上海市社区高血压管理患者诊内收缩压短时变化分析

郎冬晨; 严青华; 苏旭燕; 施燕; 吴菲; 王玉恒; 罗炜; 程旻娜; 吴毅凌

doi:10.19428/j.cnki.sjpm.2023.22499

上海市社区高血压管理患者诊内收缩压短时变化分析

Systolic blood pressure variation within a visit of community hypertension patients in Shanghai

摘要

摘要:
目的探讨社区诊室随访血压的收缩压诊内短时变化特征及其影响因素。
方法基于2018—2021年上海市各社区卫生服务中心就诊高血压管理患者的标准化测压数据系统以及上海市新慢病一体化信息系统数据库，描述社区高血压管理患者的收缩压短时变化，分析影响因素。
结果 112 680名社区高血压管理患者男性占46.87%，年龄中位数为69岁，收缩压变异系数（CV_S）为0.038 6±0.035 0。广义线性模型分析显示性别（女性高于男性，B=0.032，P<0.001）、年龄（60~69岁组、70~79岁组、≥80岁组均高于<50岁组，B分别为0.042、0.056、0.074，P分别为0.020、0.002、<0.001）、吸烟（过去吸、每天吸低于从不吸，B分别为-0.032、-0.028，P分别为0.023、0.007）、测量时平均收缩压（140~159 mmHg组、160~179 mmHg组、≥180 mmHg组均低于<140 mmHg组，B分别为-0.039、-0.091、-0.175，均P<0.001）、测量季节（秋季低于春季，B=-0.056，P<0.001）与CV_S有关。配对检验显示运用3次测量数据计算所得CV_S比运用2次测量数据计算所得结果增大1.04%（P<0.001）。
结论上海市社区高血压患者连续2次血压测量的CV_S离散程度较高，影响因素较多。

Abstract:
Objectives To investigate characteristics and influencing factors of short-term variation of systolic blood pressure of community hypertension patients in Shanghai.
Methods Based on the standardized blood pressure measurement data of hypertensive patients in Shanghai （2018‒2021） and the noninfectious chronic disease management system database， coefficient of variation of systolic blood pressure （CV_S） was described and the influencing factors were analyzed.
Results Among 112 680 community hypertension patients， males accounted for 46.87% with a median age of 69 years. CV_S was 0.038 6 ± 0.035 0. Generalized linear model analysis showed the following influencing factors of CV_S： gender， females were higher than males， B=0.032， P<0.001； age group， 60‒69 years， 70‒79 years old group， and ≥80 years groups were all higher than <50 years group， B=0.042， 0.056， and 0.074 respectively with P values of 0.020， 0.002， and <0.001 respectively； smoking， smoking cessation and smoking everyday was lower than never smoking， B=-0.032 and-0.028 respectively with P values of0.023 and 0.007 respectively； systolic blood pressure， 140‒159 mmHg group， 160‒179 mmHg group， and ≥180 mmHg group were lower then <140 mmHg group， B=-0.039， -0.091， and -0.175 respectively with P values all <0.001； and measurement season， autumn was lower than spring，（B=-0.056， P<0.001）. The paired test showed that CV_S calculated from the three measurements was 1.04% higher than that calculated from the two measurements （P<0.001）.
Conclusion The coefficient of variation of systolic blood pressure of community hypertension patients in Shanghai has large variation， and was influenced by many factors.

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