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Article(id=1241676528296186804, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407044, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1720022400000, receivedDateStr=2024-07-04, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773968353579, onlineDateStr=2026-03-20, pubDate=1731168000000, pubDateStr=2024-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773968353579, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773968353579, creator=13701087609, updateTime=1773968353579, updator=13701087609, issue=Issue{id=1241676522256388920, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='21', pageStart='3841', pageEnd='4032', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773968352140, creator=13701087609, updateTime=1773968629818, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241677686985249701, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241677686985249702, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3889, endPage=3894, ext={EN=ArticleExt(id=1241676528761754582, articleId=1241676528296186804, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the association between social activities and hypertension in the population aged ≥ 45 in China: an empirical study based on the CHARLS database, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the association between social activities and hypertension in individuals aged ≥ 45 in China, providing new intervention strategies for the prevention and treatment of hypertension.

Methods

A cross-sectional study was conducted using data from the fifth national survey of the China Health and Retirement Longitudinal Study (CHARLS) 2020.Demographic characteristics, lifestyle factors, and indicators of social activities of the study subjects were included. The association between seven types of social activities and hypertension among middle-aged and elderly individuals was analyzed using χ2 tests and multivariate logistic regression.

Results

A total of 19 213 middle-aged and elderly individuals were included, comprising 10 159 men and 9 054 women, with a median age of 63 years (ranging from 55 to 70 years). The prevalence of hypertension was 40.08% (7 702/19 213). Logistic regression analysis indicated that after adjusting for all confounding factors, visiting neighbors and socializing with friends (OR=1.08, 95%CI: 1.01-1.15, P=0.022) and participating in volunteer or charity activities (OR=1.23, 95%CI: 1.04-1.46, P=0.016) were positively associated with the risk of hypertension. Conversely, activities such as dancing, exercising, or practicing Qigong in parks or other venues were negatively associated with the risk of hypertension (OR=0.88, 95%CI: 0.78-1.00, P=0.044).

Conclusion

Participation in different social activities is associated with hypertension. It is recommended to encourage middle-aged and elderly individuals to actively engage in health-promoting social activities to reduce the risk of hypertension, thereby providing scientific guidance for achieving “Healthy China 2030”.

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目的

探讨我国≥45岁人群中社交活动与高血压的关联性，为高血压的防治提供新的干预策略。

方法

采用中国健康与养老追踪调查项目（CHARLS）2020年第五轮全国调查的数据进行横断面研究。纳入研究对象的人口学特征、生活方式和社交活动指标，利用χ2检验和多因素logistic回归分析七项社交活动与中老年高血压之间的关联。

结果

总纳入19 213名中老年人，男性10 159人，女性9 054人，中位年龄为63岁（55～70岁）。高血压的患病率为40.08%（7 702/19 213）。Logistic回归显示，在校正所有混杂后，串门、跟朋友交往（OR=1.08, 95%CI: 1.01～1.15, P=0.022）和参加志愿者活动或者慈善活动（OR=1.23, 95%CI: 1.04～1.46, P=0.016）均与高血压患病风险呈正向关联；而去公园或者其他场所跳舞、健身、练气功等活动则与高血压患病风险呈负向关联（OR=0.88, 95%CI: 0.78～1.00, P=0.044）。

结论

参与不同社交活动与高血压存在一定关联。应鼓励中老年人积极参与有益健康的社交活动，以降低高血压的患病风险，并为实现“健康中国2030”提供科学的指导依据。

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史淑芳，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Jgg3EzKaDAZ/NglXAZwjzQ==, magXml=bmuyM5sO1C9ct7L+BE8PQg==, pdfUrl=null, pdf=DlIoOVtGFv2CCc2pLjnMSA==, pdfFileSize=647534, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=dDRo+6qJBrynjgJ0OBw0zA==, mapNumber=null, authorCompany=null, fund=null, authors=

任青青（1984—），女，本科，主管护师，研究方向：外科护理教育

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Chinese Journal of Cardiovascular Medicine, 2020, 25(4): 393-396.(In Chinese), articleTitle=Exercise, hypertension and cognitive function, refAbstract=null), Reference(id=1241821871444919217, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, doi=null, pmid=null, pmcid=null, year=2024, volume=43, issue=6, pageStart=465, pageEnd=472, url=null, language=null, rfNumber=[15], rfOrder=25, authorNames=王潘悦, 王艳, journalName=中国运动医学杂志, refType=null, unstructuredReference=王潘悦， 王艳.中等强度健步走对中老年高血压患者睡眠质量的影响[J].中国运动医学杂志，2024，43（6）：465-472., articleTitle=中等强度健步走对中老年高血压患者睡眠质量的影响, refAbstract=null), Reference(id=1241821871663023032, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, doi=null, pmid=null, pmcid=null, year=2024, volume=43, issue=6, pageStart=465, pageEnd=472, url=null, language=null, rfNumber=[15], rfOrder=26, authorNames=Wang PY, Wang Y, journalName=Chinese Journal of Sports Medicine, refType=null, unstructuredReference=Wang PY, Wang Y. Effects of moderate-intensity brisk walking on sleep quality in middle-aged and elderly patients with hypertension[J]. Chinese Journal of Sports Medicine, 2024, 43(6): 465-472.(In Chinese), articleTitle=Effects of moderate-intensity brisk walking on sleep quality in middle-aged and elderly patients with hypertension, refAbstract=null), Reference(id=1241821871801435070, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, doi=null, pmid=null, pmcid=null, year=2022, volume=40, issue=4, pageStart=741, pageEnd=748, url=null, language=null, rfNumber=[16], rfOrder=27, authorNames=Foti K, Hardy ST, Chang AR, journalName=Journal of Hypertension, refType=null, unstructuredReference=Foti K, Hardy ST, Chang AR, et al. BMI and blood pressure control among United States adults with hypertension[J]. Journal of Hypertension, 2022, 40(4): 741-748., articleTitle=BMI and blood pressure control among United States adults with hypertension, refAbstract=null)], funds=[Fund(id=1241821866164290260, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, awardId=2021RC006, language=CN, fundingSource=山西白求恩医院人才引进科研启动金项目(2021RC006), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241821853434577121, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, xref=1., ext=[AuthorCompanyExt(id=1241821853447160034, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, companyId=1241821853434577121, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi 030032, China), AuthorCompanyExt(id=1241821853472325859, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, companyId=1241821853434577121, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.山西白求恩医院(山西医学科学院)，山西医科大学第三医院；同济山西医院护理部，山西 太原 030032)]), AuthorCompany(id=1241821853610737896, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, xref=2., ext=[AuthorCompanyExt(id=1241821853627515113, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, companyId=1241821853610737896, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.中山市中医院老年病科)]), AuthorCompany(id=1241821853749149933, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, xref=3., ext=[AuthorCompanyExt(id=1241821853761732846, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, companyId=1241821853749149933, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.山西省人民医院全科医疗科)]), AuthorCompany(id=1241821853929505018, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, xref=4., ext=[AuthorCompanyExt(id=1241821853937893627, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, companyId=1241821853929505018, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.山西医科大学公共卫生学院)])], figs=[ArticleFig(id=1241821863886783125, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, language=EN, label=Table 1, caption=

Comparison of demographic characteristics and lifestyle under different blood pressure status ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总(n=19 213)无高血压(n=11 511)高血压(n=7 702)χ2值P值
年龄 (岁)844.280<0.001
45～597 770 (40.44)5 549 (48.21)2 221 (28.84)
60～696 264 (32.60)3 556 (30.89)2 708 (35.16)
70及以上5 179 (26.96)2 406 (20.90)2 773 (36.00)
性别0.7070.400
男10 159 (52.88)6 058 (52.63)4 101 (53.25)
女9 054 (47.12)5 453 (47.37)3 601 (46.75)
教育程度53.706<0.001
初等教育未完成8 278 (43.09)4 728 (41.07)3 550 (46.09)
小学教育4 213 (21.93)2 551 (22.16)1 662 (21.58)
中等教育4 239 (22.06)2 674 (23.23)1 565 (20.32)
高等教育2 483 (12.92)1 558 (13.53)925 (12.01)
居住地11.299<0.001
非农村4 898 (25.49)2 835 (24.63)2 063 (26.79)
农村14 315 (74.51)8 676 (75.37)5 639 (73.21)
锻炼77.333<0.001
否2 186 (11.38)1 120 (9.73)1 066 (13.84)
是17 027 (88.62)10 391 (90.27)6 636 (86.16)
饮酒58.511<0.001
否12 320 (64.12)7 132 (61.96)5 188 (67.36)
是6 893 (35.88)4 379 (38.04)2 514 (32.64)
抽烟56.671<0.001
否14 314 (74.50)8 353 (72.57)5 961 (77.40)
是4 899 (25.50)3 158 (27.43)1 741 (22.60)
), ArticleFig(id=1241821864000029343, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, language=CN, label=表1, caption=

不同血压状态下人口学特征和生活方式的对比［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总(n=19 213)无高血压(n=11 511)高血压(n=7 702)χ2值P值
年龄 (岁)844.280<0.001
45～597 770 (40.44)5 549 (48.21)2 221 (28.84)
60～696 264 (32.60)3 556 (30.89)2 708 (35.16)
70及以上5 179 (26.96)2 406 (20.90)2 773 (36.00)
性别0.7070.400
男10 159 (52.88)6 058 (52.63)4 101 (53.25)
女9 054 (47.12)5 453 (47.37)3 601 (46.75)
教育程度53.706<0.001
初等教育未完成8 278 (43.09)4 728 (41.07)3 550 (46.09)
小学教育4 213 (21.93)2 551 (22.16)1 662 (21.58)
中等教育4 239 (22.06)2 674 (23.23)1 565 (20.32)
高等教育2 483 (12.92)1 558 (13.53)925 (12.01)
居住地11.299<0.001
非农村4 898 (25.49)2 835 (24.63)2 063 (26.79)
农村14 315 (74.51)8 676 (75.37)5 639 (73.21)
锻炼77.333<0.001
否2 186 (11.38)1 120 (9.73)1 066 (13.84)
是17 027 (88.62)10 391 (90.27)6 636 (86.16)
饮酒58.511<0.001
否12 320 (64.12)7 132 (61.96)5 188 (67.36)
是6 893 (35.88)4 379 (38.04)2 514 (32.64)
抽烟56.671<0.001
否14 314 (74.50)8 353 (72.57)5 961 (77.40)
是4 899 (25.50)3 158 (27.43)1 741 (22.60)
), ArticleFig(id=1241821864138441384, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, language=EN, label=Table 2, caption=

Comparison of different social activities and hypertension prevalence rate ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总(n=19 213)无高血压(n=11 511)高血压(n=7 702)χ2值P值
串门、跟朋友交往0.8600.354
否13 073 (68.04)7 803 (67.79)5 270 (68.42)
是6 140 (31.96)3 708 (32.21)2 432 (31.58)
打麻将、下棋、打牌、去社区活动室5.6290.018
否16 389 (85.30)9 762 (84.81)6 627 (86.04)
是2 824 (14.70)1 749 (15.19)1 075 (13.96)
无偿向与您不住在一起的亲人、朋友或者邻居提供帮助33.335<0.001
否16 253 (84.59)9 596 (83.36)6 657 (86.43)
是2 960 (15.41)1 915 (16.64)1 045 (13.57)
去公园或者其他场所跳舞、健身、练气功等17.693<0.001
否17 898 (93.16)10 651 (92.53)7 247 (94.09)
是1 315 (6.84)860 (7.47)455 (5.91)
参加社团组织活动<0.0010.985
否18 756 (97.62)11 237 (97.62)7 519 (97.62)
是457 (2.38)274 (2.38)183 (2.38)
志愿者活动或者慈善活动0.1870.665
否18 609 (96.86)11 144 (96.81)7 465 (96.92)
是604 (3.14)367 (3.19)237 (3.08)
上学或者参加培训课程6.4330.011
否18 910 (98.42)11 308 (98.24)7 602 (98.70)
是303 (1.58)203 (1.76)100 (1.30)
), ArticleFig(id=1241821864268464816, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, language=CN, label=表2, caption=

不同社交活动与高血压患病率的比较［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总(n=19 213)无高血压(n=11 511)高血压(n=7 702)χ2值P值
串门、跟朋友交往0.8600.354
否13 073 (68.04)7 803 (67.79)5 270 (68.42)
是6 140 (31.96)3 708 (32.21)2 432 (31.58)
打麻将、下棋、打牌、去社区活动室5.6290.018
否16 389 (85.30)9 762 (84.81)6 627 (86.04)
是2 824 (14.70)1 749 (15.19)1 075 (13.96)
无偿向与您不住在一起的亲人、朋友或者邻居提供帮助33.335<0.001
否16 253 (84.59)9 596 (83.36)6 657 (86.43)
是2 960 (15.41)1 915 (16.64)1 045 (13.57)
去公园或者其他场所跳舞、健身、练气功等17.693<0.001
否17 898 (93.16)10 651 (92.53)7 247 (94.09)
是1 315 (6.84)860 (7.47)455 (5.91)
参加社团组织活动<0.0010.985
否18 756 (97.62)11 237 (97.62)7 519 (97.62)
是457 (2.38)274 (2.38)183 (2.38)
志愿者活动或者慈善活动0.1870.665
否18 609 (96.86)11 144 (96.81)7 465 (96.92)
是604 (3.14)367 (3.19)237 (3.08)
上学或者参加培训课程6.4330.011
否18 910 (98.42)11 308 (98.24)7 602 (98.70)
是303 (1.58)203 (1.76)100 (1.30)
), ArticleFig(id=1241821864390099644, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, language=EN, label=Table 3, caption=

Logistic regression analysis of different social activities on hypertension

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
串门、跟朋友交往1.04 (0.98～1.11)0.1811.04 (0.98～1.11)0.2001.08 (1.01～1.15)0.022
打麻将、下棋、打牌、去社区活动室0.93 (0.85～1.01)0.0860.92 (0.85～1.00)0.0610.96 (0.88～1.04)0.314
无偿向与您不住在一起的亲人、朋友或者邻居提供帮助0.94 (0.86～1.02)0.1570.94 (0.86～1.02)0.1370.97 (0.89～1.06)0.504
去公园或者其他场所跳舞、健身、练气功等0.88 (0.78～1.00)0.0440.87 (0.77～0.98)0.0240.88 (0.78～1.00)0.044
参加社团组织活动1.04 (0.86～1.27)0.6661.03 (0.85～1.25)0.7651.07 (0.87～1.30)0.526
志愿者活动或者慈善活动1.20 (1.01～1.42)0.0371.19 (1.00～1.41)0.0451.23 (1.04～1.46)0.016
上学或者参加培训课程1.03 (0.80～1.31)0.8381.02 (0.79～1.30)0.8801.04 (0.81～1.33)0.752
), ArticleFig(id=1241821865904243394, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528296186804, language=CN, label=表3, caption=

不同社交活动对高血压的logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
串门、跟朋友交往1.04 (0.98～1.11)0.1811.04 (0.98～1.11)0.2001.08 (1.01～1.15)0.022
打麻将、下棋、打牌、去社区活动室0.93 (0.85～1.01)0.0860.92 (0.85～1.00)0.0610.96 (0.88～1.04)0.314
无偿向与您不住在一起的亲人、朋友或者邻居提供帮助0.94 (0.86～1.02)0.1570.94 (0.86～1.02)0.1370.97 (0.89～1.06)0.504
去公园或者其他场所跳舞、健身、练气功等0.88 (0.78～1.00)0.0440.87 (0.77～0.98)0.0240.88 (0.78～1.00)0.044
参加社团组织活动1.04 (0.86～1.27)0.6661.03 (0.85～1.25)0.7651.07 (0.87～1.30)0.526
志愿者活动或者慈善活动1.20 (1.01～1.42)0.0371.19 (1.00～1.41)0.0451.23 (1.04～1.46)0.016
上学或者参加培训课程1.03 (0.80～1.31)0.8381.02 (0.79～1.30)0.8801.04 (0.81～1.33)0.752
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我国≥45岁人群社交活动与高血压的关联性分析——基于CHARLS数据库的实证分析
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任青青 1 , 梁小玲 2 , 宋文浩 2 , 张海芬 3 , 丁新民 1 , 宋文柱 1, 4 , 史淑芳 1
现代预防医学 | 流行病与统计方法 2024,51(21): 3889-3894
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现代预防医学 | 流行病与统计方法 2024, 51(21): 3889-3894
我国≥45岁人群社交活动与高血压的关联性分析——基于CHARLS数据库的实证分析
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任青青1, 梁小玲2, 宋文浩2, 张海芬3, 丁新民1, 宋文柱1, 4, 史淑芳1
作者信息
  • 1.山西白求恩医院(山西医学科学院)，山西医科大学第三医院；同济山西医院护理部，山西 太原 030032
  • 2.中山市中医院老年病科
  • 3.山西省人民医院全科医疗科
  • 4.山西医科大学公共卫生学院

    • 任青青（1984—），女，本科，主管护师，研究方向：外科护理教育

通讯作者:

史淑芳，E-mail:
Analysis of the association between social activities and hypertension in the population aged ≥ 45 in China: an empirical study based on the CHARLS database
Qing-qing REN1, Xiao-ling LIANG2, Wen-hao SONG2, Hai-fen ZHANG3, Xin-min DING1, Wen-zhu SONG1, 4, Shu-fang SHI1
Affiliations
  • Department of Nursing, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan, Shanxi 030032, China
出版时间: 2024-11-10 doi: 10.20043/j.cnki.MPM.202407044
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摘要
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目的

探讨我国≥45岁人群中社交活动与高血压的关联性，为高血压的防治提供新的干预策略。

方法

采用中国健康与养老追踪调查项目（CHARLS）2020年第五轮全国调查的数据进行横断面研究。纳入研究对象的人口学特征、生活方式和社交活动指标，利用χ2检验和多因素logistic回归分析七项社交活动与中老年高血压之间的关联。

结果

总纳入19 213名中老年人，男性10 159人，女性9 054人，中位年龄为63岁（55～70岁）。高血压的患病率为40.08%（7 702/19 213）。Logistic回归显示，在校正所有混杂后，串门、跟朋友交往（OR=1.08, 95%CI: 1.01～1.15, P=0.022）和参加志愿者活动或者慈善活动（OR=1.23, 95%CI: 1.04～1.46, P=0.016）均与高血压患病风险呈正向关联；而去公园或者其他场所跳舞、健身、练气功等活动则与高血压患病风险呈负向关联（OR=0.88, 95%CI: 0.78～1.00, P=0.044）。

结论

参与不同社交活动与高血压存在一定关联。应鼓励中老年人积极参与有益健康的社交活动，以降低高血压的患病风险，并为实现“健康中国2030”提供科学的指导依据。

社交活动  /  高血压  /  横断面研究  /  关联性分析  /  中国健康与养老追踪调查
Objective

To explore the association between social activities and hypertension in individuals aged ≥ 45 in China, providing new intervention strategies for the prevention and treatment of hypertension.

Methods

A cross-sectional study was conducted using data from the fifth national survey of the China Health and Retirement Longitudinal Study (CHARLS) 2020.Demographic characteristics, lifestyle factors, and indicators of social activities of the study subjects were included. The association between seven types of social activities and hypertension among middle-aged and elderly individuals was analyzed using χ2 tests and multivariate logistic regression.

Results

A total of 19 213 middle-aged and elderly individuals were included, comprising 10 159 men and 9 054 women, with a median age of 63 years (ranging from 55 to 70 years). The prevalence of hypertension was 40.08% (7 702/19 213). Logistic regression analysis indicated that after adjusting for all confounding factors, visiting neighbors and socializing with friends (OR=1.08, 95%CI: 1.01-1.15, P=0.022) and participating in volunteer or charity activities (OR=1.23, 95%CI: 1.04-1.46, P=0.016) were positively associated with the risk of hypertension. Conversely, activities such as dancing, exercising, or practicing Qigong in parks or other venues were negatively associated with the risk of hypertension (OR=0.88, 95%CI: 0.78-1.00, P=0.044).

Conclusion

Participation in different social activities is associated with hypertension. It is recommended to encourage middle-aged and elderly individuals to actively engage in health-promoting social activities to reduce the risk of hypertension, thereby providing scientific guidance for achieving “Healthy China 2030”.

Social activities  /  Hypertension  /  Cross-sectional study  /  Association analysis  /  China Health and Retirement Longitudinal Study
任青青, 梁小玲, 宋文浩, 张海芬, 丁新民, 宋文柱, 史淑芳. 我国≥45岁人群社交活动与高血压的关联性分析——基于CHARLS数据库的实证分析. 现代预防医学, 2024 , 51 (21) : 3889 -3894 . DOI: 10.20043/j.cnki.MPM.202407044
Qing-qing REN, Xiao-ling LIANG, Wen-hao SONG, Hai-fen ZHANG, Xin-min DING, Wen-zhu SONG, Shu-fang SHI. Analysis of the association between social activities and hypertension in the population aged ≥ 45 in China: an empirical study based on the CHARLS database[J]. Modern Preventive Medicine, 2024 , 51 (21) : 3889 -3894 . DOI: 10.20043/j.cnki.MPM.202407044
正文
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高血压是全球范围内的重大公共卫生问题，对人类健康造成重大挑战。高血压可引起心、脑、肾等器官的病理性损害[1]，是心脑血管疾病的首要风险因素[2]。过去30年间，全球高血压患者数量翻了一番，已突破12亿人[3]。我国约有2.45亿高血压患者，患病率为27.9%，而知晓率、治疗率和控制率分别为51.6%、45.8%和16.8%[3]。尽管高血压患者趋于年轻化，但随着我国人口老龄化加剧，中老年人仍是高血压防治的目标对象，老年人群晚年生活的幸福感和满足感也深受其害。药物治疗在高血压管理中起着关键作用，但全球高血压患者的药物依从性普遍较低[4]，导致血压控制不佳，心血管事件风险增加。探索可改变生活方式的上游干预仍为高血压防治的重要组成部分，也是响应“健康中国行动”的必需一环。
目前，常见的高血压生活干预措施包括健康饮食、戒烟、戒酒和睡眠管理等[5]。研究表明，社交活动作为一种健康的生活方式，对老年人的身心健康具有积极作用[6]。参与社交活动不仅能缓解抑郁情绪，还能降低失能率，改善老年人健康状况和生活质量。少量研究显示，社交活跃度是高血压患病的保护因素[7]，即社交越活跃，高血压患病风险越低。然而，不同社交方式与血压之间的关联研究仍然匮乏。
本研究利用2020年中国健康与养老追踪调查（China Health and Retirement Longitudinal Study,CHARLS）数据，探讨我国45岁及以上中老年人群中社交活动与高血压之间的关联性，旨在降低我国中老年人的高血压患病率，提升人民的健康水平、为实现“健康中国2023”提供重要而深入的科学参考依据。
1　资料与方法
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1.1　数据来源
本研究数据来源于2020年开展的第五轮全国性CHARLS调查数据。CHARLS是我国首个针对45岁及以上人群的全国代表性人口调查，提供了高质量的公共微观数据集库[8]。第五轮调查共涉及19 395名中老年人。本研究剔除了不符合要求的样本，包括<45岁人群128人、锻炼情况缺失43人、饮酒情况缺失3人和居住地缺失8人，最终纳入有效样本19 213例。
CHARLS各轮调查均经北京大学生物医学伦理委员会批准（IRB00001052-11015），所有受访者均签署了知情同意书。
1.2　研究内容
1.2.1　一般资料收集
研究纳入人口学特征和生活方式等资料。人口学特征包括性别、年龄、教育程度和居住地。其中年龄分为45～59、60～69和70岁组。教育程度定义为：初等教育未完成、小学教育、中等教育和高等教育；初等教育未完成包括未受过教育（文盲）、未读完小学、私塾毕业，小学教育即为小学毕业，中等教育即为初中毕业，高等教育包含高中毕业、中专毕业、大专毕业、本科毕业、硕士毕业、博士毕业。居住地分为农村和非农村。生活方式资料包含锻炼、目前是否抽烟、喝酒，均定义为是或否。
1.2.2　社交活跃度问卷
社交活跃度问卷是CHARLS问卷的一部分，本研究本纳入7个社交活动项目：串门、跟朋友交往；打麻将、下棋、打牌、去社区活动室；无偿向与您不住在一起的亲人、朋友或者邻居提供帮助；去公园或者其他场所跳舞、健身、练气功等；参加社团组织活动；志愿者活动或者慈善活动；上学或者参加培训课程；均定义为是或者否。通过问卷中的问题：“您过去1个月是否进行了以下社交活动？“1”表示是，“0”表示否。
1.2.3　结局变量
将高血压的发生与否作为结局变量，以问题“是否有医师曾经告诉过您患有高血压病？”的回答为判定依据。“1”表示高血压的发生，“0”表示未发生高血压。
1.3　统计学方法
采用R语言（4.3.1）统计学软件进行数据分析。计数资料以例数（百分比）表示，采用χ2检验进行人口学特征和生活方式、不同社交活动与高血压患病率的比较。采用多因素logistic回归分析模型进行不同社交活动与高血压之间的关联性分析。检验水准为α=0.05。
2　结果
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2.1　基本情况
在19 213名中老年人中，男性有10 159人（52.88%），女性有9 054人（47.12%），中位年龄为63（55～70）岁。高血压患病率为40.08%（7 702/19 213）。教育水平方面，初等教育未完成者8 278人（43.09%），小学教育4 213人（21.93%），中等教育4 239人（22.06%），高等教育2 483人（12.92%）。居住地方面，非农村人口为4 898人（25.49%），农村人口为14 315人（74.51%）。在生活方式方面，不锻炼者2 186人（11.38%），不饮酒者12 320人（64.12%），不吸烟者14 314人（74.50%）。χ2检验显示，年龄、教育水平、居住地、锻炼、吸烟和饮酒与是否高血压之间均存在显著差异（P<0.05）。见表1。
2.2　不同社交活动与高血压患病率的比较
在19 213名中老年人中，6 140人（31.96%）有串门、与朋友交往的活动；2 824人（14.70%）参与打麻将、下棋、打牌或去社区活动室；2 960人（15.41%）无偿向与您不住在一起的亲人、朋友或者邻居提供帮助；1 315人（6.84%）去公园或者其他场所跳舞、健身、练气功等；604人（3.14%）参与志愿者活动或者慈善活动；457人（2.38%）参加社团组织活动；303人（1.58%）参与上学或参加培训课程。分析结果显示，打麻将、下棋、打牌、去社区活动室，无偿向与您不住在一起的亲人、朋友或者邻居提供帮助，去公园或者其他场所跳舞、健身、练气功等以及上学或者参加培训课程在高血压组和非高血压组之间的构成差异具有统计学意义（P<0.05）。见表2。
2.3　社交活动与高血压患病的关联性分析
由于本研究样本量较大，故将可能的影响因素全纳入分析。以是否高血压为因变量（是=1，否=0）；串门、跟朋友交往（是=1，否=0），打麻将、下棋、打牌、去社区活动室（是=1，否=0），无偿向与您不住在一起的亲人、朋友或者邻居提供帮助（是=1，否=0），去公园或者其他场所跳舞、健身、练气功等（是=1，否=0），参加社团组织活动（是=1，否=0），志愿者活动或者慈善活动（是=1，否=0），上学或者参加培训课程（是=1，否=0），以上7项为自变量，进行多因素logistic回归分析。
Logistic回归显示，在校正年龄和性别后，“去公园或者其他场所跳舞、健身、练气功等”和“参加志愿者活动或者慈善活动”分别与高血压患病风险呈负向（OR=0.88, 95%CI: 0.78～1.00, P=0.044）和正向关联（OR=1.20, 95%CI: 1.01～1.42, P=0.037）。进一步校正教育水平和居住地后，这两项社交活动与高血压的患病风险之间的关联仍然显著。同时，再进一步校正抽烟、喝酒和锻炼后，上述关联依然成立，且“串门、跟朋友交往”这一活动与高血压患病风险呈正向关联（OR=1.08, 95%CI: 1.01～1.15, P=0.022）。见表3。
3　讨论
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本研究以CHARLS 2020年第五轮全国调查的19 213名45岁及以上中老年人为对象，从可改变的生活方式出发，探讨七项社交活动与高血压之间的关联，包括“去公园或者其他场所跳舞、健身、练气功等”及“无偿向与您不住在一起的亲人、朋友或者邻居提供帮助”等。研究结果表明，参与“串门、跟朋友交往”以及“参加志愿者活动或者慈善活动”均与高血压患病风险呈正向关联；而“去公园或者其他场所跳舞、健身、练气功等”这一活动与高血压患病风险呈负向关联。这一发现为高血压防治提供了新视角，对推进“健康中国2023”具有参考价值。
以往关于社交活动与高血压的关联研究结果与本研究具有类似之处。唐文斌等人[7]的研究表明，社交活跃度与高血压患病密切关联，即社交活跃度与我国中老年人高血压患病呈负向关联。来自日本的研究表明，每月至少参与一次平等关系的活动与高血压呈负相关[9]。无独有偶，日本的另一项研究表明，与无社交活动相比，参与两个或更多团体的老年人高血压控制较好。调整协变量后，参与多个社交团体与更好的高血压控制相关[10]。
本文聚焦于七种具体的社交活动，能更为详细探讨生活中的社交类型与高血压的关联，具有针对性。研究显示，“串门、跟朋友交往”与“参加志愿者活动或者慈善活动”与高血压患病风险呈正向关联。研究显示，适当的志愿等社会参与活动能降低高血压的患病风险[11]。然而，在某些情况下，这类社交活动可能涉及较大的体力劳动、引发压力或不良情绪，导致睡眠质量下降、内分泌失调等[12]，进而增加高血压的患病风险，但其作用机制还有待研究。
“去公园或者其他场所跳舞、健身、练气功等”与高血压患病风险呈现负向关联。这一社交活动主要涉及有氧运动和情感交流。中国老年高血压管理指南2023指出，老年高血压及高血压前期患者进行合理的有氧运动可有效降低血压，建议以中等强度有氧运动为主[13]。运动参与血压调节机制主要与下列三种机制有关：运动可调节交感神经活动、降低血浆儿茶酚胺水平；运动可改善血管舒缩状态，即运动可通过对肾素血管紧张素醛固酮系统的调控，降低血浆肾素活性，减少血管收缩，进而使血压下降；血压可受胰岛素的调节[14]，即运动不仅可改善胰岛素敏感性，还可降低其血浆浓度，从而降低血压[15]。
值得一提的是，虽然三个模型均显示“无偿向与您不住在一起的亲人、朋友或者邻居提供帮助”与高血压患病风险并无统计学关联，但无偿向他人提供帮助能提供情感上的交流。这种交流可在一定程度上引起心灵共鸣，可缓解心理压力及提供情绪价值，避免血压出现大范围的波动，从而进一步降低高血压患病风险。此外，中老年人在参与社交活动时，通过相应的角色代入在理想状态中能实现自身价值，高频次参与社交活动有利于不良情绪的发泄，缓解心理压力，降低抑郁等心理疾病的发生，对高血压的患病风险起到负向关联作用[7]。
本文具有一定的优势。首先，本文涉及全国19 213名中老年人，样本量大且具有代表性。其次，本研究采用多个logistic回归模型校正了潜在的混杂，使得研究结果具有可靠性。最后，本研究从社交活动出发，首次探讨了不同社交活动与高血压之间的关联，能为高血压的上游干预提供新的突破口。随着人民生活水平和健康意识的提高，本研究所涉及到的社交活动逐渐成为老年生活常见的日常娱乐项目，有针对性的开展这类项目有助于降低高血压的患病率，也为落实“健康中国行动”提供新方向。
本研究也存在一定的局限性。一方面，本研究为横断面研究，难以区分社交方式与高血压之间的时序关系。另一方面，由于数据是通过问卷形式收集，可能存在研究对象的主观偏见，可能存在回忆偏倚。在今后的研究中，我们将进一步采用纵向数据进一步的探讨社交方式与高血压之间的因果关联。此外，尽管我们在模型中控制了人口学特征以及生活方式等潜在混杂，但可能存在残余混杂或未测量的混杂，如身体质量指数[16]。后期需要在人群中开展纵向研究以验证本研究结果。
总而言之，参与不同社交活动与高血压存在一定关联。作为医务人员，我们应鼓励中老年高血压患者有针对性参与有益健康的社交活动，如去公园或者其他场所跳舞、健身、练气功等，进而预防和降低高血压的发生和患病风险，从而提高生活质量和健康水平。
基金
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  • 山西白求恩医院人才引进科研启动金项目(2021RC006)
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2024年第51卷第21期
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doi: 10.20043/j.cnki.MPM.202407044
  • 接收时间：2024-07-04
  • 首发时间：2026-03-20
  • 出版时间：2024-11-10
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  • 收稿日期：2024-07-04
基金
山西白求恩医院人才引进科研启动金项目(2021RC006)
作者信息
    1.山西白求恩医院(山西医学科学院)，山西医科大学第三医院；同济山西医院护理部，山西 太原 030032
    2.中山市中医院老年病科
    3.山西省人民医院全科医疗科
    4.山西医科大学公共卫生学院

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