原发性高血压患者心血管风险水平分层研究

Cardiovascular disease-related risk levels among patients with essential hypertension

摘要:

目的  了解原发性高血压（EH）患者心血管风险水平分层评估现状及特点。方法  选取2011年1月-2015年4月期间于内江市第二人民医院门诊或病房收治的361例EH患者为研究对象，通过问卷调查、体格检查和实验室检测结果对患者进行心血管风险水平的分层。结果  361例患者中高血压等级为Ⅰ级、Ⅱ级、Ⅲ级的比例分别为76.7%、17.7%及5.5%，年龄较大、吸烟、糖耐量异常、空腹血糖受损、TC异常、LDL异常、HDL-C异常、有早发心血管病家族史、腹型肥胖、肥胖、血清同型半胱氨酸（Hcy）异常、伴随脑血管疾病、心脏疾病、糖尿病的比例分别为44.4%、18.6%、72.0%、5.0%、10.8%、16.1%、35.7%、1.9%、40.4%、13.9%、6.9%、2.2%、3.3%及16.9%，心血管危险因素具有一定的聚集性，具有2个（29.9%）、3个（31.9%）的危险因素的比例最高。男性中年龄较大、吸烟、空腹血糖受损、TC升高、腹型肥胖等的发生率显著高于女性（P <0.05），心血管危险因素聚集状况也更明显（P <0.05），而女性患者糖尿病的发生率显著高于男性患者（P <0.05）。心血管风险水平为低危、中危、高危和很高危的比例分别为9.7%、47.7%、18.8%和23.8%，不同心血管风险水平分层患者的性别、年龄、居住地和对高血压的知晓情况比较差异有统计学意义（P <0.05）。结论  多数EH患者有2个或3个心血管危险因素，心血管风险水平分层的现状不容乐观，高危和很高危的患者比例较高，尤其是对于男性、≥65岁、居住在城市的患者。

Abstract:

Objective To understand the current status and characteristics of cardiovascular disease-related risk levels among patients with essential hypertension (EH). Methods 361 patients with EH from January 2011 to April 2015 in outpatient and ward of our hospital were enrolled the study and accessed the cardiovascular disease-related risk levels according to the questionnaire, physical examination and laboratory test results. Results The proportion of Grade-1, Grade-2, Grade-3 of hypertension were respectively 76.7 %, 17.7 %, 5.5 %. The rates of older age, smoking, abnormal fasting glucose, impaired fasting glucose, abnormal TC, abnormal LDL-C, abnormal HDL-C, have a family history of early onset of cardiovascular disease, abdominal obesity, obesity, abnormal Homocysteine (Hcy), complicated with cerebrovascular disease, heart disease, diabetes were respectively 44.4 %, 18.6 %, 72.0 %, 5.0 %, 10.8 %, 16.1 %, 35.7 %, 1.9 %, 40.4 %, 13.9 %, 6.9 %, 2.2 %, 3.3 %, 2.2 %. Cardiovascular risk factors have a certain aggregation. Most of patients had 2 (30.44 ％) or 3 risk factors (29.96 ％). The rates of older age, smoking, impaired fasting glucose, abnormal TC, abdominal obesity in male patients were all significantly higher than that in female patients (P < 0.05), and aggregation of cardiovascular risk factors of male patients was significantly more obvious than the female. But the incidence of diabetes in female patients was significantly higher than that of male patients (P  < 0.05). The proportions of low, medium, high and very high risks were 9.7 %, 47.7 %, 18.8 % and 9.7 % respectively. There were significant differences on cardiovascular risk stratification between age groups, sex, regionsand awareness of EH. Conclusions Most of EH patients have two or three cardiovascular risk factors, and the current status of their cardiovascular disease-related risk levels is not optimistic. High proportion of EH patients have high or very high risk, especially in those males, 65-year-olds and urban residents.