Yang Yong-Li, Fu Peng-Yu, Hu Dong-Sheng, Zhang Wei-Dong, Zhang Mei-Xi, Wang Chong-Jian, Ping Zhi-Guang
Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Jul;30(7):716-9.
To analyze the region cluster and risk factors of hypertension in the Chinese adult population and to explore the application of multilevel regression model in the risk factors of hypertension.
Multi-stage random sampling technique was used to choose 15,540 individuals aged 35-74 years from 10 regions in China. Two-level logistic regression models were fitted under MLwiN 2.02 software.
The region cluster of hypertension existed and variance portion coefficient was 3.1%. After adjusting for the age and gender, overall obese people (BMI> or =28 kg/m2) were 4.50 (95% CI: 4.00-5.06) times, overweight people (BMI=24-27.9 kg/m2) were 2.26 (95% CI: 2.07-2.46) times more likely to be hypertensive as compared with those of normal BMI (18.5-23.9 kg/m2), and those centrally obesive people (Waist circumference > or =85 cm in male or 80 cm in female) were 2.62 (95% CI: 2.42-2.83) times more likely to be hypertensive as compared with those of normal WC. The age-and gender-adjusted odds ratios (ORs) of triglyceride (TG), serum total cholesterol (TC), glucose, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and drinking alcohol were 2.10 (95% CI: 1.89-2.33), 2.08 (95% CI: 1.84-2.35), 1.85 (95% CI: 1.60-2.14), 1.58 (95% CI: 1.38-1.81), 1.49 (95% CI: 1.32-1.69) and 1.15 (95% CI: 1.05-1.27), respectively.
The prevalence of hypertension was not only affected by individual risk factors, such as obesity, drinking alcohol, abnormal glucose and serum lipids profile, but also affected by the geographic environment where people resided in. Population-and risk factors targeted strategies, proved a promising way to reduce individual risk of hypertension in the primary prevention of hypertension.
分析中国成年人群高血压的地区聚集性及危险因素，并探讨多水平回归模型在高血压危险因素研究中的应用。
采用多阶段随机抽样技术，从中国10个地区选取15540名35 - 74岁的个体。在MLwiN 2.02软件下拟合二级逻辑回归模型。
高血压存在地区聚集性，方差分量系数为3.1%。在调整年龄和性别后，总体肥胖者（BMI≥28 kg/m²）患高血压的可能性是正常BMI（18.5 - 23.9 kg/m²）者的4.50倍（95%可信区间：4.00 - 5.06），超重者（BMI = 24 - 27.9 kg/m²）是2.26倍（95%可信区间：2.07 - 2.46），中心性肥胖者（男性腰围≥85 cm或女性腰围≥80 cm）是2.62倍（95%可信区间：2.42 - 2.83）。甘油三酯（TG）、血清总胆固醇（TC）、血糖、低密度脂蛋白胆固醇（LDL - C）、高密度脂蛋白胆固醇（HDL - C）及饮酒经年龄和性别调整后的优势比（OR）分别为2.10（95%可信区间：1.89 - 2.33）、2.08（95%可信区间：1.84 - 2.35）、1.85（95%可信区间：1.60 - 2.14）、1.58（95%可信区间：1.38 - 1.81）、1.49（95%可信区间：1.32 - 1.69）和1.15（95%可信区间：1.05 - 1.27）。
高血压患病率不仅受个体危险因素如肥胖、饮酒、血糖及血脂异常的影响，还受人们居住的地理环境影响。针对人群及危险因素的策略，在高血压一级预防中是降低个体高血压风险的一种有前景的方法。
