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目的探讨18~30岁人群体质量指数与高血压发病的关系。方法采用前瞻性队列研究,以参加2006年7月至2007年10月开滦集团健康体检的18~30岁人群为研究对象,排除既往高血压病史、妊娠者及资料不全,排除2008-2009,2010-2011或2012-2013年均未参加查体者,最终纳入统计分析的4765人,观察不同体质量指数分组人群高血压发病情况,并分析进展至不同亚型高血压的情况。采用寿命表法计算高血压累积发病率,Cox比例风险回归模型分析体质量指数与高血压发病的关系。结果中位随访5.8年,期间共发生高血压999例,其中单纯收缩期高血压(ISH)占14%,单纯舒张期高血压(IDH)占62%,收缩舒张期高血压(SDH)占24%。低体质量组、正常体质量组、超重组和肥胖组累积高血压发病率分别为9.90%、18.28%、34.97%和61.13%,发病密度分别为12.19人/千人年、24.86人/千人年、51.14人/千人年、103.75人/千人年,组间比较差异有统计学意义(P<0.05)。校正年龄、性别、吸烟、饮酒、体育锻炼、教育程度、基线收缩压、低密度脂蛋白胆固醇及高血压家族史等混杂因素后,超重组和肥胖组发生高血压的风险分别为体质量正常组的1.60(95%CI 1.36~1.87)和2.88(2.44~3.39)倍。结论在18~30岁人群中,高血压发病以IDH为主。随体质量指数增加,高血压发病率及发病风险增加。超重和肥胖对青年人群IDH和SDH发病的影响更大。
Objective To explore the relationship between body mass index (18 ~ 30 years) and the incidence of hypertension. Methods A prospective cohort study was conducted to participate in the 18-30-year-old population from July 2006 to October 2007 in Kailuan Group for physical examination. Exclusion of past history of hypertension, pregnancy and incomplete data, excluding 2008-2009, During 2010-2011 or 2012-2013, 4765 people who did not participate in the survey were included in the statistical analysis, and observed the incidence of hypertension in different mass index groups, and analyzed the progress to different subtypes of hypertension. The cumulative incidence of hypertension was calculated by the life table method, and the relationship between body mass index and the incidence of hypertension was analyzed by Cox proportional hazards regression model. Results During a median follow-up of 5.8 years, there were 999 cases of hypertension, including ISH 14%, IDH 62%, and systolic-diastolic hypertension 24% %. The incidence rates of cumulative hypertension in low body weight group, normal body weight group, overweight group and obesity group were 9.90%, 18.28%, 34.97% and 61.13% respectively, and the incidence densities were 12.19 persons / thousand person-years, 24.86 persons / Year, 51.14 person / thousand person year, 103.75 person / thousand person year, the difference between groups was statistically significant (P <0.05). After adjusting for confounding factors such as age, sex, smoking, drinking, physical exercise, education level, baseline systolic blood pressure, LDL cholesterol and family history of hypertension, the risk of developing hypertension in overweight and obesity groups were normal weight group Of 1.60 (95% CI 1.36 ~ 1.87) and 2.88 (2.44 ~ 3.39) times. Conclusion Among 18 ~ 30-year-olds, the incidence of hypertension is mainly IDH. With the increase of body mass index, the incidence of hypertension and morbidity increased. Overweight and obesity have a greater impact on the incidence of IDH and SDH in young people.