摘要
目的分析45岁以上中老年人心脑血管疾病危险因素的暴露特征。方法横断面研究,选取2016年9月至2017年8月天津市第一中心医院体检的在职和离退休人员,年龄≥45岁4815例,根据既往心肌梗死或冠状动脉支架置入史、脑出血、脑梗死病史,分为心脑血管疾病组947例和对照组3868例;并根据年龄分为45~59岁组2123例,60~74岁组1434例,≥75岁组1258例。收集空腹血糖、糖化血红蛋白、血脂、血压、体质指数等临床资料,Logistic回归分析心脑血管疾病危险因素。结果心脑血管疾病组和对照组体质指数、血压、血糖、糖化血红蛋白及三酰甘油、高密度脂蛋白胆固醇比较,差异有统计学意义(均P<0.05)。60~74岁(OR=1.67,95%CI:1.37~2.02,P<0.01)、≥75岁组(OR=2.95,95%CI:2.42~3.61,P<0.01)、消瘦(OR=1.44,95%CI:1.21~2.26,P<0.01)、超重(OR=1.24,95%CI:1.04~1.48,P<0.05)及肥胖(OR=1.49,95%CI:1.17~1.91,P<0.01)是患心脑血管疾病的危险因素;糖尿病患者血糖控制不达标较未患糖尿病的心血管疾病患病风险升高(OR=1.74,95%CI:1.42~2.14,P<0.01);随高血压分级的增加,患冠心病的风险亦增加(OR值分别为1.50、1.78和2.96),血压控制达标者,其患病风险较无高血压人群亦升高(OR=1.92,95%CI:1.46~2.54,P<0.01)。性别、吸烟史、血脂异常及脂肪肝与45岁及以上中老年人心脑血管疾病发病无相关性。结论45岁及以上中老年人维持适当的体重、控制血压、调整血糖及对并发症的综合管理是心脑血管疾病的防治重点。
Objective To analyze the risk factors for cardio-cerebrovascular disease(CCVD)in adults aged 45 years and over,so as to provide the basis for formulating intervention and control measures of risk factors and improving the prognosis.Methods In-service and retired employees of Tianjin First Central Hospital who underwent health examinations from September 2016 to August 2017 were enrolled in this cross-sectional study.A total of 4815 subjects aged 45 years and over were included,and they were divided into the CCVD group(n=947)and the control group(n=3868)according to previous history of myocardial infarction or coronary stent implantation,cerebral hemorrhage and cerebral infarction.Meanwhile,subjects were divided into the 45-59 years old group(n=2123),the 60-74 years old group(n=1434)and the 75-84 years old group(n=1258).Fasting blood glucose(FBG),glycated hemoglobin(HbA1c),blood lipids,blood pressure(BP)and body mass index(BMI)were measured and recorded.Risk factors for CCVD were analyzed by logistic regression analysis.Results A total of 4815 valid samples were obtained.There were statistically significant differences in BMI,BP,FBG,HbA1c,triglyceride and high-density lipoprotein cholesterol(HDL-C)between the CCVD group and the control group(P<0.05).60-74 years old(OR=1.67,95%CI:1.37-2.02,P<0.01),75-84 years old(OR=2.95,95%CI:2.42-3.61,P<0.01),emaciation(OR=1.44,95%CI:1.21-2.26,P<0.05),overweight(OR=1.24,95%CI:1.04-1.48,P<0.05)and obesity(OR=1.49,95%CI:1.17-1.91,P<0.01)were risk factors for CCVD.The risk of CCVD was higher in diabetes mellitus patients with poor blood glucose control than in subjects without diabetes mellitus(OR=1.74,95%CI:1.42-2.14,P<0.01).With the increase of hypertension grade,the risk of coronary heart disease(CHD)was also increased(OR=1.50,1.78 and 2.96,respectively).Compared with subjects without hypertension,hypertensive patients with target blood pressure control had a higher risk for CHD(OR=1.92,95%CI:1.46-2.54,P<0.01).Gender,smoking history,dyslipidemia and fatty liver were not correlated with CCVD in people aged 45 years and above.Conclusions The prevention and treatment of CCVD should be focused on proper body weight maintenance,BP control,FBG adjustment and comprehensive management of complications in people aged 45 years and above.
作者
罗迪
王小飞
Luo Di;Wang Xiaofei(International Medical Centre,Tianjin First Central Hospital,Tianjin 300192,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2020年第7期774-778,共5页
Chinese Journal of Geriatrics
基金
天津市第一中心医院春风计划(CF201821)。
关键词
心血管疾病
脑血管障碍
危险因素
Cardiovascular Diseases
Cerebrovascular disorders
Risk Factors
