Bloch Katia Vergetti, Klein Carlos Henrique, de Souza e Silva Nelson Albuquerque, Nogueira Armando da Rocha, Salis Lucia Helena Alvares
Hospital Universitário Clementino Fraga Filho (UFRJ) Escola Nacional de Saúde Pública, Rio Janeiro, Brasil.
Arq Bras Cardiol. 2003 Feb;80(2):179-86, 171-8. doi: 10.1590/s0066-782x2003000200006. Epub 2003 Feb 25.
The present study aims to evaluate the environmental role in the distribution of hypertension, obesity, and smoking and spousal concordance for the presence/absence of these 3 cardiovascular risk factors.
A cross-sectional study was conducted in a community in Rio de Janeiro, Brazil. The households were randomly selected. Odds ratios were estimated to measure spousal concordance, across socioeconomic levels.
Overall a significant aggregation of all 3 risk factors was present. The crude odds ratio for hypertension was 1.78 (95%CI=1.02-3.08); for obesity, it was 1.80 (95%CI=1.09-2.96); and for smoking, it was 3.40 (95% CI=2.07-5.61). The spousal concordance for hypertension decreased significantly (p<0.001) from the lower to the higher educational level. In the case of obesity and smoking, the opposite was observed, although p-values for the linear trend were 0.10 and 0.08, respectively.
In lower socioeconomic levels, couples are more concordant for hypertension and discordant for smoking. For hypertension and smoking, education seems to be a discriminant stronger than income, but for obesity the 2 socioeconomic indicators seem to represent different aspects of the environmental determinants of risk factor distribution.
本研究旨在评估环境因素在高血压、肥胖症及吸烟分布中的作用,以及夫妻双方在这三种心血管危险因素存在与否方面的一致性。
在巴西里约热内卢的一个社区开展了一项横断面研究。家庭是随机选取的。估计比值比以衡量不同社会经济水平下夫妻双方的一致性。
总体而言,所有这三种危险因素均存在显著聚集现象。高血压的粗比值比为1.78(95%置信区间=1.02 - 3.08);肥胖症的粗比值比为1.80(95%置信区间=1.09 - 2.96);吸烟的粗比值比为3.40(95%置信区间=2.07 - 5.61)。从低教育水平到高教育水平,夫妻双方在高血压方面的一致性显著降低(p<0.001)。在肥胖症和吸烟方面则观察到相反情况,尽管线性趋势的p值分别为0.10和0.08。
在社会经济水平较低的人群中,夫妻在高血压方面更为一致,而在吸烟方面不一致。对于高血压和吸烟,教育似乎比收入更具区分性,但对于肥胖症,这两个社会经济指标似乎代表了危险因素分布环境决定因素的不同方面。