| 摘要: | 高血壓是一項盛行率很高的疾病，是現代社會很重要的一種慢性疾病。高血壓是多致病因子的疾病，包括先天性的遺傳因子與後天的飲食、生活型態、環境等因子，同時也是影響其他疾病如腦中風與心臟病的一個重要的預後因子。自2003年高血壓躍升為國人第十大死因，更可見其重要性。但因為高血壓症狀不明顯，所以其對健康的影響常被人低估。
我們利用2002年國民健康局在全台灣地區性抽樣問卷調查資料，進行本研究，分析盛行狀況並做病例對照研究探討高血壓相關因子。凡居住在台灣地區各縣市年滿十五歲以上之本國籍人口，均為國民健康局調查的對象，總計完成26,755人。本研究以3204名有醫師診斷的患者為病例，22,704名沒有高血壓者為病例對照研究之對照組。
本研究結果顯示高血壓的粗盛行率合計為12.4 %，高齡者、女性、教育程度低、原住民等、離婚寡居者、高身體質量指數、抽菸者、喝酒、戒檳榔、無二手菸暴露、每天攝食水果、有運動等，都有較高的高血壓盛行率(p <0.05)，而居住地區則無顯著差別(p = 0.1265)。而在多變項羅吉斯迴歸分析中，相較身體質量指數小於18 kg/㎡者，指數較高者有較高的危險比，介於18-24 kg/㎡者的odds ratio(OR) = 2.22,95% confidence interval (CI) = 1.53-3.23、24-27 kg/㎡者為 OR = 4.29, 95% CI = 2.94-6.26，及等於大於27 kg/㎡以上者為OR = 7.78, 95% CI = 5.31-11.4。有糖尿病的人高血壓的盛行率幾乎達到一半，有高血壓的人，糖尿病的盛行率也比較高，兩者共病的情形，有統計上的差別(p < 0.0001)，高血壓和糖尿病共病者和BMI > 27 kg/㎡的勝算比稍增加到8.35（95％可信限 ＝ 4.27-16.3）。
本研究發現，高血壓的最主要危險因子是肥胖，男女盛行率相近，較高齡者罹病率也較高。
Hypertension is a common chronic disease with high prevalence in the modern society populations. It is a disease with multifactorial associations including congenital hereditary factors, and environmental factors such as diet, exercise and other lifestyles. It is also an important prognostic factor of some serious diseases, such as cerebrovascular attack and other cardiovascular diseases. But hypertension is always ignored due to no obvious symptoms and sings. In 2003, the trend of hypertension uprised to the tenth leading cause of deaths for people in Taiwan; the disease thus plays an important role for the population.
This study estimated the prevalence of and searched risk factors associated with hypertension using cases-control study based on the year 2002 data of regional random sample survey obtained from the Bureau of Health Promotion of Taiwan. Study subjects were 26,755 native population aged 15 years or elder living in Taiwan. There were 3204 hypertensive patients diagnosed by physicians, and the other 22,704 individuals with normal blood pressure were considered as controls for this study.
The results showed that the crude prevalence of hypertension among the study population was 12.4%. People who were older, female, less education, divorced or widowed, aborigines, smoking, drinking, areca-quid chewing, obese, free of second hand smoking, taking fruit daily and exercising daily, had higher prevalence of hypertension (p <
0.05). However, the multivariate regression analyses revealed that body
mass index(BMI)was the most important factor associated with the risk for hypertension. Compared to people with BMI of < 18 ㎏/㎡, those with BMI 18-24 ㎏/㎡ and > 27 ㎏/㎡ had higher risk for hypertension, with the odds ratios (OR) of 2.22 (95% confidence interval (CI) = 1.53-3.23) and 7.78 (95% CI = 5.31-11.4), respectively. The co-morbidity of hypertension and diabetes mellitus was also significantly associated with obesity. The odds ratio increased to 8.35(95% CI = 4.27-16.3 ).
Our study found the prevalence of hypertension in Taiwan was strongly associated with obesity. The prevalence between males and females are similar, and the older people had a higher prevalence. |
