血压控制疗效与肥胖类别的关联性研究

摘要/Abstract

摘要： 目的探究血压控制疗效与肥胖类别的关联性。方法收集2023年 1月至2025年12月期间体检门诊高血压病患者,根据纳入排除标准入组病人,按身体质量指数（BMI）分组,分为正常组、超重组及肥胖组;按腰围（WC）分组,分为正常组及中心性肥胖组。分析超重/中心性肥胖的一般特征差异性,并最终分析入组人群血压达标率及其与肥胖类别的关联性。结果单因素逻辑回归分析显示,超重/中心性肥胖与年龄均呈正相关性[（53.3±6.7 vs 51.8±6.4）岁、（55.1±7.2 vs 51.8±6.4）岁],差异有统计学意义（P<0.05）,按BMI分组,超重组的基础血压水平均高于正常体重组（153.7±10.4 vs 150.2±11.2）mmHg,差异有统计学意义（P<0.05）,且肥胖组的基础血压水平更高于正常体重组（157.4±12.2 vs 150.2±11.2）mmHg,差异有统计学意义（P<0.05）;按WC分组,中心性肥胖组基础血压的平均坐位收缩压水平均高于正常体重组（162.2±12.3 vs 159.2±11.4）mmHg,差异有统计学意义（P<0.05）。多因素逻辑回归分析显示,年龄与超重+肥胖人群密切相关（OR 1.22,95%CI 1.05-1.48,P=0.036）,平均坐位收缩压超重+肥胖人群密切相关（OR 1.37,95%CI 1.12-1.53,P=0.024）];年龄、高脂血症、冠心病及糖尿病与中心性肥胖人群密切相关[年龄OR 1.23,95%CI 1.14-1.62,P=0.027、冠心病OR 1.23,95%CI 1.12-1.74,P=0.07）、高脂血症OR 1.28,95%CI 1.07-1.43,P=0.026、糖尿病OR 1.31, 95%CI 1.14-1.68,P=0.033]。调整后的多变量逻辑回归模型分析结果显示血压控制疗效与BMI密切相关。结论年龄是肥胖的危险因素,中心性肥胖人群更倾向于患高脂血症、冠心病及糖尿病,超重/肥胖人群更倾向于患高血压,BMI能更好地预测高血压人群的降压疗效。

关键词: 身体质量指数, 腰围, 高血压, 血压达标率

邓超, 孔亚梅, 官庆, 彭娟娟, 罗涓, 姜月. 血压控制疗效与肥胖类别的关联性研究[J]. 心血管病防治知识, 2026, 16(11): 34-38.

参考文献

[1] Jiang Q, Gong D, Li H, et al.Development and Validation of a Risk Score Screening Tool to Identify People at Risk for Hypertension in Shanghai, China[J]. Risk management and healthcare policy, 2022,15:553-562.
[2] Zhang Y, Hou L, Tang W, et al.High prevalence of obesity-related hypertension among adults aged 40 to 79 years in Southwest China[J]. Scientific reports, 2019,9(1):15838.
[3] 中华医学会内分泌学分会肥胖学组. 中国成人肥胖症防治专家共识(J). 中华内分泌代谢杂志, 2011,27(9):7.
[4] 刘力生. 中国高血压防治指南2010[J]. 中国医学前沿杂志(电子版), 2011,3(5):42-93.
[5] Zhang Y, Wang S.High blood pressure in Chinese youth across categories of BMI and waist circumference[J]. Blood pressure monitoring, 2021,26(2):124-128.
[6] Li Z, Wang X, Liu X, et al.Relationship of body mass index, waist circumference and waist-to-hip ratio with diabetes mellitus in community residents aged 15 years old and above in Pudong new district, Shanghai[J]. Zhonghua liu xing bing xue za zhi, 2020, 41(3):326-330.
[7] 周婕, 吴延莉, 王艺颖, 等. BMI水平及其变化与高血压发病风险的前瞻性队列研究[J]. 现代预防医学, 2022,(6):49.
[8] 吕垚, 周伊恒, 刘力滴, 等. 美国肥胖医学协会《肥胖和高血压临床实践声明》解读[J].中国全科医学, 2025,28(3):272-9.
[9] Tanaka M.Improving obesity and blood pressure[J]. Hypertension research : official journal of the Japanese Society of Hypertension, 2020,43(2):79-89.
[10] 孙秀芹, 魏兰萱, 刘金波, 等. 北京市石景山区40-70岁社区人群高血压危险因素及生活方式对高血压的影响分析[J].中国心血管杂志, 2025,30(1):86-94.
[11] Tinawi M.New Trends in the Diagnosis and Management of Hyper-tension[J]. Cureus, 2022,14(2):e22393.
[12] 徐振霞, 贾恩志. 青少年超重,肥胖和血压临界值的相关性[J].中西医结合心脑血管病杂志, 2024,22(20):3792-3795.
[13] Guyenet P, Stornetta R, Souza G, et al.Neuronal Networks in Hyper-tension: Recent Advances[J]. Hypertension (Dallas, Tex : 1979), 2020,76(2):300-11.
[14] Hall M, Cohen J, Ard J, et al.Weight-Loss Strategies for Prevention and Treatment of Hypertension: A Scientific Statement From the American Heart Association[J]. Hypertension (Dallas, Tex : 1979), 2021,78(5):e38-e50.
[15] Chrysant S.Pathophysiology and treatment of obesity-related hypertension[J]. Journal of clinical hypertension (Greenwich, Conn), 2019,21(5):555-9.
[16] Landsberg L, Aronne L, Beilin L, et al.Obesity-related hyper-tension: pathogenesis, cardiovascular risk, and treatment--a position paper of the The Obesity Society and The American Society of Hypertension[J]. Obesity, 2013,21(1):8-24.
[17] Haddadin F, Sud K, Munoz Estrella A, Moctezuma S, et al.The prevalence and predictors of resistant hypertension in high-risk overweight and obese patients: A cross-sectional study based on the 2017 ACC/AHA guidelines[J]. Journal of clinical hypertension , 2019,21(10):1507-15.
[18] Chudek A, Owczarek A, Ficek J, et al.A Stronger Effect of Body Mass Index and Waist Circumference on the Prevalence of Uncontrolled Hypertension among Caucasian Men than Women[J]. Kidney & blood pressure research, 2021,46(3):298-309.
[19] 张海龙, 赵宝成, 刘育鹏, 等. 老年高血压合并冠心病患者的血压达标情况及影响因素分析[J]. 中国临床保健杂志, 2019,22(1):5.
[20] Tran N, Blizzard C, Luong K,et al.The importance of waist circumference and body mass index in cross-sectional relationships with risk of cardiovascular disease in Vietnam[J]. PloS one, 2018,13(5):e0198202.
[21] Chihiro G, Kohei M, Yasuhiro M, et al.Prevalence and coexistence of locomotive syndrome with reduced mobility and metabolic syndrome: a cross-sectional study of 35,059 Japanese adults[J]. Sci Rep, 2025,15(1).
[22] Siegfried E, Siegfried B F, Alfons M, et al.Meta-analysis of three observational studies of amlodipine/valsartan in hypertensive patients with additional risk factors[J]. Blood Press, 2013, Suppl 1:11-21.