农村中老年高血压患者血压水平与身体测量指标的相关性研究

目的 探讨农村社区中老年高血压患者血压水平与肥胖相关身体测量指标的关系.方法 采用横断面调查方法,对连云港农村社区9 991名45 ～75岁原发性高血压患者进行流行病学问卷调查,测量血压,并计算身体测量指标,包括体质指数、腰围、腰臀比、腰围身高比、锥削度指数等.结果 除了女性锥削度指数,舒张压在其他各项肥胖指标四分位数组的分布均呈逐渐升高趋势(均有P＜0.001)；多元线性回归分析表明,在调整了年龄、血糖、血脂、吸烟、饮酒等混杂因素后,体质指数、腰围身高比、腰臀比与男性高血压患者的收缩压相关,其中体质指数影响最大(β=1.011,R2=0.052,P=0.002)；体质指数、腰围身高比、腰围与女性高血压患者的收缩压相关,以体质指数影响最大(β=0.870,R2=0.040,P＜0.001).各肥胖指标对男女性舒张压影响均有统计学意义(均有P＜0.001),以体质指数影响最大(β=2.001,R2=0.147,P＜0.001).结论 各项肥胖指标均能不同程度的反映农村社区中老年高血压人群的血压水平,其中体质指数与其血压水平关联更为密切.

The relationships between anthropometric indices and blood pressures among middle aged and aged hypertension population in rural areas

Objective To investigate the correlation between anthropometric indices and blood pressure levels in middle aged and aged hypertensive residents in rural areas.Methods A total of 9 991 aged 45-75 years participants with essential hypertension were recruited through a cross-sectional survey during 2008 and 2009 from rural areas of Lianyungang City.Blood pressure,body mass index（BMI）,waist circumference（WC）,waist-hip ratio（WHR）,waist-height ratio（WHtR） and conicity index（CI） were measured.Results Except for the CI of female,there was a tendency of increased diastolic blood pressure with high levels of obesity indicators（P〈0.001）.It showed that BMI,WHtR and WHR were significantly related with systolic blood pressure in men and BMI was the most significant index（β=1.011,R^2=0.052,P=0.002） by multiple linear regression analysis adjusted for age,fasting plasma glucose,blood fat,smoking and alcohol consumption and so on.BMI,WHtR and WC were the influencing factors of systolic blood pressure in women by using multiple linear regression,of which BMI was the most significant indexing（β=0.870,R^2=0.040,P〈0.001）.All obesity indices were significant for diastolic blood pressure for both genders,of which BMI was the strongest（β=2.001,R^2=0.147,P〈0.001）.Conclusions All obesity indices are related to blood pressure levels in varying degrees among middle aged and aged patients with primary hypertension in the rural areas,while BMI is most closely related with blood pressure levels in hypertension population.