1.General Practice, Gaohang Community Health Service Center, Shanghai 201208, China;
2.Heart Failure Institute, Shanghai East Hospital Dongfang Hospital Affiliated to Tongji University, Shanghai 200120, China;
3.Department of Cardiology, the Second People's Hospital of Pinghu, Zhejiang Province, Pinghu 314201, China
Abstract:Objectives To estimate the prevalence of heart failure with preserved ejection fraction (HFpEF) in elderly community, and to discuss the risk factors. Methods All target individuals were included in Gaohang communities from June to October in 2013. And they were divided into HFpEF group and control group. Step-wise Logistic regression was used to explore risk factors of HFpEF. Results A total of 4000 questionnaires were distributed to the community elderly. There were 3950 valid questionnaires and the effectives rate of 98.75%. There were 1312 patients with HFpEF and 2638 control individuals. There were significant difference between two groups in composition ratio of normal weight, overweight and obesity (P < 0.05). The regression model indicated that elderly age, female gender and lower HDL-C level were risk factors of HFpEF (P < 0.05), when adjusted variables included gender, age, SBP, obese, HDL-C, LDL-C and hs-CRP. Conclusion The prevalence of HFpEF is higher in elderly community population in Shanghai. Elderly age, female gender and lower HDL-C level are risk factors of HFpEF.
吴宏1 郑亮2 田才林3 朱成英1 姜晓兰1 岳爱学2 范慧敏2▲. 上海市高行老年社区射血分数保留的心力衰竭危险因素分析[J]. 中国医药导报, 2018, 15(15): 51-53,64.
WU Hong1 ZHENG Liang2 TIAN Cailin3 ZHU Chengying1 JIANG Xiaolan1 YUE Aixue2 FAN Huimin2▲. Analysis of the risk factors of elderly community with heart failure with preserved ejection fraction in Gaohang Community in Shanghai. 中国医药导报, 2018, 15(15): 51-53,64.
[1] Lloyd-Jones D,Adams R,Camethon M,et al. Heart disease and stroke statistics—2009 update:a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommitee [J]. Circulation,2009,119(5):e21-e181.
[2] 刘春霞,陈明.舒张性心力衰竭的发病机制和治疗进展[J].心血管病学进展,2013,34(2):254-257.
[3] 郑亮,吴宏,兰琴,等.上海市高行老年社区人群动脉硬化性心血管疾病患病率的现况调查与危险因素分析[J].中国循证心血管医学杂志,2016,6(8):705-708.
[4] Kelly JP,Mentz RJ,Mebazaa A,et al. Patient selection in heart failure with preserved ejection fraction clinical trials [J]. J Am Coll Cardiol,2015,65(16):1668-1682.
[5] 中国肥胖问题工作组数据汇总分析协作组.我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J].中华流行病学杂志,2002,23(1):5-10.
[6] Wang G,Zheng L,Li X,et al. Using brachial-ankle pulse wave velocity to screen for metabolic syndrome in community population [J]. Sci Rep,2015,5:1-7.
[7] Sahle BW,Owen AJ,Mutowo MP,et al. Prevalence of heart failure in Australia:a systematic review [J]. BMC Cardiovasc Disord,2016,16(1):32-38.
[8] van Riet EES,Hoes AW,Limbueg A,et al. Prevalence of unrecognized heart failure in older persons with shortness of breath on exertion [J]. Eur J Heart Fail,2014,16(7):772-777.
[9] 詹红,Tse Hung-fat,曹晶茗,等.不同左心室射血分数老年充血性心力衰竭患者药物治疗的临床研究[J].中国危重病急救医学,2006,18(4):210-215.
[10] Piro M,Bona RD,Abbate A,et al. Sex-related differences in myocardial recmodeling [J]. J Am Coll Cardiol,2010,55(11):1057-1065.
[11] 刘莉,叶鹏,Obokata M,等.射血分数保留的心力衰竭患者的不同肥胖表型[J].中华高血压杂志,2017(9):1122-1127.
[12] Tsujimoto T,Kajio H. Abdominal obesity is associated with an increased risk of all-cause mortality in patients with HFpEF [J]. J Am Coll Cardiol,2017,70(22):2739-2749.
[13] Fan H,Li X,Zheng L,et al. Abdominal obesity is strongly associated with cardiovascular disease and its risk factors in elderly and very elderly community-dwelling Chinese [J]. Sci Rep,2016.DOI:10.1038/srep21521.
[14] Peng S,Shen T,Liu J,et al. Uncontrolled hypertension increases with age in an older community-dwelling Chinese population in Shanghai [J]. Aging Dis,2017,8(5):558-569.
[15] 王瑾,严胜,王英,等.基于IMB模型的上海市女性流动人口生殖健康干预效果评价[J].上海交通大学学报:医学版,2013,33(3):335-339.
[16] 周晓农,蔡黎,张小萍,等.上海市流动人口对血吸虫病传播的潜在危险性研究[J].中国寄生虫学与寄生虫病杂志,2007,25(3):180-184.