青年人群高血压风险的影响因素：基于航天无锡健康管理中心的横断面和队列研究

Risk factors for hypertension in young adults: evidence from a cross-sectional and cohort study at the Aerospace Wuxi Health Management Center

    摘要
  • 摘要:
    目的 探讨青年人群（18～45岁）高血压风险的影响因素，为其有效管理提供依据。
    方法 本文分为2个部分。第一部分，选取于2014年1月至2023年12月于航天无锡健康管理中心体检的所有青年人（共计143 898人），纳入logistic回归进行横断面分析，以初步探索青年高血压患病风险的影响因素。第二部分，排除无随访体检数据以及首次体检时确诊高血压者后，共计24 076人纳入Cox比例风险模型进行队列研究，以进一步探讨高血压发病风险的影响因素。
    结果 横断面研究提示该人群高血压患病率为15.57%（22 399/143 898）。高血压患病危险因素包括年龄、男性、体重指数（BMI）≥24 kg/m2、腰臀比偏高、心率≥100 次/min、甘油三酯≥1.7 mmol/L、低密度脂蛋白胆固醇（LDL-C）≥3.4 mmol/L、空腹血糖≥6.1 mmol/L、血尿酸≥420 μmol/L、估算的肾小球滤过率（eGFR）＜90 mL/(min·1.73 m2)、有高血压家族史。队列研究中位随访时间2.951年，4 383人发病，发病密度为44.73/1 000人年。年龄、男性、曾经/当下吸烟、BMI≥24 kg/m2、腰臀比偏高、心率≥100 次/min、甘油三酯≥ 1.7 mmol/L、LDL-C≥3.4 mmol/L、空腹血糖≥6.1 mmol/L、血尿酸≥420 μmol/L、有高血压家族史与青年人群高血压发病风险增加相关。在横断面和队列研究中均发现不同性别影响因素的分布和作用存在差异（P交互＜0.05）。
    结论 年龄增加、男性、高血压家族史是青年人群新发或患高血压不可改变的风险因素。体重增加、糖脂代谢紊乱、高尿酸血症、肾功能下降、心率增快是新发或患高血压可改变的代谢相关风险因素。同一危险因素所致的高血压风险可能存在性别差异。

     

    Abstract:
    Objective To explore the risk factors of hypertension in young adults aged 18–45 years and provide evidence for effective management strategies.
    Methods A total of 143 898 young adults who underwent health check-ups at the Aerospace Wuxi Health Management Center from January 2014 to December 2023 were included in the study. Logistic regression analysis was conducted for a cross-sectional study to preliminarily identify the factors associated with hypertension prevalence. After excluding individuals without follow-up data and those diagnosed with hypertension at baseline, 24 076 participants were included in follow-up study using a Cox proportional hazards model to further investigate risk factors for incident hypertension.
    Results The cross-sectional study indicated a hypertension prevalence of 15.57% (22 399/143 898) in this population. Risk factors of hypertension included older age, male gender, body mass index (BMI) ≥24 kg/m2, elevated waist-to-hip ratio, heart rate ≥100 beats per minute, triglycerides (TG) ≥1.7 mmol/L, low density lipoprotein cholesterol (LDL-C) ≥3.4 mmol/L, fasting blood glucose ≥6.1 mmol/L, serum uric acid ≥420 μmol/L, estimated glomerular filtration rate (eGFR)＜90 mL/(min·1.73 m2), and a family history of hypertension. In the cohort study, the median follow-up period was 2.951 years, during which 4 383 participants developed hypertension, with an incidence density of 44.73 per 1 000 person-years. Risk factors significantly associated with incident hypertension included age, male gender, current or former smoking, BMI ≥24 kg/m2, elevated waist-to-hip ratio, heart rate ≥100 beats per minute, TG ≥1.7 mmol/L, LDL-C ≥3.4 mmol/L, fasting blood glucose ≥6.1 mmol/L, serum uric acid ≥420 μmol/L, and a family history of hypertension. Both the cross-sectional study and cohort study identified differences in the distribution and impact of risk factors across genders (Pinteraction＜0.05).
    Conclusions Advancing age, male gender, and a family history of hypertension are non-modifiable risk factors for the development or presence of hypertension in young adults. Modifiable metabolic factors, including increased body weight, dysregulated glucose and lipid metabolism, hyperuricemia, impaired renal function, and elevated heart rate, are significant contributors to hypertension risk. Furthermore, the risk associated with certain factors may differ by gender.

     

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