超重/肥胖与血脂异常及其交互作用对社区高血压患者血压控制的影响

doi:10.12183/j.scjpm.2024.0227

摘要/Abstract

摘要： 目的探讨超重/肥胖与血脂异常及其交互作用对社区高血压患者血压控制的影响。方法选取临平区中西医结合医院医共体社区随访管理的11 254例高血压患者为研究对象,利用其2021年健康体检数据分析血压控制情况,采用logistic回归模型分析超重/肥胖、血脂异常对血压控制的影响,以及采用相乘和相加模型分析超重/肥胖与血脂异常对血压控制的交互作用。结果社区高血压患者血压控制率为39.63%,合并超重/肥胖、血脂异常的患者比例分别为60.41%、58.00%。多因素非条件logistic回归分析结果显示,超重/肥胖（OR=0.694）、血脂异常（OR=0.900）均为血压控制的影响因素（均P<0. 01）。交互作用分析显示,超重/肥胖且血脂异常者血压控制仅为非超重/肥胖且血脂正常者的0.664倍（95% CI：0.596~0.738）;超重/肥胖与血脂异常交互作用超额相对危险度、交互作用归因比和交互作用指数分别为-0.228（95% CI：-0.289~-0.167）、-0.500（95% CI：-0.626~-0.374）、1.721（95% CI：1.244~2.381）,超重/肥胖与血脂异常对血压控制存在相加交互作用;超重/肥胖与血脂异常对血压控制的相乘交互作用无统计学意义（OR=0.987,95% CI：0.950~1.024,P>0.05）。结论超重/肥胖和血脂异常是社区高血压患者血压控制的重要危险因素,两者的相加交互作用增加了社区高血压患者血压未控制的风险。

关键词: 高血压, 超重/肥胖, 血脂异常, 交互作用

Abstract: Objective To explore the effects of overweight/obesity and dyslipidemia and their interaction on blood pressure control in community hypertensive patients. Methods A total of 11 254 hypertensive patients with follow-up management in the medical community of Linping District Integrated Traditional Chinese and Western Medicine Hospital were selected for the study. The blood pressure control situation was analyzed by using the data of their health examination in 2021,and the influence of overweight/obesity and dyslipidemia on blood pressure control was analyzed by logistic regression model. The interaction between overweight/obesity and dyslipidemia on blood pressure control was analyzed using a multiplicative and additive model. Results The blood pressure control rate of hypertensive patients was 39.63%,and the proportion of patients with overweight/obesity and dyslipidemia were 60.41% and 58.00% respectively. Multivariate unconditional logistic regression analysis showed that overweight/obesity （OR=0.694） and dyslipidemia （OR=0.900） were both influential factors for blood pressure control （both P<0.01）. Interaction analysis showed that the blood pressure control of overweight/obesity with dyslipidemia was only 0.664 times that of non-overweight/obesity with normal blood lipids （95% CI：0.596-0.738）. The excess relative risk,interaction attribution ratio,and interaction index of overweight/obesity and dyslipidemia were -0.228 （95% CI：-0.289- -0.167）,-0.500 （95% CI：-0.626- -0.374）,and 1.721 （95% CI：1.244-2.381）,respectively. Overweight/obesity and dyslipidemia had additive interaction on blood pressure control. The multiplicative interaction between overweight/obesity and dyslipidemia on blood pressure control was not statistically significant （OR=0.987,95% CI：0.950-1.024）. Conclusion Overweight/obesity and dyslipidemia are important risk factors for blood pressure control in community hypertensive patients,and their additive interaction increases the risk of uncontrolled blood pressure in community hypertensive patients.

Key words: Hypertension, Overweight/obesity, Dyslipidemia, Interaction

中图分类号:

R195.4

张兰, 郭艳强. 超重/肥胖与血脂异常及其交互作用对社区高血压患者血压控制的影响[J]. 华南预防医学, 2024, 50(3): 227-230.

ZHANG Lan, GUO Yanqiang. Effects of overweight/obesity and dyslipidemia and their interactions on blood pressure control in community hypertensive patients[J]. South China Journal of Preventive Medicine, 2024, 50(3): 227-230.

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