Pilakkadavath Zarin, Shaffi Muhammed
Department of Family Medicine, Lourdes Hospital, Kochi, Kerala, India; Department of Family Medicine, KIMS Hospital, Thiruvananthapuram, Kerala, India.
Global Institute of Public Health, Ananthapuri Hospital, Thiruvananthapuram, Kerala, India.
J Family Med Prim Care. 2016 Jan-Mar;5(1):114-9. doi: 10.4103/2249-4863.184634.
Hypertension is a major cause of cardiovascular morbidity and mortality in Kerala. Excess dietary salt, low dietary potassium, overweight and obesity, physical inactivity, excess alcohol, smoking, socioeconomic status, psychosocial stressors, and diabetes are considered as modifiable risk factors for hypertension.
To estimate and compare the distribution of modifiable risk factors among hypertensive (cases) and nonhypertensive (controls) patients and to estimate the effect relationship of risk factors.
Age- and sex-matched case-control study was conducted in a tertiary care hospital in Kerala using a pretested interviewer-administered structured questionnaire based on the WHO STEPS instrument for chronic disease risk factor surveillance. Bivariate and multiple logistic regression analyses were done.
A total of 296 subjects were included in the study. The mean age of study sample was 50.13 years. All modifiable risk factors studied vis-ΰ-vis obesity, lack of physical activity, inadequate fruits and vegetable intake, diabetes, smoking, and alcohol use were significantly different in proportion among cases and controls. Obesity, lack of physical activity, smoking, and diabetes were found to be significant risk factors for hypertension after adjusting for other risk factors.
Hypertension is strongly driven by a set of modifiable risk factors. Massive public awareness campaign targeting risk factors is essential in controlling hypertension in Kerala, especially focusing on physical exercise and control of diabetes, obesity, and on quitting smoking.
高血压是喀拉拉邦心血管疾病发病和死亡的主要原因。过量的饮食盐分、低饮食钾摄入、超重和肥胖、身体活动不足、过量饮酒、吸烟、社会经济地位、心理社会压力源以及糖尿病被认为是高血压的可改变风险因素。
估计并比较高血压患者(病例)和非高血压患者(对照)中可改变风险因素的分布情况,并估计风险因素的效应关系。
在喀拉拉邦的一家三级护理医院进行了年龄和性别匹配的病例对照研究,使用基于世界卫生组织慢性病风险因素监测的“STEPS”工具预先测试的、由访谈员实施的结构化问卷。进行了双变量和多因素逻辑回归分析。
共有296名受试者纳入研究。研究样本的平均年龄为50.13岁。在病例组和对照组中,与肥胖、缺乏身体活动、水果和蔬菜摄入不足、糖尿病、吸烟和饮酒相关的所有可改变风险因素在比例上均有显著差异。在调整其他风险因素后,肥胖、缺乏身体活动、吸烟和糖尿病被发现是高血压的显著风险因素。
高血压受到一系列可改变风险因素的强烈驱动。在喀拉拉邦,针对风险因素开展大规模公众宣传活动对于控制高血压至关重要,尤其要关注体育锻炼以及糖尿病、肥胖症的控制和戒烟。