Huang Y Q, Li J, Chen J Y, Feng Y Q
Guangdong Cardiovascular Institute, Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2021 Oct 24;49(10):986-992. doi: 10.3760/cma.j.cn112148-20210311-00214.
To analyze the prevalence trends and related factors of hypertension patients complicating with dyslipidemia in community. This was a cross-sectional survey, patients with hypertension were selected from the different communities of Guangdong province in 2013 and 2018 respectively. General clinical characteristics, including demographic information, past history, family history, and medication history, were collected. Dyslipidemia was defined as follows: at least 1 item elevation of total cholesterol (TC)≥5.2 mmol/L, triglyceride (TG) ≥1.7 mmol/L, low-density lipoprotein cholesterol (LDL-C)≥3.4 mmol/L, or reduced high-density lipoprotein cholesterol (HDL-C)<1.0 mmol/L. The incidence of dyslipidemia was standardized based on the 2010 China Census data, and further subgroup analysis was performed according to age (<50, 50-60, ≥60 years old) and sex (male, female). Multivariate logistic regression was used to analyze the related factors of dyslipidemia. In 2013 and 2018, 7 866 (4 148 (52.7%) females, with the age of (62.4±13.6) years) and 11 611 (6 692 (57.6%) females, with the age of (58.2±9.3)years) patients with hypertension were enrolled for data analysis, respectively. In 2013, the total prevalence rate of dyslipidemia in patients with hypertension in the community of Guangdong province was 56.3%, among which the prevalence rates of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia, and low HDL-Cemia were 17.1. %, 21.3%, 2.3% and 24.4%, respectively. The total prevalence of dyslipidemia in patients with hypertension in the community of Guangdong in 2018 was 47.3%, prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia and low HDL-Cemia was 14.1%, 20.3%, 12.0% and 19.4%, respectively. Subgroup analysis showed that the total prevalence of dyslipidemia in male patients with hypertension in the community of Guangdong in 2013 and 2018 was 59.0% and 50.7%, respectively, among which hypercholesterolemia was 13.8% and 8.0%, and hypertriglyceridemia was 22.3%, 20.9%, high LDL-Cemia was 1.7%, 8.1%, low HDL-Cemia was 32.9%, 30.3%, respectively. In 2013 and 2018, the total prevalence of dyslipidemia in female patients with hypertension in the community of Guangdong province was 53.9% and 44.8%, among which prevalence of hypercholesterolemia was 20.5% and 18.5%, hypertriglyceridemia was 20.4% and 19.8%, and high LDL-Cemia was 2.7% and 14.9%, and hypo-HDL-Cemia was 16.8% and 11.3%, respectively. Age subgroup analysis showed that the prevalence of dyslipidemia among hypertensive patients aged<50, 50-60, and ≥60 years in Guangdong community in 2013 were 60.1%, 60.6%, and 53.7%, respectively; and 46.2%, 49.3% and 46.5% in 2018, respectively. Multivariate logistic regression analysis showed that women (=0.860,95% 0.761-0.973,=0.017), obese (=2.295,95% 2.007-2.624,<0.001), diabetes (=1.314,95% 1.090-1.583,=0.004), stroke (=1.894,95% 1.227-2.924,=0.004) and the level of fasting blood glucose (=1.105,95% 1.066-1.146,<0.001) were independently related with the occurrence of dyslipidemia. The prevalence of dyslipidemia in patients with hypertension in the communities of Guangdong province is relatively high, and the prevalence differs in sex and age. Between 2013 and 2018, the total prevalence of dyslipidemia, hyper-TCemia, and hypo-HDL-Cemia in hypertensive patients shows a downward trend. The prevalence of hyper-TGemia remains unchanged, but the prevalence of high LDL-C shows an upward trend. Several factors are related to the prevalence of dislipidemia in hypertension patients in Guandong community.
分析社区高血压患者合并血脂异常的流行趋势及相关因素。本研究为横断面调查，于2013年和2018年分别从广东省不同社区选取高血压患者。收集一般临床特征，包括人口统计学信息、既往史、家族史和用药史。血脂异常定义如下：总胆固醇（TC）≥5.2 mmol/L、甘油三酯（TG）≥1.7 mmol/L、低密度脂蛋白胆固醇（LDL-C）≥3.4 mmol/L至少1项升高，或高密度脂蛋白胆固醇（HDL-C）<1.0 mmol/L降低。血脂异常发病率根据2010年中国人口普查数据进行标准化，并根据年龄（<50岁、50 - 60岁、≥60岁）和性别（男、女）进一步进行亚组分析。采用多因素logistic回归分析血脂异常的相关因素。2013年和2018年分别纳入7866例（4148例（52.7%）女性，年龄（62.4±13.6）岁）和11611例（6692例（57.6%）女性，年龄（58.2±9.3）岁）高血压患者进行数据分析。2013年，广东省社区高血压患者血脂异常总患病率为56.3%，其中高胆固醇血症、高甘油三酯血症、高LDL-C血症和低HDL-C血症患病率分别为17.1%、21.3%、2.3%和24.4%。2018年广东省社区高血压患者血脂异常总患病率为47.3%，高胆固醇血症、高甘油三酯血症、高LDL-C血症和低HDL-C血症患病率分别为14.1%、20.3%、12.0%和19.4%。亚组分析显示，2013年和2018年广东省社区男性高血压患者血脂异常总患病率分别为59.0%和50.7%，其中高胆固醇血症分别为13.8%和8.0%，高甘油三酯血症分别为22.3%、20.9%，高LDL-C血症分别为1.7%、8.1%，低HDL-C血症分别为32.9%、30.3%。2013年和2018年，广东省社区女性高血压患者血脂异常总患病率分别为53.9%和44.8%，其中高胆固醇血症患病率分别为20.5%和18.5%，高甘油三酯血症分别为20.4%和19.8%，高LDL-C血症分别为2.7%和14.9%，低HDL-C血症分别为16.8%和11.3%。年龄亚组分析显示，2013年广东省社区高血压患者中年龄<50岁、50 - 60岁和≥60岁者血脂异常患病率分别为60.1%、60.6%和53.7%；2018年分别为46.2%、49.3%和46.5%。多因素logistic回归分析显示，女性（=0.860，95% 0.761 - 0.973，=0.017）、肥胖（=2.295，95% 2.007 - 2.624，<0.001）、糖尿病（=1.314，95% 1.090 - 1.583，=0.004）、中风（=1.894，95% 1.227 - 2.924，=0.004）和空腹血糖水平（=1.105，95% 1.066 - 1.146，<0.001）与血脂异常的发生独立相关。广东省社区高血压患者血脂异常患病率较高，且在性别和年龄上存在差异。2013年至2018年，高血压患者血脂异常、高TC血症和低HDL-C血症总患病率呈下降趋势。高TG血症患病率保持不变，但高LDL-C患病率呈上升趋势。广东社区高血压患者血脂异常患病率与多种因素有关。
