Li Dianjiang, Rong Chao, Kang Qi
Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China.
Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China.
J Hum Hypertens. 2023 Apr;37(4):321-326. doi: 10.1038/s41371-022-00684-y. Epub 2022 Apr 8.
It still remains unclear whether perceived stress is associated with hypertension. We aimed to investigate the association between perceived stress with hypertension in Chinese adults. Data on 10,823 participants aged 18 years or older were obtained from the 2015 China Health and Nutrition Survey (CHNS). Hypertension was defined as a mean systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, self-reported physician diagnosis of hypertension, and/or use of antihypertensive medications. Perceived stress was assessed by the 14-item perceived stress scale, with the scale data then divided into quartiles. Logistic regression models and restricted cubic spline regression were performed to evaluate the association between perceived stress and hypertension. After adjustment for age, gender, marital status, education level, per capita household income, employment status, residential areas, current smoking and alcohol consumption, the odds ratio (OR) [95% confidence interval (CI)] for every standard deviation (SD) increment in perceived stress was 0.94 (0.90-0.98); compared to the lowest quartile of perceived stress (Q1), the ORs (95% CIs) for hypertension were 0.88 (0.78-1.01) for Q2, 0.91 (0.81-1.03) for Q3, and 0.82 (0.72-0.92) for Q4 (P for trend < 0.001). The inverse association between perceived stress and hypertension was persistent in the subgroup analyses stratified by age, gender, employment status, residential areas, smoking status, and alcohol consumption. In addition, the restricted cubic spline curve revealed a linear and negative association between perceived stress and hypertension (P for nonlinearity = 0.872). Because this study was a cross-sectional design, future prospective studies are needed to confirm these findings.
感知压力是否与高血压相关仍不清楚。我们旨在调查中国成年人中感知压力与高血压之间的关联。从2015年中国健康与营养调查（CHNS）中获取了10823名18岁及以上参与者的数据。高血压定义为平均收缩压≥140 mmHg、舒张压≥90 mmHg、自我报告医生诊断为高血压和/或使用抗高血压药物。通过14项感知压力量表评估感知压力，然后将量表数据分为四分位数。进行逻辑回归模型和受限立方样条回归以评估感知压力与高血压之间的关联。在调整年龄、性别、婚姻状况、教育水平、家庭人均收入、就业状况、居住地区、当前吸烟和饮酒情况后，感知压力每增加一个标准差（SD）的比值比（OR）[95%置信区间（CI）]为0.94（0.90 - 0.98）；与感知压力最低四分位数（Q1）相比，Q2的高血压OR（95% CI）为0.88（0.78 - 1.01），Q3为0.91（0.81 - 1.03），Q4为0.82（0.72 - 0.92）（趋势P < 0.001）。在按年龄、性别、就业状况、居住地区、吸烟状况和饮酒情况分层的亚组分析中，感知压力与高血压之间的负相关持续存在。此外，受限立方样条曲线显示感知压力与高血压之间存在线性负相关（非线性P = 0.872）。由于本研究为横断面设计，需要未来的前瞻性研究来证实这些发现。
