辽宁农村地区坐位与仰卧位高血压检出率及相关特征的差异

A comparative analysis of hypertension prevalence and features in sitting versus supine positions in rural areas of Liaoning Province

  • 摘要:
    目的 探究采用坐位与仰卧位血压对高血压诊断的影响,同时探究这种影响在不同年龄、性别之间的差异。
    方法 于2021年3—7月在辽宁省阜新市阜新蒙古族自治县招募4个乡镇、33个自然村,共有3 482人完成数据收集,排除缺少关键坐位、仰卧位血压测量值的研究对象,共纳入2 379名个体,平均年龄为(61.6±9.6)岁,其中男性830人,占比34.9%。坐位与仰卧位高血压定义为收缩压≥140 mmHg和/或舒张压≥90 mmHg,和/或在过去两周内接受降压药治疗。比较不同性别、年龄组在坐位高血压与仰卧位高血压单一状态下的检出率差异。继而,将人群按不同体位高血压情况分为四类:不患有坐位和仰卧位高血压,仅患有坐位高血压,仅患有仰卧位高血压,同时患有坐位和仰卧位高血压。分析不同性别、年龄在四种高血压分类中的分布差异。应用单因素logistic回归分析探讨性别与年龄对坐位高血压及仰卧位高血压的影响。排除有服药行为人群后,进行敏感性分析。
    结果 仰卧位收缩压及舒张压高于坐位收缩压及舒张压(141.7±21.3)比(137.3±21.0)mmHg,t=−18.218,P<0.001;(85.9±11.3)比(85.3±11.2)mmHg,t=−4.489,P<0.001,仰卧位高血压检出率高于坐位高血压检出率(54.8%比41.5%,χ2=884.931,P<0.001),406(17.1%)人仅患有仰卧位高血压。单因素logistic回归分析显示,坐位血压正常而患有仰卧位高血压群体更易出现在女性(OR=1.427, 95%CI:1.108~1.838)和老年人(年龄≥65岁, OR=2.110, 95%CI:1.675~2.659)中。敏感性分析结果显示,女性与老年人(年龄≥65岁)为仅患仰卧位高血压的高危人群。
    结论 坐位与仰卧位的血压测量值及高血压检出率存在差异;仰卧位血压测量值及高血压检出率均高于坐位。仅患仰卧位高血压的情况在女性和老年人(年龄≥65岁)中更为常见。

     

    Abstract:
    Objective To explore the distribution and impact of sitting and supine blood pressure measurements on prevalenve of hypertension, as well as to investigate the differences of this impact among different ages and genders.
    Methods A study was conducted from March to July 2021 in Fuxin Mongolian Autonomous County, Fuxin City, Liaoning Province. A total of 3 660 people from 4 townships and 33 natural villages participated in the data collection. After excluding the subjects who lacked sitting and supine blood pressure measurements, a total of 2 379 individuals were included in this study. With an average age of (61.6±9.6) years. Among them, 830 were male, accounting for 34.9%. Hypertension in the sitting and supine positions were defined as systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg, and/or having received antihypertensive medication within the past two weeks. Continuous data were analyzed using t tests, and rate comparisons were conducted using χ2 tests. Multivariate logistic regression analysis was applied to explore the effects of gender and age on hypertension in the sitting and supine positions. Sensitivity analysis was performed after excluding individuals with medication-taking behavior.
    Results The results showed that the systolic and diastolic blood pressures in the supine position were higher than those in the sitting position (141.7±21.3) vs (137.3±21.0) mmHg, t=−18.218, P<0.001; (85.9±11.3) vs (85.3±11.2) mmHg, t=−4.489, P<0.001, and the prevalence of hypertension in the supine position was higher than that in the sitting position (54.8% vs 41.5%, χ2=884.931, P<0.001). 406 (17.1%) individuals only had hypertension in the supine position. Multivariate logistic regression analysis revealed that individuals with normal sitting blood pressure but hypertension in the supine position were more likely to be found in females (OR=1.427, 95%CI: 1.108−1.838) and the elderly(≥65 years old, OR=2.110, 95%CI: 1.675−2.659). The sensitivity analysis results indicated that females and the elderly (≥65 years old) were the high-risk groups for only having hypertension in the supine position.
    Conclusions There are significant differences in blood pressure measurements and the prevalence of hypertension between the sitting position and the supine position; the blood pressure measurements and the prevalence of hypertension in the supine position are both higher than those in the sitting position. The situation of only having hypertension in the supine position is more common among women and the elderly (≥65 years old).

     

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