrolled.Blood pressure was measured in a seated position.Fasting blood lipids was conducted to test serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and High density liptein cholesterol(HDL-C).According blood pressure values,all cases were divided into normal blood pressure group(n=2764),isolated systolic hypertension group(ISH group,n=2357),isolated diastolic hypertension group(IDH group,n=543),and systolic-diastolic hypertension group(SDH group,n=443).A comparative study was conducted on blood lipid test indexes among 4 groups.The correlation between blood pressure and lipid levels were analyzed by single factor analysis and multi-factor analysis.RESULTS According to the comparison of general situation of male and female,systolic blood pressure,pulse pressure,TC,TG,LDL-C AND HDL-C of the elderly female were higher than elderly male.The differences had statistic significance.In the whole population and the elderly male,serum TG,LDL-C had varied distribution in these four different blood pressures.Serum TG distributed differently in these four types of the elderly female’s blood pressures(χ~2=19.67,P=0.000).The multivariate Logistic regression analysis showed that TG was a risk factor to systolic blood pressure and pulse pressure.HDL-C in 60~69 years elderly male and TC in 70~79 years elderly male were protective factors to systolic hypertension.CONCLUSION In the therapeutic course of hypertension in the elders,in addition to simple antihypertensive medication,the drugs for regulating lipid metabolism should be administrated at the same time.It was more important to distinguish different types of hypertensive patients in different sexes and different ages.Individualized therapy was given to achieve better curative effect and really delayed the development process of hypertension.