老年人群腰围与高血压发生风险的关联:基于人群队列研究的分析

doi:10.3969/j.issn.1003-9198.2023.05.008

摘要/Abstract

摘要： 目的探究老年人群腰围与新发高血压之间的相关性。方法基于中国健康与养老追踪调查(CHARLS)资料(2011~ 2015年),纳入2038例(男1129例,女909例)基线无高血压的老年人(≥60岁),对协变量进行多重插补后,比较新发高血压组及无新发高血压组个体的基线特征,通过广义加性模型和Spearman相关系数评估腰围与血压的相关性,采用多因素Cox回归模型分析腰围对新发高血压的影响,并应用限制性三次样条分析其是否存在非线性相关。结果 2038例老年人平均随访3.26年,期间共有717例(35.2%)发生高血压。广义加性模型和Spearman秩相关分析结果表明,腰围与基线收缩压和舒张压均呈正相关(P<0.001)。在调整年龄、性别、吸烟、饮酒、BMI、LDL、相关疾病(糖尿病、心脏病和脑卒中)后,腰围每增加10 cm,高血压发病风险增加19%(HR=1.19,95%CI:1.06~1.34);与腰围低四分位数(Q1)组老年人相比,高四分位数(Q4)组的高血压发病风险较高,HR为1.33(95%CI:1.01~1.75)。限制性立方样条结果显示,随着腰围的增加,高血压的发病风险逐渐升高。结论高腰围是老年人群新发高血压的独立危险因素。

关键词: 老年人, 腰围, 体质量指数, 高血压, 肥胖

Abstract: Objective To explore the association between waist circumference and new-onset hypertension in the elderly people. Methods A total of 2038 elderly individuals(male/female: 1129/909, aged≥60 years) without hypertension at baseline were collected from the China Health and Retirement Longitudinal Study(CHARLS) 2011-2015. After preprocessing missing covariates via multiple imputation based on 5 replications, we compared baseline characteristics between individuals with new-onset hypertension and those without hypertension. The generalized additive model and SpearmaŃs correlation analysis were used to evaluate the association between waist circumference and baseline blood pressure. Multivariate Cox regression model was used to analyze the effect of waist circumference on new-onset hypertension. Moreover, restricted cubic spline was used to visualize the nonlinear correlation between waist circumference and new-onset hypertension. Results After a mean follow-up of 3.26 years, 717(35.2%) participants presented with hypertension. The generalized additive model and SpearmaŃs rank revealed the significant positive correlation of waist circumference with the baseline systolic and diastolic blood pressure(P<0.001). After adjusting age, sex, alcohol intake, smoking status, body mass index, low density lipoprotein and chronic diseases(diabetes mellitus, heart disease and stroke), the risk of new-onset hypertension increased by 19% with 10 cm increase in waist circumference. After multivariable adjustment, compared with the lowest quantile group, the hazard ratio(HR) of new-onset hypertension was 1.33(95%CI: 1.01-1.75) in the highest quantile group. Restricted cubic spline regression analysis showed that the risk of hypertension increased with the increase of waist circumference. Conclusions This study demonstrates that high waist circumference can be an independent risk factor for new-onset hypertension.

Key words: aged, waist circumference, body mass index, hypertension, obesity

中图分类号:

R 544.1

刘恒利, 渠强, 孙劲禹, 孙伟, 熊亚晴. 老年人群腰围与高血压发生风险的关联:基于人群队列研究的分析[J]. 实用老年医学, 2023, 37(5): 464-469.

LIU Heng-li, QU Qiang, SUN Jin-yu, SUN Wei, XIONG Ya-qing. Relationship between waist circumference and newly-developed hypertension in elderly people: a population-based cohort study[J]. Practical Geriatrics, 2023, 37(5): 464-469.

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