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[西藏藏族人群单纯舒张期高血压的患病率及影响因素]

[Prevalence and Influencing Factors of Isolated Diastolic Hypertension in Tibetan Population in Tibet].

作者信息

Zhou Yaxi, Xiong Hai, Zhong Huaichang, Wan Yang, Zhang Yufei

机构信息

/ / ( 610041) Department of Gerontology/Neurology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.

( 850000) Medical College of Tibet University, Lhasa 850000, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2024 Mar 20;55(2):360-366. doi: 10.12182/20240360501.

Abstract

OBJECTIVE

To investigate the prevalence and influencing factors of isolated diastolic hypertension (IDH) in the Tibetan population in Tibet and to provide some evidence for the prevention and control of hypertension and other related diseases in high-altitude areas.

METHODS

A multistage stratified whole-group random sampling method was used to enroll participants from Ngari Prefecture, Nagqu City, Shannan City, and Lhasa City, Tibet. A total of 3918 native Tibetans with complete data were enrolled in the survey between June 2020 and August 2023. The participants were aged from 18 to 80. The demographic data, life habits, and chronic disease prevalence of the participants were collected. Fasting venous blood samples were collected to perform the routine blood tests and blood biochemistry tests. The prevalence of IDH in subgroups with different characteristics was analyzed and the influencing factors were analyzed by multivariate logistic regression, accordingly. The predictive value of influencing factors on the prevalence of IDH was analyzed by the receiver operating characteristic (ROC) curve and the findings were compared with those of the previous prediction models for IDH.

RESULTS

The prevalence of hypertension in the participants was 33.7% (=1321), among which, 395 had IDH, accounting for 29.9% of the hypertensive patients. The results of multivariate regression showed that age, heart rate, body mass index, waist circumference, hemoglobin, and low-density lipoprotein cholesterol were associated with risks of developing IDH (<0.05). The area under the ROC curve () was 0.71, which indicated improved accuracy for predicting the risks for IDH in comparison with previous predictive models for IDH. Among the influencing factors, BMI showed the best predictive value for IDH risks.

CONCLUSION

The prevalence of IDH is high among Tibetans in Tibet, suggesting the necessity for rational allocation of health resources in accordance. Compared with the previous IDH prediction models, the model proposed in this study is more suited for the Tibetan population. Targeted interventions should be carried out for the high-risk populations, such as young and middle-aged adults and populations suffering from overweight/obesity, central obesity, high-altitude polycythemia, and dyslipidemia, so as to effectively control the occurrence and development of IDH.

摘要

目的

调查西藏藏族人群中单纯舒张期高血压(IDH)的患病率及其影响因素,为高海拔地区高血压及其他相关疾病的防治提供依据。

方法

采用多阶段分层整群随机抽样方法,从西藏阿里地区、那曲市、山南市和拉萨市选取研究对象。2020年6月至2023年8月,共纳入3918名资料完整的藏族本地居民,年龄在18至80岁之间。收集研究对象的人口学资料、生活习惯及慢性病患病情况。采集空腹静脉血进行血常规及血液生化检查。分析不同特征亚组中IDH的患病率,并采用多因素logistic回归分析其影响因素。通过受试者工作特征(ROC)曲线分析影响因素对IDH患病率的预测价值,并与既往IDH预测模型的结果进行比较。

结果

研究对象中高血压患病率为33.7%(n = 1321),其中395例为IDH,占高血压患者的29.9%。多因素回归结果显示,年龄、心率、体重指数、腰围、血红蛋白及低密度脂蛋白胆固醇与IDH发病风险相关(P < 0.05)。ROC曲线下面积(AUC)为0.71,表明与既往IDH预测模型相比,本研究模型预测IDH发病风险的准确性有所提高。在影响因素中,BMI对IDH风险的预测价值最佳。

结论

西藏藏族人群中IDH患病率较高,提示应合理配置卫生资源。与既往IDH预测模型相比,本研究提出的模型更适合藏族人群。应对中青年及超重/肥胖、中心性肥胖、高原红细胞增多症、血脂异常等高危人群进行针对性干预,以有效控制IDH的发生发展。

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