Abstract:Objective To investigate the prevalence and influencing factors of comorbidity of chronic diseases among hypertensive patients with uncontrolled blood pressure in Huzhou City, so as to provide insights into community hypertension control. Methods Hypertensive patients with uncontrolled blood pressure at ages of 35 to 74 years were sampled using a cluster random sampling method from 5 districts (counties) of Huzhou City. Participants' demographics, living behaviors, and development of chronic diseases were collected using questionnaires, and the height, body weight, waist circumference and blood pressure were measured. Blood glucose, blood lipid and other biochemical parameters were detected, and the number and combination of comorbidity of chronic diseases were descriptively analyzed. Factors affecting the comorbidity of chronic diseases were identified using a multivariable ordinal logistic regression model. Results A total of 1 215 respondents were included, with a mean age of (60.83±7.76) years, and including 652 men (53.66%) and 563 women (46.34%). The prevalence of dyslipidemia, diabetes, hyperuricemia and cardiac encephalopathy was 45.10%, 30.95%, 23.05% and 5.10%, respectively. The prevalence of comorbidity of chronic diseases was 69.22% among respondents, and there were 497 respondents with one comorbidity (40.91%), 272 with two comorbidities (22.39%) and 72 with three and more comorbidities (5.93%). Hypertension+dyslipidemia (20.74%), hypertension+diabetes+dyslipidemia (9.96%) and hypertension+diabetes+dyslipidemia+hyperuricemia (4.36%) were predominant comorbid combinations. Multivariable ordinal logistic regression analysis showed that participants with overweight (OR=1.782, 95%CI: 1.390-2.286), obesity (OR=2.411, 95%CI: 1.802-3.222), grade 2 hypertension (OR=1.438, 95%CI: 1.077-1.919) had a higher risk of multiple comorbidities than those with normal body mass index and controlled blood pressure, and women (OR=0.563, 95%CI: 0.456-0.696) had a lower risk of multiple comorbidities than men. Conclusions The prevalence of comorbidity of chronic diseases was 69.22% among community hypertensive patients with uncontrolled blood pressure in Huzhou City, and the comorbidity of chronic diseases mainly included dyslipidemia and diabetes. Men, overweight, obesity and hypertension resulted in a high risk of comorbidity of chronic diseases.
[1] 曹琴琴,蒋蔚,华烨,等.卒中发病前高血压控制情况与缺血性脑卒中分型的相关性分析[J].实用临床医药杂志,2021,25(11):39-42. [2] 刘仕俊,袁寒艳,姜彩霞,等.杭州市老年高血压患者血压控制的影响因素研究[J].预防医学,2021,33(7):660-664. [3] 季燕,丁静,巫继东,等.基层家庭医生签约高血压患者多病共存现状调查[J].中华全科医师杂志,2021,20(12):1269-1274. [4] 郑帅印,李富业,谢尔瓦妮古丽·阿卜力米提,等.克拉玛依市35~75岁体检人群高血压、糖尿病、血脂异常调查[J].预防医学,2022,34(3):232-239. [5] 徐小兵,李迪,孙扬,等.基于关联规则的中国老年人慢性病共病分析[J].中国慢性病预防与控制,2021,29(11):808-812. [6] GAVRILOVA A,BANDERE D,RUTKOVSKA I,et al.Knowledge about disease,medication therapy,and related medication adherence levels among patients with hypertension[J/OL].Medicina,2019,55(11)[2023-04-17].https://doi.org/10.3390/medicina55110715. [7] UNGER T,BORGHI C,CHARCHAR F,et al.2020 International Society of Hypertension global hypertension practice guidelines[J].J Hypertens,2020,38(6):982-1004. [8] 中华人民共和国国家心血管病中心,国家基本公共卫生服务项目基层高血压管理办公室,国家基层高血压管理专家委员会.国家基层高血压防治管理指南2020版[J].中国循环杂志,2021,36(3):209-220. [9] 中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-953. [10] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,13(4):315-409. [11] 中华医学会内分泌学分会.中国高尿酸血症与痛风诊疗指南(2019)[J].中华内分泌代谢杂志,2020,36(1):1-13. [12] 中华人民共和国卫生部.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006. [13] 张吉,戴舒红,陈洪恩,等.南山区居民吸烟行为影响因素分析[J].预防医学,2022,34(5):466-470. [14] 祁月,严琼,孙力菁,等.上海市2004—2019年青少年吸烟饮酒行为变化趋势[J].中国学校卫生,2022,43(7):1003-1006. [15] 胡建功,何朝,赵颖,等.北京市顺义区高血压患者合并症的危险因素分析[J].中国健康教育,2019,35(3):221-224. [16] 闫芳芳,蒋玲,齐蒙蒙,等.高血压患者多病共存现状研究[J].华南预防医学,2022,48(4):424-428. [17] 王浩,张琳,方晓雅,等.中国中老年人慢性病共病现状及其空间分布研究[J].中国全科医学,2022,25(10):1186-1190. [18] GEBREMICHAEL G B,BERHE K K,ZEMICHAEL T M.Uncontrolled hypertension and associated factors among adult hypertensive patients in Ayder comprehensive specialized hospital,Tigray,Ethiopia,2018[J/OL].BMC Cardiovasc Disord,2019,19(1)[2023-04-17].https://doi.org/10.1186/s12872-019-1091-6. [19] 赵春艳,张国峰,张建明,等.北京市通州区25岁及以上人群糖尿病、高血压、高血脂共病现状及影响因素研究[J].医学动物防制,2022,38(8):719-722. [20] MANNAN A,AKTER K M,AKTER F,et al.Association between comorbidity and health-related quality of life in a hypertensive population:a hospital-based study in Bangladesh[J/OL].BMC Public Health,2022,22(1)[2023-04-17].https://doi.org/10.1186/s12889-022-12562-w. [21] 吴梦怡,胡劲松,黄霜,等.湖南省30岁及以上社区居民高血压、糖尿病、高血脂共病的影响因素分析[J].预防医学,2021,33(2):157-161. [22] 于宁,张梅,张笑,等.中国中老年居民高血压、糖尿病和血脂异常共病现状及影响因素研究[J].中华流行病学杂志,2023,44(2):196-204. [23] 庞林鸿,施艺,赵雅静霜,等.高血压患者行为危险因素聚集对血压控制的影响现代[J].预防医学,2022,49(21):3962-3967. [24] 艾飞玲,曹雪,李小春,等.基于前瞻性队列研究的亚洲成人吸烟与2型糖尿病发生风险关系的Meta分析[J].中华健康管理学杂志,2020,14(3):251-259.