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社区高血压患者的糖尿病和高脂血症状况及血压控制的影响因素分析

Diabetes Mellitus and Hyperlipidemia Status Among Hypertensive Patients in the Community and Influencing Factors Analysis of Blood Pressure Control.

作者信息

Zhang Shijia, Yang Yunou, Chen Xiongfei, Fan Liumei, Wu Jiagang, Liu Xiangyi, Lin Weiquan, Zhai Zhiyu, Lin Guozhen, Liu Hui, Zhou Qin

机构信息

Department of Chronic Diseases Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China.

Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.

出版信息

J Clin Hypertens (Greenwich). 2025 Feb;27(2):e14965. doi: 10.1111/jch.14965.

Abstract

To evaluate the prevalence of type 2 diabetes mellitus (T2DM) and hyperlipidemia in hypertensive patients in South China and assess the relationship between these comorbidities and blood pressure control to develop targeted strategies for hypertension management. Data from the 2020 Guangzhou National Basic Public Health Service Program were analyzed using Chi-square tests, t-tests, and logistic regression with R 4.1.2. Among 275,789 hypertensive patients, the blood pressure control rate was 51.51%. The prevalence of T2DM and hyperlipidemia comorbidities was 12.79%, with 12.78% for T2DM alone, 33.54% for hyperlipidemia alone, and 40.89% with no comorbidities. Blood pressure control rates significantly differed by comorbidity (p < 0.05): 52.84% for those without T2DM/hyperlipidemia, 54.18%, 49.25% for T2DM or hyperlipidemia alone, and 50.52% for both conditions. Multivariate analysis indicated a lower blood pressure control rate in patients with hyperlipidemia alone (OR = 1.144) or both T2DM and hyperlipidemia (OR = 1.082), and a higher rate in those with T2DM alone (OR = 0.936). Subgroup analysis revealed that males, older age, higher education, obesity, alcohol use, lack of physical activity, and poor medication adherence were associated with lower control rates. This study found a high prevalence of diabetes and hyperlipidemia among hypertensive patients in Guangzhou. Additionally, hypertensive patients with hyperlipidemia had poorer blood pressure control compared to other diabetic patients. Key factors such as obesity, being overweight, and unhealthy lifestyle choices significantly impact blood pressure management in this population. Therefore, comprehensive measures should be implemented to integrate lipid management into community health efforts and to effectively control blood pressure levels among hypertensive patients.

摘要

评估中国南方高血压患者中2型糖尿病(T2DM)和高脂血症的患病率,并评估这些合并症与血压控制之间的关系,以制定高血压管理的针对性策略。使用卡方检验、t检验和R 4.1.2进行逻辑回归分析2020年广州国家基本公共卫生服务项目的数据。在275789例高血压患者中,血压控制率为51.51%。T2DM和高脂血症合并症的患病率为12.79%,其中单纯T2DM患病率为12.78%,单纯高脂血症患病率为33.54%,无合并症患病率为40.89%。合并症不同,血压控制率有显著差异(p<0.05):无T2DM/高脂血症患者的血压控制率为52.84%,单纯T2DM或高脂血症患者的血压控制率分别为54.18%、49.25%,两种情况并存患者的血压控制率为50.52%。多因素分析表明,单纯高脂血症患者(OR=1.144)或同时患有T2DM和高脂血症患者(OR=1.082)的血压控制率较低,单纯T2DM患者的血压控制率较高(OR=0.936)。亚组分析显示,男性、年龄较大、教育程度较高、肥胖、饮酒、缺乏体育活动和药物依从性差与较低的控制率相关。本研究发现广州高血压患者中糖尿病和高脂血症的患病率较高。此外,与其他糖尿病患者相比,高脂血症高血压患者的血压控制较差。肥胖、超重和不健康的生活方式选择等关键因素对该人群的血压管理有显著影响。因此,应采取综合措施,将血脂管理纳入社区卫生工作,有效控制高血压患者的血压水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/017a/11856054/22c943228e0b/JCH-27-e14965-g001.jpg

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