首页 > 资讯 > 社会经济地位、健康生活方式对心血管疾病影响的前瞻性队列研究

社会经济地位、健康生活方式对心血管疾病影响的前瞻性队列研究

泰然健康网
2024-12-14 02:13

摘要： 背景目前尚不清楚社会经济地位（socioeconomic status, SES）如何影响发展中国家的健康生活方式（healthy lifestyle, HL）和心血管疾病（cardiovascular disease，CVD）。本研究旨在探讨SES和HL联合作用对CVD发生率的影响。目的了解社会经济地位（socioeconomic status, SES）、健康生活方式（healthy lifestyle, HL）与心血管疾病（cardiovascular disease，CVD）的关系，为人群CVD防控提供依据。方法本研究采用多阶段整群随机抽样方法，于2010年抽取9280名贵州省12个（县、区）18岁及以上常住居民进行基线调查，于2016-2020年对该队列所有人群进行随访；采用2检验、t检验进行单因素分析，运用COX比例风险回归模型分析SES、HL对CVD发病的影响,采用加速失效时间模型分析不同SES、HL对CVD发病时间的影响。结果排除基线CVD患者、失访者及信息缺失者后，最终纳入分析的有效样本量为4148人，CVD发病123人，发病密度为4.13/1000人年。多因素分析结果显示：与低SES（≤7分）人群相比，高SES（＞7分）人群CVD发病风险下降40.60%（HR=0.594，95%CI：0.402～0.878）。与≤6种HL人群相比，拥有8种、≥9种HL人群CVD发病风险分别下降44.40%（HR=0.556，95%CI：0.320～0.968）、49.20%（HR=0.508，95%CI：0.284～0.912）。与低SES（≤7分）且HL≤6种的人群相比，低SES（≤7分）且HL为7、8、≥9种的人群CVD发病风险均无差异（P＞0.05）；高SES（＞7分）且HL为8、9种以上人群CVD发病风险将分别下降61.80%（HR=0.382，95%CI：0.163～0.894）、70.20%（HR=0.298，95%CI：0.119～0.748），呈下降趋势。加速失效时间模型结果显示：与低SES（≤7分）且HL≤6种的人群相比，高SES（＞7分）且拥有8种、≥9种HL人群CVD发病时间分别推迟1.148年（95%CI：0.049～2.247）、1.407年（95%CI：0.227～2.588）。结论不同SES、HL与CVD发病呈负相关；在高SES人群中，随着HL种类的增加CVD发病时间随之延长。低SES人群是贵州省CVD防控的重点人群，应采取措施提高其健康素养，同时针对性地开展CVD的健康教育与健康促进工作。

关键词: 心血管疾病, 社会经济地位, 健康生活方式, Cox回归分析, 队列研究

Abstract: Background It is unclear how socioeconomic status (socioeconomic status, SES) affects healthy lifestyle and cardiovascular disease (cardiovascular disease, CVD) in developing countries. This study aimed to investigate the effect of the combined effect of SES and HL on the incidence of CVD. Objective To understand the relationship between socioeconomic status (socioeconomic status, SES), healthy lifestyle (healthy lifestyle, HL) and cardiovascular disease (cardiovascular disease, CVD), and to provide a basis for the prevention and control of CVD in the population. Methods In this study, using multi-stage cluster random sampling method, 928012 (counties and districts) were selected for baseline survey and followed all populations in the cohort from 2016 to 2020; univariate analysis was conducted by (2 and t-test and COX proportional risk regression model for the influence of SES and HL on the onset of CVD, and accelerated failure time model for the effect of different SES and HL on the onset of CVD. Results After excluding baseline CVD patients, lost-to-follow-up and missing information, the valid sample size included in the analysis was 4148, CVD onset 123, and the incidence density was 4.13 / 1000 person-years. The results of multivariate analysis showed that compared with low SES (7 points), the risk of CVD in high SES (> 7 points) decreased by 40.60% (HR=0.594,95%CI: 0.402~0.878). Compared with 6 HL populations, the population with 8 and 9 HL decreased by 44.40% (HR=0.556,95%CI: 0.320~0.968) and 49.20% (HR=0.508,95%CI: 0.284~0.912). Compared with those with low SES (7 points) and 6 HL, the risk of CVD in those with 7 points) (7,8 or 9 (P> 0.05); those with high SES (> 7 points) and HL of 8 or 9 decreased CVD risk by 61.80% (HR=0.382,95%CI: 0.163~0.894) and 70.20% (HR=0.298,95%CI = 0.119~0.748, respectively), showing a decreasing trend. The results of the accelerated failure time model showed that those with high SES (> 7 points), those with 8 species and 9 HL were delayed by 1.148 years (95%CI: 0.049 ~ 2.287) and 95% 7 (95%CI: 0.227~2.588). Conclusion Different SES and HL are negatively associated with CVD onset; in high SES population, the duration of CVD onset increases with increasing HL species. Low SES population is the key population of CVD prevention and control in Guizhou Province, so measures should be taken to improve their health literacy, and the health education and health promotion of CVD should be carried out accordingly.

Key words: Cardiovascular disease, Socioeconomic status, Healthy lifestyle, Cox regression analysis, Cohort study