Lu Shan, Bao Ming-Yang, Miao Shu-Mei, Zhang Xin, Jia Qing-Qing, Jing Shen-Qi, Shan Tao, Wu Xiao-Hong, Liu Yun
Department of Geratology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Health Education Section, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Ann Transl Med. 2019 Sep;7(18):436. doi: 10.21037/atm.2019.09.04.
This study aimed to investigate the prevalence and risk factors for hypertension, diabetes, and dyslipidemia, and to evaluate their additive effects on myocardial infarction (MI) and stroke in Nanjing in East China.
A multistage, stratified random cluster sampling method was used to select representative participants. All eligible participants completed questionnaires, physical measurements, and blood tests. Multivariable and univariable logistic regression analyses were used to identify associated risk factors and evaluate additive effects on cardiovascular events, respectively.
Hypertension was the most prevalent chronic disease among 11,036 participants enrolled (18.5%), followed by dyslipidemia (8.3%) and diabetes (6.0%). The prevalence of hypertension was higher in men than in women while no sex-related difference was observed in the prevalence of diabetes and dyslipidemia. Older age and higher body mass index were risk factors for all three diseases. Sex, central obesity, smoking, number of family members, salt intake, and family history of hypertension were associated with hypertension; central obesity, smoking, alcohol assumption, and family history of diabetes correlated with diabetes; and female sex, higher education, and alcohol assumption were risk factors for dyslipidemia. Hypertension complicated with dyslipidemia conferred more risk of MI and stroke than independent effects. Diabetes also contributed to risk based on hypertension or dyslipidemia.
The burden of hypertension and diabetes has stopped increasing. However, total cholesterol (TC) concentration in the population has not been well controlled. A more comprehensive approach to managing dyslipidemia, hypertension, and diabetes needs to be developed, especially for individuals with multiple cardiovascular risk factors.
本研究旨在调查中国东部南京市高血压、糖尿病和血脂异常的患病率及危险因素，并评估它们对心肌梗死（MI）和中风的叠加影响。
采用多阶段分层随机整群抽样方法选取有代表性的参与者。所有符合条件的参与者均完成问卷调查、体格检查和血液检测。分别采用多变量和单变量逻辑回归分析来确定相关危险因素并评估对心血管事件的叠加影响。
在纳入的11036名参与者中，高血压是最常见的慢性病（18.5%），其次是血脂异常（8.3%）和糖尿病（6.0%）。男性高血压患病率高于女性，而糖尿病和血脂异常患病率未观察到性别差异。年龄较大和体重指数较高是所有三种疾病的危险因素。性别、中心性肥胖、吸烟、家庭成员数量、盐摄入量和高血压家族史与高血压相关；中心性肥胖、吸烟、饮酒和糖尿病家族史与糖尿病相关；女性、高学历和饮酒是血脂异常的危险因素。高血压合并血脂异常比单独存在时赋予更高的心肌梗死和中风风险。糖尿病在高血压或血脂异常基础上也增加风险。
高血压和糖尿病的负担已停止增加。然而，人群中的总胆固醇（TC）浓度尚未得到良好控制。需要制定更全面的方法来管理血脂异常、高血压和糖尿病，尤其是对于具有多种心血管危险因素的个体。
