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预防医学  2022, Vol. 34 Issue (8): 816-820    DOI: 10.19485/j.cnki.issn2096-5087.2022.08.012
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
基于基本公共卫生服务项目构建中老年人群高血压风险评估模型
林天祥, 邱银伟, 汪炜, 赵艳荣, 姜学文, 杨清
浙江省疾病预防控制中心公共卫生监测与业务指导所,浙江 杭州 310051
Establishment of a hypertension risk assessment model among middle-aged and elderly populations based on the basic publichealth service program
LIN Tianxiang, QIU Yinwei, WANG Wei, ZHAO Yanrong, JIANG Xuewen, YANG Qing
Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China
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摘要 目的 基于基本公共卫生服务项目居民电子健康档案,建立中老年人群高血压风险评估模型,为预防高血压提供指导。方法 通过浙江省某县基本公共卫生服务项目居民电子健康档案收集2019—2020年≥40岁居民人口学信息及体检资料;采用多因素logistic回归模型筛选高血压风险因素,采用校正公式将各风险因素的OR值转换为近似RR值,代入哈佛公共卫生学院提供的疾病风险计算公式建立高血压风险评估模型;采用受试者工作特征(ROC)曲线评价模型的预测效果。结果 纳入7 275人,年龄为(66.15±7.91)岁;男性3 189人,女性4 086人,男女比为0.78∶1;新发高血压190例,占2.61%。多因素logistic回归分析结果显示,控制性别和年龄后,超重、肥胖、中心性肥胖、三酰甘油(TG)边缘升高、TG升高、空腹血糖(FPG)异常、血压高值和高血压家族史纳入高血压风险评估模型,近似RR值分别为1.66、1.96、1.54、1.17、1.64、1.45、1.69和1.11。模型的ROC曲线下面积(AUC)为0.678(95%CI:0.641~0.715,P<0.001),最佳阳性阈值为0.899,利用该模型评估高血压相对风险高于0.899的研究对象有139例,灵敏度为73.16%,特异度为55.79%。结论 本研究构建的高血压风险评估模型可用于评估中老年人群高血压发病相对风险,在健康管理中具有一定的应用价值。
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林天祥
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姜学文
杨清
关键词 高血压风险因素风险评估基本公共卫生服务项目    
AbstractObjective To establish a hypertension risk assessment model among the middle-aged and elderly populations based on residents' electronic healthcare records of the basic public health service program, so as to provide insights into prevention of hypertension. Methods Demographic features and physical examinations were collected among residents at ages of 40 years and older from residents' electronic healthcare records of the basic public health service program in a county of Zhejiang Province from 2019 to 2020. The risk factors of hypertension were identified using a multivariable logistic regression model, and the odds ratio (OR) for each risk factor was transformed into approximate relative risk (RR), which was included in the formula for calculation of the disease risk proposed by Harvard School of Public Health to create a hypertension risk assessment model. The predictive value of the model was evaluated using a receiver operator characteristic (ROC) curve. Results Totally 7 275 subjects were enrolled, with a mean age of (66.15±7.91) years, and the participants included 3 189 males and 4 086 females, with a male-to-female ratio of 0.78∶1. There were 190 cases with new-onset hypertension (2.61%). Multivariable logistic regression analysis revealed that overweight, obesity, central obesity, borderline high triacylglycerol (TG), elevated TG, abnormal fasting plasma glucose (FPG), prehypertension and family history of hypertension were included in the hypertension risk assessment model, with approximate RR values of 1.66, 1.96, 1.54, 1.17, 1.64, 1.45, 1.69 and 1.11. The area under the ROC curve (AUC) of the model was 0.678 (95%CI: 0.641-0.715, P<0.001), and the optimal positive cut-off was 0.899. The model predicted 139 subjects with RR>0.899 for hypertension, with a sensitivity of 73.16% and specificity of 55.79%. Conclusions The hypertension risk assessment model created in this study is feasible to predict the RR for developing hypertension among the middle-aged and elderly populations, which has a predictive value in healthcare management.
Key wordshypertension    risk factor    risk assessment    basic public health service program
收稿日期: 2022-03-30      修回日期: 2022-06-13      出版日期: 2022-08-10
中图分类号:  R544.1  
基金资助:浙江省卫生健康科技计划(2021PY004)
作者简介: 林天祥,硕士,医师,主要从事人群健康评价工作
通信作者: 杨清,E-mail:qyang@cdc.zj.cn   
引用本文:   
林天祥, 邱银伟, 汪炜, 赵艳荣, 姜学文, 杨清. 基于基本公共卫生服务项目构建中老年人群高血压风险评估模型[J]. 预防医学, 2022, 34(8): 816-820.
LIN Tianxiang, QIU Yinwei, WANG Wei, ZHAO Yanrong, JIANG Xuewen, YANG Qing. Establishment of a hypertension risk assessment model among middle-aged and elderly populations based on the basic publichealth service program. Preventive Medicine, 2022, 34(8): 816-820.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2022.08.012      或      http://www.zjyfyxzz.com/CN/Y2022/V34/I8/816
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