Epidemic status and influencing factors of cardiovascular disease at high risk among urban and rural residents in Tibet
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摘要:
目的 了解西藏地区城乡居民心血管病高危人群现况及其影响因素，为制定西藏心血管疾病的预防控制措施提供依据。 方法 2016年5月-2019年10月采用随机整群抽样方法在西藏7个项目市(区)抽取41 476名35~75岁城乡居民进行问卷调查、体格测量和实验室检测。 结果 在符合条件的41 476名城乡居民中筛出高危者9 185人，高危率为22.15%，其中有1个危险因素者7 882人(85.81%)，2个危险因素者1 457人(15.86%)，≥3个危险因素146人(1.59%)。心血管病史型检出率为0.89%，血压高型检出率为18.62%，血脂异常型检出率为3.74%，WHO评估10年患病风险≥20%的检出率为2.17%。≥40岁、职业为农民和居住在农村的居民更易成为心血管病高危人群(均有P＜0.05)，女性和婚姻状况为在婚的西藏城乡居民更不易成为心血管病高危人群。 结论 西藏35~75岁心血管病高危人群中男性高危率高于女性，高危率随着年龄的增长而逐渐升高，西藏城乡居民心血管病高危因素以血压高为主，男性、非在婚、年龄较大者、农民等是该地区心血管病综合防治的关键人群。 Abstract:Objective To understand the current status and influencing factors of the population at high risk of cardiovascular disease in urban and rural residents of Tibet Autonomous Region, and provide a basis for the prevention and control measures of cardiovascular disease in Tibet. Methods From May 2016 to October 2019, a random cluster sampling method was used and 41 476 participants aged 35-75 years old was selected from 7 project cities (districts) in Tibet. Questionnaires, physical measurements and laboratory tests were used to investigate urban and rural residents. Results Among the 41 476 urban and rural residents eligible, 9 185 high-risk persons were screened out, with a high-risk rate of 22.15%. Among the high-risk groups, there were 7 882 people with one risk factor (85.81%), 1 457 people with 2 risk factors (15.86%) and 146 people (1.59%) with 3 or more risk factors. The detection rate of historical cardiovascular disease type was 0.89%. The detection rate of high blood pressure type was 18.62%. The detection rate of dyslipidemia type was 3.74%. The detection rate of WHO's assessment of 10 years of risk more than or equal 20% was 2.17%. Aged more than or equal 40 years, farmers and residents living in rural areas were more likely to be at high risk of cardiovascular disease (all P < 0.05). Women and subjects who were married were less likely to be at high risk of cardiovascular disease. Conclusions Among the population at high risk of Cardiovascular diseases in Tibet, there were more males than females and more elderly than young people. The high risk factor for cardiovascular disease is mainly high blood pressure. Males, non-married, older, farmers are the key population for comprehensive prevention and treatment of cardiovascular disease in Tibet. -
Key words:
- Tibet /
- Cardiovascular disease /
- High-risk population /
- Risk factors
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表 1 西藏不同特征居民心血管疾病高危率
Table 1. High risk rate of cardiovascular diseases among residents with different characteristics in Tibet
变量 高危居民 高危率(%) χ2值 P值 性别 124.762 ＜0.001 男 4 188 24.92 女 5 000 20.27 年龄(岁) 2 975.965 ＜0.001 ≥35 523 8.87 40~ 2 007 13.95 50~ 3 149 25.21 60~ 2 610 38.19 70~75 971 52.01 城乡 13.531 ＜0.001 乡村 7 061 22.57 城市 2 124 20.83 
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表 2 不同特征居民高危类型检出情况[n(%)]
Table 2. Detection of high-risk types of residents with different characteristics [n(%)]
变量 心血管病史型 血压高型 血脂异常型 WHO评估10年患病风险≥20% 性别 男 122(0.73) 3 262(19.41) 1 109(6.60) 401(2.39) 女 248(1.01) 4 460(18.08) 443(1.80) 510(2.07) χ2值 8.811 11.755 640.480 4.741 P值 0.03 0.01 < 0.001 0.29 年龄(岁) ≥35 42(0.71) 269(4.56) 235(3.98) 2(0.03) 40~ 123(0.85) 1 475(10.25) 546(3.80) 71(0.49) 50~ 98(0.78) 2 736(21.91) 432(3.46) 240(1.92) 60~ 80(1.17) 2 391(34.40) 277(4.05) 386(5.65) 70~75 27(1.45) 851(45.58) 62(3.33) 62(3.32) χ2值 16.498 3 627.451 6.603 1 435.979 P值 0.002 < 0.001 0.158 < 0.001 居住地 城市 92(0.90) 1 716(16.83) 380(3.82) 604(5.92) 乡村 278(0.81) 6 006(19.20) 1 163(3.72) 607(1.94) χ2值 0.016 28.521 0.202 38.792 P值 0.899 < 0.001 0.653 < 0.001
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表 3 不同特征居民高危类型检出情况[n(%)]
Table 3. Detection of high-risk types of residents with different characteristics [n(%)]
变量 β值 Wald χ2值 OR(95% CI)值 P值 性别 女性 1.000 男性 0.266 110.270 1.305(1.244~1.371) < 0.001 年龄组(岁) 35~ 1.000 40~ 2.244 1 145.191 1.106(1.091~1.121) < 0.001 50~ 1.774 1 098.582 1.170(1.155~1.188) < 0.001 60~ 1.035 399.141 1.355(1.321~1.393) < 0.001 70~75 0.413 59.648 1.662(1.592~1.735) < 0.001 职业 非农民 1.000 农民 0.070 3.931 1.073(1.001~1.150) 0.047 婚姻 在婚 1.000 非在婚 0.243 38.205 1.275(1.183~1.377) 0.002 是否超重或肥胖 正常 1.000 超重或肥胖 0.592 544.840 1.553(1.532~1.582) < 0.001 是否吸烟 不吸烟 1.000 吸烟 0.206 2.682 0.814(0.636~1.041) 0.102 是否饮酒 不饮酒 1.000 饮酒 0.125 8.608 1.883(1.087~1.959) 0.003
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