河南省6～17岁儿童青少年高血压流行现状及影响因素

Prevalence of hypertension and influencing factors among children and adolescents aged 6 to 17 in Henan Province

摘要

目的 了解河南省6～17岁儿童青少年高血压流行现状，并分析其相关影响因素。方法 2023年2-11月采用多阶段分层随机整群抽样的方法，从河南省全省抽取18个监测点，每个监测点随机抽取2所小学、2所初中和2所高中，再以年级分层，以班级为单位随机整群抽样，共抽取29 109名调查对象。采用问卷调查和体检的方法，收集学生基本信息、生活方式和血压水平等相关信息。采用χ²检验和多因素logistic回归模型分析儿童青少年高血压的相关影响因素。结果 河南省6～17岁儿童青少年高血压检出率为7.0%（95%CI: 6.7%～7.3%），使用全国第七次人口普查数据作为标准人口计算标准化率为6.9%，其中男生高于女生[8.1%（1 108/13 679）比5.9%（754/12 860），χ² = 50.838，P＜0.001]，城市高于农村[7.6%（876/11 535）比6.6%（986/15 004），χ² = 10.455，P = 0.001]。多因素logistic回归分析结果显示，性别（男生，OR = 1.180，95%CI：1.066～1.307）、年龄（12～<18岁，OR = 1.402，95%CI：1.216～1.616）、体重指数（超重，OR = 1.834，95%CI：1.579～2.131；肥胖，OR = 3.775，95%CI：3.103～4.592）、腰围（高腰围，OR = 1.380，95%CI：1.158～1.644）、血脂异常（高胆固醇血症，OR = 1.513，95%CI：1.152～1.987；低高密度脂蛋白胆固醇血症，OR = 1.420，95%CI：1.164～1.731；高甘油三酯血症，OR = 1.345，95%CI：1.141～1.585）、睡眠时长（睡眠时长不达标，OR = 1.138，95%CI：1.010～1.282）、每日静坐时间（第3三分位组，OR = 1.151，95%CI：1.002～1.323）和最主要照顾人文化水平（高中、中专及大专，OR = 0.882，95%CI：0.789～0.985；本科及以上，OR = 0.675，95%CI：0.539～0.845）是儿童青少年高血压的影响因素。结论 河南省儿童青少年高血压的流行特征为城市学生、男生及12岁以上年龄组检出率较高。超重、肥胖、血脂异常、静坐时间过长和睡眠不足是主要的影响因素。建议加强早期筛查力度，推动防控关口前移，并针对重要影响因素进行生活方式干预。

Abstract

Objective To investigate the prevalence of hypertension among children and adolescents aged 6 to 17 years old in Henan Province, and analyze the related influencing factors. Methods From February to November 2023, a multi-stage stratified random cluster sampling method was employed to select 18 monitoring sites across the province. In each monitoring site, 2 primary schools, 2 middle schools, and 2 high schools were randomly selected. Sampling was then stratified by grade level, with classes serving as the unit for random cluster sampling. A total of 29 109 respondents were included in the survey. Data on students' basic information, lifestyle, and blood pressure levels were collected through questionnaires and physical examinations. Chi-square tests and multivariate logistic regression models were used to explore the influencing factors of hypertension among children and adolescents. Results The detection rate of hypertension among children and adolescents aged 6 to 17 was 7.0% (95%CI: 6.7% to 7.3%), and the national standard rate was 6.9%. Which was higher in boys than that in girls (8.1% [1 108/13 679]vs 5.9% [754/12 860]，χ² = 50.838，P＜0.001), and was higher in urban areas than in rural areas (7.6% [876/11 535]vs 6.6% [986/15 004]，χ² = 10.455，P = 0.001). Multivariate logistic regression analysis showed that gender (male, OR = 1.180, 95%CI: 1.066-1.307), age (12-<18 years,OR = 1.402, 95%CI: 1.216-1.616), body mass index (overweight, OR = 1.834, 95%CI: 1.579-2.131; obesity, OR = 3.775, 95%CI: 3.103-4.592), waist circumference (high waist circumference,OR = 1.380, 95%CI: 1.158-1.644), dyslipidemia (hypercholesterolemia, OR = 1.513, 95%CI: 1.152-1.987; low high-density lipoprotein cholesterolemia, OR = 1.420, 95%CI: 1.164-1.731; hypertriglyceridemia, OR = 1.345, 95%CI: 1.141-1.585), sleep duration (not meeting recommended sleep duration, OR = 1.138, 95%CI: 1.010-1.282), daily sedentary time (3rd tertile, OR = 1.151, 95%CI: 1.002-1.323) and educational level of the primary caregiver (high school/technical secondary school/junior college, OR = 0.882, 95%CI: 0.789-0.985; bachelor's degree or above, OR = 0.675, 95%CI: 0.539-0.845). Conclusions The epidemiological characteristics of hypertension among children and adolescents in Henan Province indicate higher prevalence rates among urban students, males, and those aged 12 and above. Major influencing factors include overweight, obesity, dyslipidemia, prolonged sedentary time, and insufficient sleep. It is recommended to enhance early screening efforts, promote the shift of prevention and control measures forward, and implement lifestyle interventions targeting these key factors.

关键词

高血压 / 儿童 / 青少年 / 影响因素

Key words

hypertension / children / adolescent / influencing factors

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基金资助

河南省重点研发专项(231111313400)

河南省医学科技攻关计划项目(LHGJ20230652)

河南疾控科技攻关专项计划项目(HNCDCZD20250216)