首都公共卫生

目的 分析北京市东城区35～75岁心血管疾病高危人群比例、不同高危类型聚集情况及其影响因素,为制定东城区心血管疾病防控策略提供科学依据。方法 基于2018—2023年国家心血管病中心在北京市东城区开展的心血管病高危人群早期筛查与综合干预项目资料,以纳入的6 968名35～75岁常住居民为筛查对象。定性资料采用相对数描述,组间比较采用χ²检验,变化趋势采用Cochran-Armitage趋势检验,采用多因素二元logistic回归分析探讨心血管疾病高危状态的影响因素,采用多因素无序多分类logistic回归分析探讨不同数量高危类型聚集的影响因素。结果北京市东城区35～75岁心血管疾病高危人群检出率为16.58%,高血压型、血脂异常型、心血管疾病病史型及WHO评估患病风险≥20%型高危人群检出率分别为7.65%、6.43%、4.20%和3.11%。多因素logistic回归分析结果显示,65～75岁(OR=2.588,95%CI:1.870～3.582)、家庭年收入≥5万元(OR=1.195,95%CI:1.034～1.381)、吸烟(OR=1.815,95%CI:1.517～2.172)、饮酒(OR=1.764,95%CI:1.489～2.091)、中心性肥胖(OR=1.677,95%CI:1.420～1.980)、超重(OR=1.280,95%CI:1.071～1.530)、肥胖(OR=1.525,95%CI:1.222～1.903)与心血管疾病高危风险呈正相关(P均<0.05)。心血管疾病高危类型的聚集情况分为1、2、≥3种分别占77.75%、15.50%和6.75%。无序多分类logistic回归分析结果显示,吸烟、饮酒、中心性肥胖者聚集1、2、≥3种心血管疾病高危类型的风险较高,且关联强度随着聚集种类增多而增加(P均<0.05)。结论 北京市东城区心血管疾病的防控须重点关注高龄、超重、肥胖、中心性肥胖、吸烟、饮酒、高收入人群,应采取有针对性的干预防控措施,降低居民心血管疾病发病风险。

Objective To analyze the epidemiological characteristics of cardiovascular disease in high-risk population aged 35-75 in Dongcheng district of Beijing,and to provide scientific basis for making prevention and control strategies of in Dongcheng district.Methods Based on the data from the early screening and comprehensive intervention project for high-risk cardiovascular disease population conducted by the National Cardiovascular Disease Center in Dongcheng district of Beijing from2018 to 2023,a total of 6 968 permanent residents aged 35-75 were included as screening subjects.Qualitative data was described using relative numbers,inter group comparisons were performed using the chi-square test,and trend analysis was conducted via the Cochran-Armitage trend test.Multivariate binary logistic regression was employed to investigate determinants of high-risk cardiovascular disease status,and multivariate logistic regression was utilized to examine factors influencing the aggregation of varying numbers of high-risk types.Results The proportion of high-risk population for cardiovascular disease aged 35-75 in Dongcheng district of Beijing was 16.58 %.The proportions of high-risk population for hypertension,dyslipidemia,cardiovascular disease history,and WHO assessed disease risk ≥20% were 7.65%,6.43%,4.20%,3.11%,respectively.The results of multiple logistic regression analysis showed that aged 65-75(OR=2.588,95% CI:1.870-3.582),annual household income ≥50 000 yuan(OR=1.195,95% CI:1.034-1.381),smoking(OR=1.815,95% CI:1.517-2.172),alcohol consumption(OR=1.764,95% CI:1.489-2.091),central obesity(OR=1.677,95% CI:1.420-1.980),overweight(OR=1.280,95% CI:1.071-1.530),and obesity(OR=1.525,95% CI:1.222-1.903) were positively associated with risk of cardiovascular disease(all P<0.05).The percentages of clustering of high-risk populations composed by 1,2 or ≥3 kinds of risk factors were 77.75%,15.50%,6.75%,respectively.The results of unordered multi class logistic regression analysis showed that individuals who had smoking,drinking alcohol,or central obesity showed higher risk for risk factors clusters of cardiovascular disease,and the association increased with the number of risk factors(all P<0.05).Conclusions The prevention and control of cardiovascular disease in Dongcheng district of Beijing should focus on the elderly,overweight,obese,central obesity,smoking,alcohol consumption,and high-income populations.Targeted intervention and prevention measures should be taken to reduce the risk of cardiovascular disease among residents.