[Prevalence trends and related factors of hypertension patients complicating with dyslipidemia in community of Guandong province between 2013 and 2018].

Objective: To analyze the prevalence trends and related factors of hypertension patients complicating with dyslipidemia in community. Methods: This was a cross-sectional survey, patients with hypertension were selected from the different communities of Guangdong province in 2013 and 2018 respectively. General clinical characteristics, including demographic information, past history, family history, and medication history, were collected. Dyslipidemia was defined as follows: at least 1 item elevation of total cholesterol (TC)≥5.2 mmol/L, triglyceride (TG) ≥1.7 mmol/L, low-density lipoprotein cholesterol (LDL-C)≥3.4 mmol/L, or reduced high-density lipoprotein cholesterol (HDL-C)<1.0 mmol/L. The incidence of dyslipidemia was standardized based on the 2010 China Census data, and further subgroup analysis was performed according to age (<50, 50-60, ≥60 years old) and sex (male, female). Multivariate logistic regression was used to analyze the related factors of dyslipidemia. Results: In 2013 and 2018, 7 866 (4 148 (52.7%) females, with the age of (62.4±13.6) years) and 11 611 (6 692 (57.6%) females, with the age of (58.2±9.3)years) patients with hypertension were enrolled for data analysis, respectively. In 2013, the total prevalence rate of dyslipidemia in patients with hypertension in the community of Guangdong province was 56.3%, among which the prevalence rates of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia, and low HDL-Cemia were 17.1. %, 21.3%, 2.3% and 24.4%, respectively. The total prevalence of dyslipidemia in patients with hypertension in the community of Guangdong in 2018 was 47.3%, prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia and low HDL-Cemia was 14.1%, 20.3%, 12.0% and 19.4%, respectively. Subgroup analysis showed that the total prevalence of dyslipidemia in male patients with hypertension in the community of Guangdong in 2013 and 2018 was 59.0% and 50.7%, respectively, among which hypercholesterolemia was 13.8% and 8.0%, and hypertriglyceridemia was 22.3%, 20.9%, high LDL-Cemia was 1.7%, 8.1%, low HDL-Cemia was 32.9%, 30.3%, respectively. In 2013 and 2018, the total prevalence of dyslipidemia in female patients with hypertension in the community of Guangdong province was 53.9% and 44.8%, among which prevalence of hypercholesterolemia was 20.5% and 18.5%, hypertriglyceridemia was 20.4% and 19.8%, and high LDL-Cemia was 2.7% and 14.9%, and hypo-HDL-Cemia was 16.8% and 11.3%, respectively. Age subgroup analysis showed that the prevalence of dyslipidemia among hypertensive patients aged<50, 50-60, and ≥60 years in Guangdong community in 2013 were 60.1%, 60.6%, and 53.7%, respectively; and 46.2%, 49.3% and 46.5% in 2018, respectively. Multivariate logistic regression analysis showed that women (OR=0.860,95%CI 0.761-0.973,P=0.017), obese (OR=2.295,95%CI 2.007-2.624,P<0.001), diabetes (OR=1.314,95%CI 1.090-1.583,P=0.004), stroke (OR=1.894,95%CI 1.227-2.924,P=0.004) and the level of fasting blood glucose (OR=1.105,95%CI 1.066-1.146,P<0.001) were independently related with the occurrence of dyslipidemia. Conclusions: The prevalence of dyslipidemia in patients with hypertension in the communities of Guangdong province is relatively high, and the prevalence differs in sex and age. Between 2013 and 2018, the total prevalence of dyslipidemia, hyper-TCemia, and hypo-HDL-Cemia in hypertensive patients shows a downward trend. The prevalence of hyper-TGemia remains unchanged, but the prevalence of high LDL-C shows an upward trend. Several factors are related to the prevalence of dislipidemia in hypertension patients in Guandong community.目的： 分析2013、2018年广东省社区高血压患者血脂异常的患病率及其相关因素。 方法： 该研究为横断面研究。分别入选2013年1至12月和2018年1至12月广东省不同社区年度管理的社区高血压患者。由经过统一培训并考核合格的人员对入选者进行问卷调查和样本采集。主要采集入选患者的人口学信息、既往史、家族史和服用药物史等一般临床资料。血脂异常为具有下列至少1种情况，即总胆固醇（TC）水升高（≥5.2 mmol/L）、甘油三酯（TG）水平升高（≥1.7 mmol/L）、低密度脂蛋白胆固醇（LDL-C）水平升高（≥3.4 mmol/L）或高密度脂蛋白胆固醇（HDL-C）水平降低（<1.0 mmol/L）。血脂异常发生率根据2010年中国人口普查数据进行标化，并进一步行性别和年龄（<50，50~60，≥60岁）亚组分析。采用单因素和多因素logistic回归模型分析入选的高血压患者血脂异常发生的相关因素。 结果： 在2013、2018年分别入选患者7 866例［年龄（62.4±13.6）岁，女性4 148 例（52.7%）］、11 611例［年龄（58.2±9.3）岁，女性6 692例（57.6%）］。2013年广东省社区高血压患者血脂异常的总患病率为56.3%，其中高TC血症、高TG血症、高LDL-C血症和低HDL-C血症的患病率分别为17.1%、21.3%、2.3%和24.4%；2018年广东省社区高血压患者血脂异常的总患病率为47.3%，其中高TC血症、高TG血症、高LDL-C血症和低HDL-C血症的患病率分别为14.1%、20.3%、12.0%和19.4%。性别亚组分析结果显示，2013、2018年广东省社区高血压男性患者血脂异常的总患病率为59.0%、50.7%，其中高TC血症为13.8%、8.0%，高TG血症为22.3%、20.9%，高LDL-C血症为1.7%、8.1%，低HDL-C血症为32.9%、30.3%；2013、2018年广东省社区高血压女性患者血脂异常的总患病率为53.9%、44.8%，其中高TC血症为20.5%、18.5%，高TG血症为20.4%、19.8%，高LDL-C血症为2.7%、14.9%，低HDL-C血症为16.8%、11.3%。年龄亚组分析结果显示，2013年广东省社区年龄<50、50~60和≥60岁的高血压患者血脂异常的患病率分别为60.1%、60.6%和53.7%，2018年分别为46.2%、49.3%和46.5%。多因素logistic回归分析结果显示，女性（OR=0.860，95%CI 0.761~0.973，P=0.017）、肥胖（OR=2.295，95%CI 2.007~2.624，P<0.001）、糖尿病（OR=1.314，95%CI 1.090~1.583，P=0.004）、卒中（OR=1.894，95%CI 1.227~2.924，P=0.004）和空腹血糖（OR=1.105，95%CI 1.066~1.146，P<0.001）与高血压患者合并血脂异常独立相关。 结论： 广东省社区高血压患者血脂异常的患病率较高，且存在性别、年龄差异。相较于2013年，2018年高血压患者血脂异常总患病率以及高TC血症和低HDL-C血症患病率显示出下降趋势，高TG血症患病率未见明显变化，而高LDL-C血症患病率显示出上升趋势。高血压患者合并血脂异常的相关因素较多。.