首頁資訊社會經(jīng)濟地位、健康生活方式對心血管疾病影響的前瞻性隊列研究

社會經(jīng)濟地位、健康生活方式對心血管疾病影響的前瞻性隊列研究

來源：泰然健康網(wǎng) 時間：2024年12月14日 02:13

摘要： 背景目前尚不清楚社會經(jīng)濟地位（socioeconomic status, SES）如何影響發(fā)展中國家的健康生活方式（healthy lifestyle, HL）和心血管疾?。╟ardiovascular disease，CVD）。本研究旨在探討SES和HL聯(lián)合作用對CVD發(fā)生率的影響。目的了解社會經(jīng)濟地位（socioeconomic status, SES）、健康生活方式（healthy lifestyle, HL）與心血管疾?。╟ardiovascular disease，CVD）的關(guān)系，為人群CVD防控提供依據(jù)。方法本研究采用多階段整群隨機抽樣方法，于2010年抽取9280名貴州省12個（縣、區(qū)）18歲及以上常住居民進行基線調(diào)查，于2016-2020年對該隊列所有人群進行隨訪；采用2檢驗、t檢驗進行單因素分析，運用COX比例風險回歸模型分析SES、HL對CVD發(fā)病的影響,采用加速失效時間模型分析不同SES、HL對CVD發(fā)病時間的影響。結(jié)果排除基線CVD患者、失訪者及信息缺失者后，最終納入分析的有效樣本量為4148人，CVD發(fā)病123人，發(fā)病密度為4.13/1000人年。多因素分析結(jié)果顯示：與低SES（≤7分）人群相比，高SES（＞7分）人群CVD發(fā)病風險下降40.60%（HR=0.594，95%CI：0.402～0.878）。與≤6種HL人群相比，擁有8種、≥9種HL人群CVD發(fā)病風險分別下降44.40%（HR=0.556，95%CI：0.320～0.968）、49.20%（HR=0.508，95%CI：0.284～0.912）。與低SES（≤7分）且HL≤6種的人群相比，低SES（≤7分）且HL為7、8、≥9種的人群CVD發(fā)病風險均無差異（P＞0.05）；高SES（＞7分）且HL為8、9種以上人群CVD發(fā)病風險將分別下降61.80%（HR=0.382，95%CI：0.163～0.894）、70.20%（HR=0.298，95%CI：0.119～0.748），呈下降趨勢。加速失效時間模型結(jié)果顯示：與低SES（≤7分）且HL≤6種的人群相比，高SES（＞7分）且擁有8種、≥9種HL人群CVD發(fā)病時間分別推遲1.148年（95%CI：0.049～2.247）、1.407年（95%CI：0.227～2.588）。結(jié)論不同SES、HL與CVD發(fā)病呈負相關(guān)；在高SES人群中，隨著HL種類的增加CVD發(fā)病時間隨之延長。低SES人群是貴州省CVD防控的重點人群，應(yīng)采取措施提高其健康素養(yǎng)，同時針對性地開展CVD的健康教育與健康促進工作。

關(guān)鍵詞: 心血管疾病, 社會經(jīng)濟地位, 健康生活方式, Cox回歸分析, 隊列研究

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