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35岁以上社区居民高血压患病率及总体心血管事件危险分析
作者:曹邦明 周永兰 李岩松  
单位:徐州市中心医院北院
关键词:高血压 危险分层 心血管危险因素 
分类号:
出版年·卷·期(页码):2011·39·第五期(529-532)
摘要:

【摘要】 目的 了解社区人群高血压患病情况,并进行总体心血管危险分层,为高血压分级管理提供依据。方法 按《国家基本公共卫生服务规范》(2009年版)居民健康档案,健康体检项目要求进行社区检查,并以2009年基层版《中国高血压防治指南》为标准定义各种危险因素、亚临床靶器官损害和临床疾患及相关技术指标,对高血压患者依据血压水平和心血管危险因素进行总体心血管危险分层。结果35岁以上居民体检1143人,平均血压随着年龄增加而升高,发现高血压420人,轻中度高血压占大多数(34.60%),重度高血压占2.19%,高血压前期比例较高(22.41%)。单纯收缩期高血压(Isolated systolic hypertension ISH)105例,占体检人数的9.19%。知道自己患有高血压的196例,知晓率为46.66%。知道自己患有高血压治疗者58例,治疗率29.5%。而58例治疗者仅有10例达标,控制率为17.24%。高血压患者不同危险因素显示年龄、腹性肥胖、早发心血管病家族史的患病率最高。根据420例高血压患者血压水平分层:低危285例(67.93%),中危110例(26.19%),高危25例(5.95%)。添加现存的危险因素或靶器官损害或临床疾患再进行危险分层:低危11例,2.62%;中危30例,7.14%;高危379例,90.24%,高血压高危患者比例明显增加(添加后90.24%,对添加前5.95%,X2 P<0.01)。结论 本组资料35岁以上社区居民高血压患病率高,知晓率、治疗率、控制率低,高血压的社区管理仅仅根据患者血压水平进行分层,低估了高血压人群中的高危患者,添加现存的危险因素或靶器官损害或临床疾患再进行危险分层提高了高危患者检出率。心血管危险因素对高血压患者总心血管危险分层有着决定性的影响,治疗策略应根据初始危险分层进行。

【Abstract】Objective To investigate the hypertension situation in a community,and find out the total cardiovascular risk stratification in hypertensive patients among community,and then provide basis for hypertension classification management Methods Physical examination is made in a community according to the healthy check-up project requirement for inspection from residents health records on the basis of The national basic public health service rules (2009 edition).Risk factors ,subclinical organ damage(SOD), clinical diseases and related technical indicators are based on chinese hypertension guidelines(Grassroots version).All patients are stratified not only by grade of hypertension but also their total cardiovascular risk facts.Results The average blood pressure increase with aging among the 1143 people examed,and 420 hypertensives are found .Low and moderate hypertensives make up to 34.60%,high level hypertensives take up 2.19%,while the proportion of prehypertension is 22.41%. Isolated systolic hypertension(ISH)is 105 cases, accounting for 9.19% of this physical examination . 196 example know their hypertension, for 46.66% awareness. 58 cases accepted treatment among the 196 example who know their hypertension, dots 29.5%, and only 10 cases reach standard control, for 17.24% control. Age, abdominal obesity and family history of premature cardiovascular disease are popular among the risk factors in hypertensives.Based on the the level of hypertension , patients are classified as follows: 67.93% at low cardiovascular risk, 26.19% at moderate cardiovascular risk, 5.95% at high cardiovascular risk.Risk factors , organ damage, clinical diseases added to stratification: 11 hypertensives,2.62% at low cardiovascular risk;30 hypertensives,7.14% at moderate cardiovascular risk; 379 hypertensives,90.24% at high cardiovascular risk.The proportion of patients at high risk increased remarkablely (90.24% vs 5.95%,X2 P<0.01).Conclusion Hypertension mo

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