Awareness rate, treatment rate, and control rate of hypertension and its influencing factors in Xiangxi minority areas
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摘要:
目的 了解湘西少数民族地区高血压知晓率、治疗率和控制率现状, 探讨其可能的影响因素。 方法 应用多阶段随机抽样方法抽取湘西少数民族地区≥35岁的428名个体进行调查, 分析高血压患者高血压知晓、治疗和控制情况, 并采用多因素Logistic回归分析模型分析其可能的影响因素。 结果 湘西少数民族地区高血压患病率、知晓率、治疗率和控制率分别为52.34%(95% CI:47.6%~57.1%)、59.38%(95% CI:52.9%~65.9%)、44.20%(95% CI:37.6%~50.8%)和8.48%(95% CI:4.8%~12.2%)。多因素Logistic回归分析模型结果显示, 年龄是高血压知晓率、治疗率和控制率的共同影响因素(均有P < 0.05)。男性(OR=2.481, 95% CI:1.308~4.703)高血压知晓率低于女性; 超重者和每年至少测量一次血压者其高血压知晓率和治疗率较高(均有P < 0.05)。而有慢性疾病史者(OR=0.269, 95% CI:0.090~0.808)高血压控制率高于无慢性疾病史者。 结论 湘西少数民族地区35岁及以上居民高血压知晓率、治疗率和控制率总体上仍处于较低水平, 尤其是血压控制率低。 Abstract:Objective To understand the awareness rate, treatment rate and control rate of hypertension in Xiangxi minority areas, and explore the possible influencing factors. Methods Using the multi-stage random sampling method, 428 individuals ≥35 years old in Xiangxi minority areas were selected for investigation. The awareness rate, treatment rate and control rate of hypertension in hypertensive patient were analyzed. Meanwhile, multivariate Logistic regression model was used to analyze the possible influencing factors. Results The prevalence rate, awareness rate, treatment rate and control rate of hypertension were 52.34%(95% CI:47.6%-57.1%), 59.38%(95% CI:52.9%-65.9%), 44.20%(95% CI:37.6%-50.8%)and 8.48%(95%CI:4.8%-12.2%), respectively. The multivariate Logistic regression analysis showed that age was the common influencing determinant of hypertension awareness rate, treatment rate and control rate(all P < 0.05). The hypertension awareness rate of the males(OR=2.481, 95% CI: 1.308-4.703) was lower than that of the females. Overweight patients and those whose blood pressure was measured at least once a year had higher rates of hypertension awareness and treatment(all P < 0.05). However, patients with a history of chronic diseases(OR=0.269, 95% CI: 0.090-0.808) had a higher hypertension control rate than those without a history of chronic diseases. Conclusions The awareness rate, treatment rate and control rate of hypertension in residents over 35 years old are still at a low level, especially the blood pressure control rate. -
Key words:
- Hypertension /
- Tujia nationality /
- Awareness /
- Treatment /
- Control
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表 1 2019年3月-5月湘西不同特征人群中高血压患病状况分布
Table 1. The distribution of hypertension in different characteristics in Xiangxi from March to May 2019
变量 调查人数[n(%)] 患者例数[n(%)] χ2值 P值 性别 6.093 0.014 男 158(36.9) 96(42.9) 女 270(63.1) 128(57.1) 年龄(岁) 36.053 < 0.001 < 50 98(22.9) 26(11.6) 50~ 124(29.0) 65(29.0) ≥60 206(48.1) 133(59.4) 民族 0.94 0.625 土家族 274(64.0) 139(62.1) 苗族 100(23.4) 56(25.0) 汉族 54(12.6) 29(12.9) 户口类型 4.032 0.045 城市 89(20.8) 55(24.6) 农村 339(79.2) 169(75.4) 婚姻状况 2.167 0.141 已婚 371(86.7) 189(84.4) 丧偶 57(13.3) 35(15.6) 教育程度 3.793 0.150 小学及以下 235(54.9) 133(59.4) 初中 112(26.2) 53(23.7) 高中及以上 81(18.9) 38(16.9) 职业 0.455 0.500 农业 272(63.6) 139(62.1) 非农业 156(36.4) 85(37.9) 人均月收入(元) 0.207 0.902 < 1 000 204(47.7) 109(48.7) 1 000 ~ 149(34.8) 76(33.9) ≥3 000 75(17.5) 39(17.4) 有无保险 0.058 0.810 有 393(91.8) 205(91.5) 无 35(8.2) 19(8.5) 
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表 2 2019年3月-5月湘西少数民族人群高血压知晓、治疗和控制率影响因素的单因素分析
Table 2. Univariate analysis of influential factors of hypertension awareness rate, treatment rate and control rate in the minority population of Western Hunan from March to may 2019
变量 知晓率[n(%)] χ2值 P值 治疗率[n(%)] χ2值 P值 控制率[n(%)] χ2值 P值 性别 6.121 0.013 2.178 0.140 4.03 0.045 男 48(50.0) 37(38.5) 4(4.2) 女 85(66.4) 62(48.4) 15(11.7) 年龄(岁) 2.905 0.234 6.071 0.048 1.807 0.405 < 50 13(50.0) 7(26.9) 4(15.4) 50~ 35(53.8) 25(38.5) 5(7.7) ≥60 85(63.9) 67(50.4) 10(7.5) 民族 1.741 0.419 1.698 0.428 1.365 0.505 土家族 78(56.1) 60(43.2) 10(7.2) 苗族 37(66.1) 23(41.1) 5(8.9) 汉族 18(62.1) 16(55.2) 4(13.8) 户口类型 0.012 0.913 2.151 0.142 0.035 0.852 城市 33(60.0) 29(52.7) 5(9.1) 农村 100(59.2) 70(41.4) 14(8.3) 婚姻状况 0.086 0.770 0.296 0.586 0.000 0.984 已婚 113(59.8) 85(45.0) 16(8.5) 丧偶/未婚 20(57.1) 14(40.0) 3(8.6) 教育程度 6.532 0.038 3.086 0.214 4.326 0.115 小学及以下 88(66.2) 62(46.6) 13(9.8) 初中 25(47.2) 18(34.0) 1(1.9) 高中及以上 20(52.6) 19(50.0) 5(13.2) 职业 0.946 0.331 0.014 0.904 0.011 0.917 农业 86(61.9) 61(43.9) 12(8.6) 非农业 47(55.3) 38(44.7) 7(8.2) 人均月收入(元) 3.583 0.167 2.534 0.282 6.134 0.047 < 1 000 71(65.1) 52(47.7) 13(11.9) 1 000~ 43(56.6) 28(36.8) 2(2.6) ≥3 000 19(48.7) 19(48.7) 4(10.3) 有无医疗保险 1.241 0.265 1.34 0.247 0.009 0.923 有 124(60.5) 93(45.4) 18(8.8) 无 9(47.4) 6(31.6) 1(5.3) 高血压家族史 3.842 0.050 0.077 0.782 2.842 0.092 有 47(69.1) 31(45.6) 10(6.4) 无 86(55.1) 68(43.6) 9(13.2) 慢性疾病史 9.096 0.003 6.407 0.011 6.856 0.009 有 71(70.3) 54(53.5) 14(13.9) 无 62(50.4) 45(36.6) 5(4.1) 是否超重 10.831 0.001 4.611 0.032 0.320 0.571 是 90(68.7) 66(50.4) 10(7.6) 否 43(46.7) 33(35.9) 9(9.8) 高血压知识及格情况 0.316 0.574 0.248 0.618 0.235 0.628 及格 68(57.6) 54(45.8) 10(9.4) 不及格 65(61.3) 45(42.5) 9(7.6) 高血压态度持有情况 1.160 0.281 6.694 0.01 1.764 0.184 积极 98(61.6) 79(49.7) 16(10.1) 不积极 35(53.8) 20(30.8) 3(4.6) 高血压健康行为形成情况 20.757 < 0.001 23.545 < 0.001 1.162 0.281 形成 92(72.4) 74(58.3) 13(10.2) 未形成 41(42.3) 25(25.8) 6(6.2) 每年是否至少测量一次血压 21.632 < 0.001 23.267 < 0.001 1.372 0.242 是 112(68.7) 88(54.0) 16(13.8) 否 21(34.4) 11(18.0) 3(5.2) 高血压知识来源途径(种) 0.054 0.817 0.001 0.974 0.382 0.537 1 111(59.0) 83(44.1) 15(8.0) > 1 22(61.1) 16(44.4) 4(11.1)
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表 3 多因素Logistic回归分析模型变量赋值
Table 3. Multivariate Logistic regression analysis of variable assignment
因素 赋值 性别(X1) 0=女, 1=男 年龄(岁, X2) 1=≤50, 2=50~, 3=≥60 教育程度(X3) 1=小学及以下, 2=初中, 3=高中及以上 人均月收入(元, X4) 1=≤1 000, 2=1 000~, 3=≥3 000 慢性疾病史(X5) 0=无, 1=有 是否超重(X6) 0=否, 1=是 高血压态度(X7) 0=不积极, 1=积极 高血压行为(X8) 0=未形成, 1=形成 每年是否至少测量一次血压(X9) 0=否, 1=是 是否知晓患有高血压(Y1) 0=知晓, 1=未知晓 是否治疗高血压(Y2) 0=治疗, 1=未治疗 高血压是否控制(Y3) 0=控制, 1=未控制
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表 4 高血压知晓、治疗和控制率影响因素的多因素Logistic回归分析模型
Table 4. Multivariate Logistic regression analysis of influential factors hypertension awareness, treatment and control rate
因变量(影响因素) β值 Sx Waldχ2值 OR(95% CI)值 P值 高血压知晓率 性别 0.909 0.326 7.749 2.481(1.308~4.703) 0.005 年龄 -0.508 0.234 4.711 0.602(0.380~0.952) 0.030 超重 -1.002 0.314 10.209 0.367(0.198~0.679) 0.001 每年至少测量一次血压 -1.022 0.409 6.237 0.360(0.161~0.803) 0.013 高血压治疗率 年龄 -0.600 0.236 6.429 0.549(0.345~0.873) 0.011 超重 -0.645 0.310 4.344 0.525(0.286~0.962) 0.037 高血压健康相关行为 -0.718 0.361 3.953 0.487(0.240~0.990) 0.047 每年至少测量一次血压 -1.167 0.444 6.914 0.311(0.130~0.743) 0.009 高血压控制率 年龄 0.765 0.341 5.021 2.419(1.101~4.195) 0.025 慢性疾病史 -1.312 0.561 5.481 0.269(0.090~0.808) 0.019
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