Abstract: Background　The Kazakh herdsmen in Xinjiang are one of the five ethnic groups with the highest prevalence of hypertension in China.Due to long-term living on cold and arid areas of the plateau，unique lifestyle and eating diet，as well as behavior exposure，the prevalence of hypertension and other chronic diseases is increasing，seriously impairs the Kazak herdsmen's physical health.So exploring the incidence rate and predictive factors of new-onset hypertension in this population，can prevent and control hypertension targetedly.Objective　To investigate the prevalence and predictors of new-onset hypertension among Kazakh herdsmen in Xinjiang pastoral area，to provide a reference for prevention and treatment of hypertension in pastoral area.Methods　A prospective cohort study design was used.From the persons undergoing physical examination between January 2008 and December 2010 in Urumqi County Hospital/Health Center，Kazakh herdsmen were selected by use of stratified cluster sampling and the ratio of each subordinate town population to Urumqi County population，and were given a follow-up every two years during 2014 to 2018，and 5 327 cases of them with complete follow-up data were included in the study finally.Baseline information （gender，age，education level，marital status），questionnaire survey results （family history of hypertension，life behaviors such as smoking，alcohol consumption，physical exercise，vegetable intake，salt intake，milk tea intake），physical parameters （height，weight，blood pressure，waistline，hipline，BMI），routine blood test and biochemical parameters〔WBC，hemoglobin，platelet count，serum potassium，serum sodium，total cholesterol（TC），triglyceride（TG），high-density lipoprotein（HDL），low-density lipoprotein（LDL），fasting blood glucose（FBG），ALT，AST〕 were collected.Predictive factors of new-set hypertension were analyzed with univariate and multivariate Cox proportional hazards models.Results　After a follow-up period of 1.1to 8.5 years，a total of 1 985 cases of new-onset hypertension were found，the incidence rate was 11.75 cases per 100 person-years〔 95%CI（11.27，12.24）〕．The incidence rate of new-set hypertension differed significantly by gender，age，smoking，alcohol consumption，salt intake，milk tea intake，family history of hypertension，BMI，and baseline blood pressure status （P<0.05）．Analysis with univariate Cox proportional hazards model showed that gender，age，drinking and smoking habits，daily salt intake，milk tea intake ml/d，family history of hypertension，waist circumference，BMI，TC，TG，HDL ，FBG，prehypertension were associated with new-onset hypertension（P<0.05）.Analysis with multivariate Cox proportional hazards model showed that age，smoking habit，daily salt intake，family history of hypertension，waist circumference，TG，FBG，prehypertension were influence factor of new-onset hypertension in men（P<0.05）.Age，daily salt intake，family history of hypertension，BMI，TG，FBG，prehypertension were influence factor of new-onset hypertension in women（P<0.05）.Conclusion　The incidence rate of hypertension is high among Kazak herdsmen in Xinjiang pastoral areas.Gender，age，drinking and smoking habits，daily salt intake，family history of hypertension，waist circumference，BMI，TC，TG，HDL，FBG，prehypertensionare associated with new-onset hypertension.It is necessary to actively identify and monitor the disease by synthesizing various risk factors，so early prevention and control can be implemented timely，and the incidence of hypertension ca be reduced.

Key words: Hypertension, Incidence, Prehypertension, Cox proportional hazards model, Kazakh, Xinjiang

摘要： 背景　新疆哈萨克族牧民为我国高血压患病率最高的五个民族之一。由于哈萨克族牧民长期生活在高原高寒、干旱地区，具有独特的生活膳食及行为暴露，以高血压为代表的慢性病患病人数持续增加，严重威胁牧民的身体健康。探讨该人群新发高血压的发病情况及其影响因素，才能有针对性地进行高血压预防和控制。目的　了解新疆哈萨克族牧民新发高血压的发病情况及影响因素，以期为牧区高血压防治提供参考依据。方法　采用前瞻性队列研究设计，于2008年1月—2010年12月以乌鲁木齐县卫生院/卫生服务中心健康体检者为研究对象，采用分层整群抽样的方法，根据各乡镇人口数占全乌鲁木齐县人口的比例，纳入具有完整随访资料的哈萨克族牧民。于2014—2018年每两年进行一次随访，最终纳入5 327例18岁以上研究对象。收集研究对象的基线资料（性别、年龄、受教育程度、婚姻状况）、问卷调查结果（吸烟、饮酒、锻炼、蔬菜摄入量、食盐量、奶茶量、高血压家族史）、人体体格检查（身高、体质量、血压、腰围、臀围、BMI）、血常规及血生化指标（白细胞计数、血红蛋白、血小板计数、血清钾、血清钠、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、空腹血糖、丙氨酸氨基转移酶、天冬氨酸氨基转移酶）检测，随访截止日期2018年11月。采用单因素、多因素Cox比例风险模型分析哈萨克族牧民发生新发高血压的影响因素。结果　随访1.1~8.5年，新发高血压1 985例，发病率为11.75/100人年〔95%CI（11.27/100人年，12.24/100人年）〕。不同性别、年龄、吸烟情况、饮酒情况、食盐量、奶茶量、高血压家族史、BMI、基线血压状态人群新发高血压发病率比较，差异有统计学意义（P<0.05）。单因素Cox比例风险模型分析结果显示，性别、年龄、吸烟、饮酒、食盐量、奶茶量、高血压家族史、腰围、BMI、总胆固醇、三酰甘油、高密度脂蛋白、空腹血糖、高血压前期与新发高血压发病有关（P<0.05）。男性新疆哈萨克族牧民发生新发高血压影响因素的多因素Cox比例风险模型分析结果显示，年龄、吸烟、食盐量、高血压家族史、腰围、总胆固醇、空腹血糖、高血压前期是新发高血压的影响因素（P<0.05）。女性新疆哈萨克族牧民新发高血压影响因素的多因素Cox比例风险模型分析结果显示，年龄、食盐量、高血压家族史、BMI、总胆固醇、空腹血糖、高血压前期是新发高血压的影响因素（P<0.05）。结论　新疆哈萨克族牧民新发高血压发病率高，性别、年龄、吸烟、饮酒、食盐量、高血压家族史、BMI、腰围、总胆固醇、三酰甘油、高密度脂蛋白、空腹血糖、高血压前期与其发生新发高血压有关。应综合多种发病风险因素对疾病进行积极识别和监控，及时发现早期防控，降低高血压发病率。

关键词: 高血压, 发病率, 高血压前期, Cox比例风险模型, 哈萨克族, 新疆