Chinese General Practice ›› 2020, Vol. 23 ›› Issue (9): 1105-1111.DOI: 10.12114/j.issn.1007-9572.2019.00.800

Special Issue: 高血压最新文章合集 女性健康最新文章合集

• Monographic Research • Previous Articles     Next Articles

Risk Factors for Cardiovascular Disease and Hypertension among Female Doctors in Northern China 

  

  1. Department of Geriatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China
    *Corresponding author:BAI Xiaojuan,Professor,Doctoral supervisor;E-mail:xiaojuan.bai@163.com
  • Published:2020-03-20 Online:2020-03-20

北方地区女医生心血管病危险因素及其发生高血压的影响因素研究

  

  1. 110004辽宁省沈阳市,中国医科大学附属盛京医院老年病科
    *通信作者:白小涓,教授,博士生导师;E-mail:xiaojuan.bai@163.com

Abstract: Background In China,cardiovascular disease(CVD) is the primary disease that endangers the health of residents,and the leading cause of mortality among adult women.Women working as a doctor,a high-risk occupation for CVD,may have higher risk of developing CVD,but the exposure to risk factors for CVD in this population is still unclear.Objective To analyze the exposure to cardiovascular risk factors and hypertension-associated risk factors among female doctors in Northern China,to provide a scientific basis for CVD prevention,warning and treatment in this group.Methods This case-controlled study was conducted from October 2016 to January 2018.Participants(n=261) consisted of a subcohort in Northern China in A Cohort Study of Cardiovascular Risk Factors among Female Doctors,a public welfare project conducted by Chinese Society of Cardiology Women Health Group in 2016,and community-dwelling healthy women(n=334),a subcohort of the healthy women cohort in a national key basic research program of China named as “Mechanism and Intervention of Multiple Visceral Organs Hypofunction Induced by Heart-kidney Interaction in the Elderly(2013CB530804)” conducted by our research team previously.Intergroup and age-subgroup(35-45 years,46-55 years,and 56-65 years) comparative analyses of age,education level,family history of cardiovascular and cerebrovascular diseases,lifestyle,prevalence of menopause,history of hormone use and laboratory test parameters were performed.The influencing factors for hypertension among female doctors were analyzed.Results Compared with community-dwelling healthy women,female doctors had younger mean age,higher prevalence of postgraduate education,family history of cardiovascular and cerebrovascular diseases,insufficient exercise,tea consumption history,coffee consumption history,and insufficient sleep,and lower prevalence of overweight/obesity,menopause,and lower mean fasting plasma glucose(FPG),serum total cholesterol(TC) and low-density lipoprotein(LDL)(P<0.05).Female doctors aged 35-45 years had higher prevalence of postgraduate education,family history of cardiovascular and cerebrovascular diseases,tea consumption history,coffee consumption history,insufficient sleep,and higher mean TG,and lower mean PFG compared with community-dwelling healthy women of the same age group(P<0.05).Female doctors aged 46-55 years showed higher prevalence of postgraduate education,family history of cardiovascular and cerebrovascular diseases,insufficient exercise,tea consumption history,coffee consumption history,insufficient sleep,and hormone use history,and higher mean TC,and LDL,as well as lower prevalence of menopause compared with community-dwelling healthy women of the same age group(P<0.05).In comparison with community-dwelling healthy women aged 56-65 years,female doctors of the same age group demonstrated higher prevalence of higher prevalence of postgraduate education,family history of cardiovascular and cerebrovascular diseases,insufficient exercise,tea consumption history,coffee consumption history,insufficient sleep,FPG,TC,and LDL(P<0.05).In female doctors,those aged 46-55 years had lower prevalence of postgraduate education,insufficient exercise,coffee consumption history,and lower mean high-density lipoprotein(HDL),but higher prevalence of family history of cardiovascular and cerebrovascular diseases,menopause,and hormone use history,and higher mean FPG,TG,TC and HDL compared with those aged 35-45 years(P<0.05).Compared with other two age subgroups(35-45 and 46-55 years),female doctors aged 56-65 years had lower prevalence of postgraduate education,but higher prevalence of overweight/obesity,and menopause,and higher mean FPG,TG,TC and LDL(P<0.05).Furthermore,they showed lower prevalence of insufficient exercise than those aged 35-45 years(P<0.05).By multivariate Logistic regression analysis,age〔OR=1.110,95%CI(1.063,1.158)〕,insufficient sleep〔OR=2.273,95%CI(1.085,4.762)〕,obesity/overweight〔OR=5.491,95%CI(2.995,10.067)〕 and increased LDL〔OR=2.975,95%CI(1.371,6.457)〕were considered as the influencing factors of hypertension among female doctors(P<0.05).Conclusion In female doctors in Northern China,risk factors for CVD that deserved attention are mainly associated with lifestyle,including insufficient exercise,tea and coffee consumption history,and insufficient sleep.The risk factors for hypertension are consisting of older age,insufficient sleep,obesity/overweight and increased LDL.In view of this,priorities should be given to the above-mentioned risk factors to well perform primary prevention of CVD.

Key words: Cardiovascular diseases, Physician, Femininity, Primary prevention, Hypertension, Northern China, Root cause analysis

摘要: 背景 心血管疾病(CVD)是危害我国居民身体健康的首要疾病,是女性死亡的首要原因。女医生群体可能有更高的CVD患病风险,而针对女医生这种高危职业CVD危险因素暴露情况尚不明确。目的 分析北方地区女医生CVD危险因素暴露情况,并探究其发生高血压的影响因素,为北方地区女医生CVD防治及预警提供科学依据。方法 本研究为病例对照研究,研究时间为2016年10月—2018年1月。研究对象包括女医生和社区健康女性。其中女医生(n=681)来源于2016年中华心血管病学会女性健康学组公益项目“女医生心血管病危险因素队列研究”中的北方地区女医生亚组人群,社区健康女性(n=334)来源于本研究团队前期进行的国家重点基础研究发展项目课题“心肾交互作用影响老年内脏多器官功能减退的机制及干预研究(2013CB530804)”中的健康女性亚组人群。先总体比较女医生与社区健康女性年龄、学历、心脑血管病家族史、生活方式、绝经状态、激素服用史、实验室检查指标。再依据年龄将研究对象分为35~45岁年龄段、46~55岁年龄段、56~65岁年龄段,比较不同年龄段女医生与社区健康女性上述观察指标,最后分析女医生患高血压的影响因素。结果 女医生年龄小于社区健康女性,研究生以上学历、心脑血管病家族史、运动缺乏、饮茶史、饮咖啡史、睡眠缺乏占比高于社区健康女性,超重/肥胖占比、已绝经占比、血糖、总胆固醇、低密度脂蛋白低于社区健康女性(P<0.05)。35~45岁,女医生研究生以上学历占比、心脑血管病家族史占比、饮茶史占比、饮咖啡史占比、睡眠缺乏占比、三酰甘油高于社区健康女性,血糖低于社区健康女性(P<0.05);46~55岁,女医生研究生以上学历占比、心脑血管病家族史占比、运动缺乏占比、饮茶史占比、饮咖啡史占比、睡眠缺乏占比、激素服用史占比、总胆固醇、低密度脂蛋白高于社区健康女性,已绝经占比低于社区健康女性(P<0.05);56~65岁,女医生研究生以上学历占比、心脑血管病家族史占比、运动缺乏占比、饮茶史占比、饮咖啡史占比、饮酒史占比、睡眠缺乏占比、血糖、总胆固醇、低密度脂蛋白高于社区健康女性(P<0.05)。46~55岁女医生研究生以上学历占比、运动缺乏占比、饮咖啡史占比、高密度脂蛋白低于35~45岁,心脑血管病家族史占比、已绝经占比、激素服用史占比、血糖、三酰甘油、总胆固醇、低密度脂蛋白高于35~45岁(P<0.05);56~65岁女医生研究生以上学历占比低于35~45岁、46~55岁,超重/肥胖占比、已绝经占比、血糖、三酰甘油、总胆固醇、低密度脂蛋白高于35~45岁、46~55岁(P<0.05);56~65岁女医生运动缺乏占比低于35~45岁(P<0.05)。多因素Logistic回归分析结果显示,年龄〔OR=1.110,95%CI(1.063,1.158)〕、睡眠缺乏〔OR=2.273,95%CI(1.085,4.762)〕、肥胖/超重〔OR=5.491,95%CI(2.995,10.067)〕、低密度脂蛋白增高〔OR=2.975,95%CI(1.371,6.457)〕是女医生患高血压的影响因素(P<0.05)。结论 北方地区女医生应注意的CVD危险因素主要为生活方式,包括运动缺乏、饮茶史、饮咖啡史、睡眠缺乏。女医生患高血压的危险因素包括年龄、睡眠缺乏、肥胖/超重、低密度脂蛋白增高,应重视上述早期预警指标,做好CVD的一级预防。

关键词: 心血管疾病, 医生, 女性, 一级预防, 高血压, 中国北方, 影响因素分析