Analysis of hypertension status and influencing factors in young and middle-aged soldiers stationed in Tibet
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摘要: 目的 分析常年驻扎在西藏高海拔地区的中青年官兵高血压现状及影响因素。方法 收集某驻藏部队670名中青年男性官兵的驻藏海拔、驻藏时间、血氧饱和度、静息心率及血压等资料。基于K-means聚类分析，根据海拔分为：3400~3800 m组(206例)，3800~4500 m组(230例)，4500~5400 m组(234例)；根据驻藏时间分为： < 7年组(507例)，≥7年组(163例)。分析驻藏官兵海拔和驻藏时间与血压的关系。结果 驻藏官兵高血压患病率为11.6%(78/670)。其中，3400~3800 m组、3800~4500 m组和4500~5400 m组高血压患病率分别为7.8%、10.9%和15.8%；驻藏时间≥7年组，3400~3800 m、3800~4500 m和4500~5400 m海拔高血压患病率分别为11.4%、12.9%和29.0%，差异有统计学意义(P < 0.05)。相关分析结果示，驻藏时间 < 7年组，收缩压、舒张压与驻藏时间均呈负相关(P < 0.05)，驻藏时间≥7年组，收缩压、舒张压与驻藏时间均呈正相关(P < 0.05)。logistic回归分析结果显示，海拔、驻藏时间是官兵驻藏时间≥7年后发生高血压的危险因素。多元线性回归分析结果显示，驻藏时间≥7年后，驻藏时间是驻藏官兵血压升高的独立危险因素。结论 驻藏中青年官兵的高血压患病率为11.6%，且随海拔的升高，高血压患病率逐渐增加。另外，高原驻藏年限≥7年后，随着驻藏时间的延长，慢性高原高血压风险有增加可能。Abstract: Objective To analyze the status and influencing factors of hypertension among young and middle-aged officers and soldiers stationed in high-altitude areas of Tibet.Methods The data of 670 young and middle-aged male officers and soldiers in a Tibet-stationed army were collected, including altitude, time, blood oxygen saturation, resting heart rate, and blood pressure. Based on K-means cluster analysis, all objects were grouped according to the altitude: 3400-3800 m group(n=206), 3800-4500 m group(n=230), 4500-5400 m group(n=234). And grouped according to the residence time: < 7 years group(n=507), ≥7 years group(n=163). The relationship between altitude, time, and blood pressure in officers and soldiers stationed in Tibet was analyzed.Results The prevalence of hypertension was 11.6%(78/670). The prevalence of hypertension in the 3400-3800 m group, 3800-4500 m group, and 4500-5400 m group were 7.8%, 10.9%, and 15.8%, respectively. In the group of staying in Tibet for ≥7 years, the prevalence of hypertension at 3400-3800 m, 3800-4500 m, and 4500-5400 m were 11.4%, 12.9%, and 29.0%, respectively(P < 0.05). The results of correlation analysis showed that the systolic blood pressure and diastolic blood pressure were negatively correlated with residence time in the < 7 years group(P < 0.05), in the ≥7 years group, systolic blood pressure and diastolic blood pressure were positively correlated with residence time(P < 0.05). Logistic regression analysis showed that altitude and staying time in Tibet were the risk factors of hypertension in officers and soldiers after staying in Tibet for ≥7 years. The results of multiple linear regression analysis showed that residence time was an independent risk factor for elevated blood pressure in officers and soldiers after residence time ≥7 years.Conclusion The prevalence of hypertension among young officers and soldiers in Tibet is 11.6%, and the prevalence gradually with the increase of altitude. In addition, the risk of chronic high-altitude hypertension might increase with the extension of residence time after 7 years.
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Key words:
- hypertension /
- altitude /
- time in Tibet /
- young and middle-aged people
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表 1 不同海拔组血氧饱和度、静息心率及血压比较
Table 1. Blood oxygen saturation, resting heart rate, and blood pressure in different altitude groups
例(%), X±S 项目 3400~3800 m组
(206例)3800~4500m组
(230例)4500~5400 m组
(234例)F/χ2 P 年龄/岁 25.76±4.60 25.28±4.22 25.44±4.04 0.707 0.494 驻藏时间/年 5.29±3.97 3.42±3.421) 5.03±3.692) 16.840 < 0.001 血氧饱和度/% 90.35±2.63 89.44±4.121) 85.84±4.091)2) 93.193 < 0.001 静息心率/(次·min-1) 71.70±12.81 74.09±13.32 78.03±12.791)2) 13.457 < 0.001 收缩压/mmHg 117.72±11.40 118.10±12.00 117.30±12.90 0.250 0.779 舒张压/mmHg 79.24±8.06 77.23±9.141) 80.85±9.502) 9.488 < 0.001 高血压 16(7.8) 25(10.9) 37(15.8) 7.096 0.029 驻藏时间 < 7年 正常血压 61(44.9) 95(47.7) 76(44.2) 0.531 0.767 正常高值血压 67(49.3) 83(41.7) 77(44.8) 1.818 0.393 高血压 8(5.9) 21(10.6) 19(11.0) 2.813 0.245 驻藏时间≥7年 正常血压 21(30.0) 13(41.9) 15(24.2) 3.094 0.213 正常高值血压 41(58.6) 14(45.2) 29(46.8) 2.454 0.293 高血压 8(11.4) 4(12.9) 18(29.0) 7.556 0.023 与3400~3800 m组比较，1)P < 0.05；与3800~4500 m比较，2)P < 0.05。 
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表 2 收缩压、舒张压与驻藏时间的偏相关分析
Table 2. Partial correlation analysis between systolic, diastolic blood pressure and residence time
变量 驻藏时间 < 7年组 驻藏时间≥7年组 r P r P 模型1 收缩压 -0.121 0.007 0.224 0.004 舒张压 -0.108 0.015 0.175 0.027 模型2 收缩压 -0.110 0.014 0.212 0.007 舒张压 -0.103 0.021 0.169 0.033 模型1：控制年龄、海拔；模型2：控制年龄、海拔、血氧饱和度、静息心率。
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表 3 高血压影响因素的logistic回归分析
Table 3. Influencing factors of hypertension analyzed by logistic regression analysis
变量 B SE Walds P Exp(B) 95%CI 年龄 -0.026 0.091 0.079 0.778 0.975 0.815~1.166 海拔 0.001 0.000 7.248 0.007 1.001 1.000~1.002 驻藏时间 0.223 0.107 4.315 0.038 1.250 1.013~1.543 血氧饱和度 0.041 0.064 0.426 0.514 1.042 0.920~1.180 静息心率 -0.002 0.017 0.015 0.903 0.998 0.965~1.032
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表 4 血压影响因素的多元线性回归分析
Table 4. Influencing factors of blood pressure analyzed by Multiple linear regression analysis
变量 收缩压 舒张压 β SE 标准化β t P β SE 标准化β t P 常数 148.239 34.691 - 4.273 0.000 79.283 23.755 - 3.337 0.001 年龄 -0.430 0.405 -0.108 -1.062 0.290 -0.068 0.277 -0.025 -0.245 0.807 海拔 -0.001 0.002 -0.025 -0.268 0.789 0.001 0.001 0.078 0.857 0.393 驻藏时间 1.368 0.504 0.278 2.715 0.007 0.759 0.344 0.223 2.204 0.029 血氧饱和度 -0.324 0.298 -0.101 -1.087 0.279 -0.139 0.204 -0.063 -0.680 0.497 静息心率 0.012 0.077 0.012 0.152 0.879 0.068 0.053 0.101 1.281 0.202
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