Article(id=1321170734538404229, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170608034009636, articleNumber=null, orderNo=null, doi=10.11847/zgggws1146371, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1730995200000, receivedDateStr=2024-11-08, revisedDate=1735747200000, revisedDateStr=2025-01-02, acceptedDate=1754409600000, acceptedDateStr=2025-08-06, onlineDate=1792921249279, onlineDateStr=2026-10-25, pubDate=1765296000000, pubDateStr=2025-12-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921249279, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921249279, creator=13701087609, updateTime=1792921249279, updator=13701087609, issue=Issue{id=1321170608034009636, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='12', pageStart='1409', pageEnd='1536', issueExtLink='null', onlineDate='null', pubDate='1765296000000', pubDateStr='2025-12-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921219118, creator='13701087609', updateTime=1793011150268, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1321547806687474583, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170608034009636, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1321547806687474584, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170608034009636, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1506, endPage=1510, ext={EN=ArticleExt(id=1321170734790062470, articleId=1321170734538404229, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Sleep status and hypertension prevalence among adults in Guangdong province: a cross-sectional analysis of the 2022 China Nutrition and Health Surveillance, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between hypertension prevalence and sleep among adult residents in Guangdong province, providing scientific evidence for the control and prevention of hypertension.

Methods

Data were collected from 4 982 adult residents aged ≥18 years in 11 monitoring sites of Guangdong province in the 2022 Chinese Nutrition and Health Surveillance. The unconditional multivariate logistic regression model was employed to analyze the relationships of sleep problems and sleep duration with hypertension prevalence among adult residents in Guangdong province.

Results

Among the 4 982 adult residents in Guangdong province, there were 2 393 (49.41%) residents without sleep problems and 2 589 (50.59%) residents with sleep problems. Among them, 1 084 (19.65%), 3 168 (66.54%), and 730 (13.81%) residents had insufficient sleep, adequate sleep, and excessive sleep, respectively. There were 1 611 residents with hypertension, and the complex weighted prevalence of hypertension was 30.04%. After adjusting confounding factors such as gender, age, educational background, marital status, place of residence, current smoking, frequency of alcohol consumption, physical activity, family history of hypertension, body mass index, and central obesity, the results of the unconditional multivariate logistic regression analysis showed that the risk of hypertension among adult residents with sleep problems in Guangdong province was 1.237 times (95%CI: 1.122–1.364) that of adults without sleep problems. The risk of hypertension among adult residents aged ≥ 60 years and with sleep problems in this province was 1.468 times (95%CI: 1.183–1.823) that of those without sleep problems. The risk of hypertension among adult residents with excessive sleep was 1.228 times (95%CI: 1.046–1.442) that of those with adequate sleep. For female adult residents with excessive sleep, the risk of hypertension was 1.340 times (95%CI: 1.006–1.786) that of those with adequate sleep. For female adult residents aged ≥ 60 years and with excessive sleep, the risk of hypertension was 1.446 times (95%CI: 1.001–2.088) that of those with adequate sleep.

Conclusions

The risk of hypertension increased in adults with sleep problems in Guangdong province, especially in those aged ≥ 60 years. Excessive sleep duration was also associated with increased risk of hypertension, especially in females and the adults aged ≥ 60 years.

, authors=Qi JIANG1, Guiyuan JI1, Panpan HUANG2, Xubin HUANG1, Xiaomin HONG1, Jiaqi LI2, Jian WEN2, Gangqiang DING2, 3, authorsList=Qi JIANG, Guiyuan JI, Panpan HUANG, Xubin HUANG, Xiaomin HONG, Jiaqi LI, Jian WEN, Gangqiang DING, authorCompany=null, correspAuthors=Gangqiang DING, authorNote=null, correspAuthorsNote=
DING Gangqiang, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170735062692231, articleId=1321170734538404229, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=广东省成年居民睡眠情况与高血压患病关系:基于2022年中国居民营养与健康状况监测数据分析, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

了解广东省成年居民睡眠情况与高血压患病的关系,为高血压的预防控制提供科学依据。

方法

收集2022年中国居民营养与健康状况监测项目中广东省11个监测点4 982名≥18岁成年居民的相关调查数据。应用多因素非条件logistic回归模型分析广东省成年居民有无睡眠问题和睡眠时长与高血压患病的关系。

结果

广东省4982名成年居民中,无睡眠问题者2 393人(49.41%),有睡眠问题者2 589人(50.59%);睡眠时长不足者1 084人(19.65%),睡眠时长充足者3 168人(66.54%),睡眠时长过长者730人(13.81%);患高血压者1 611例,复杂加权后高血压患病率为30.04%。在调整性别、年龄、文化程度、婚姻状况、居住地、是否现在吸烟、饮酒频次、身体活动情况、有无高血压家族史、体质量指数和是否中心型肥胖等混杂因素后,多因素非条件logistic回归分析结果显示,广东省成年居民有睡眠问题的高血压患病风险为无睡眠问题成年居民的1.237倍(OR=1.237,95%CI=1.122~1.364),成年居民≥60岁有睡眠问题的高血压患病风险为无睡眠问题成年居民的1.468倍(OR=1.468,95%CI=1.183~1.823);广东省成年居民睡眠时长过长的高血压患病风险为睡眠时长充足成年居民的1.228倍(OR=1.228,95%CI=1.046~1.442);女性成年居民睡眠时长过长的高血压患病风险为睡眠时长充足成年居民的1.340倍(OR=1.340,95%CI=1.006~1.786),≥60岁睡眠时长过长的成年女性居民高血压患病风险为睡眠时长充足成年居民的1.446倍(OR=1.446,95%CI=1.001~2.088)。

结论

广东省成年居民尤其是≥60岁居民有睡眠问题会增加高血压患病风险,睡眠时长过长亦会增加广东省成年居民尤其是女性和≥60岁居民的高血压患病风险。

, authors=蒋琦1, 纪桂元1, 黄盼盼2, 黄栩滨1, 洪晓敏1, 李嘉琪2, 闻剑2, 丁钢强2, 3, *, *, authorsList=蒋琦, 纪桂元, 黄盼盼, 黄栩滨, 洪晓敏, 李嘉琪, 闻剑, 丁钢强, authorCompany=null, correspAuthors=丁钢强, authorNote=

蒋琦(1984—),工程师,硕士,研究方向:营养与慢性病预防控制

, correspAuthorsNote=
丁钢强,E-mail:
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蒋琦(1984—),工程师,硕士,研究方向:营养与慢性病预防控制

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蒋琦(1984—),工程师,硕士,研究方向:营养与慢性病预防控制

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Comparison of hypertension prevalence among adult residents with different characteristics in Guangdong province

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特征分类调查人数高血压患病例数高血压患病率/% aχ2值P值
性别男性227180731.803.7870.052
女性271180427.83
年龄/岁18~44169216612.68282.407<0.001
45~59162351633.23
≥60166792957.92
文化程度小学及以下154269345.6039.550<0.001
中学/中专/技校226472131.83
大专及以上117619715.99
婚姻状况未婚3404313.2879.965<0.001
已婚42371 36030.49
离异/丧偶40520849.77
居住地城市37181 29130.550.1640.686
农村126432028.57
现在吸烟否39341 25130.010.1370.711
是104836030.74
饮酒频率从不饮酒35851 14529.3547.346<0.001
<1天/周85422925.74
1~4天/周29810333.50
5~7天/周24513460.44
身体活动低水平组177250224.6512.0560.002
中等水平组152851130.19
高水平组168259834.96
睡眠问题无239397036.59493.707<0.001
有258964123.05
睡眠时长不足108443737.19
充足316892726.8533.507<0.001
过长73024734.22
高血压家族史无35921 09227.4715.610<0.001
有139051935.57
体质量指数体重过轻2656520.80167.435<0.001
正常体重253260720.87
超重164365436.99
肥胖54228549.60
中心型肥胖否1 44775449.09392.910<0.001
是353585722.28
), ArticleFig(id=1321170738380386757, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170734538404229, language=CN, label=表1, caption=

广东省不同特征成年居民高血压患病情况比较

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特征分类调查人数高血压患病例数高血压患病率/% aχ2值P值
性别男性227180731.803.7870.052
女性271180427.83
年龄/岁18~44169216612.68282.407<0.001
45~59162351633.23
≥60166792957.92
文化程度小学及以下154269345.6039.550<0.001
中学/中专/技校226472131.83
大专及以上117619715.99
婚姻状况未婚3404313.2879.965<0.001
已婚42371 36030.49
离异/丧偶40520849.77
居住地城市37181 29130.550.1640.686
农村126432028.57
现在吸烟否39341 25130.010.1370.711
是104836030.74
饮酒频率从不饮酒35851 14529.3547.346<0.001
<1天/周85422925.74
1~4天/周29810333.50
5~7天/周24513460.44
身体活动低水平组177250224.6512.0560.002
中等水平组152851130.19
高水平组168259834.96
睡眠问题无239397036.59493.707<0.001
有258964123.05
睡眠时长不足108443737.19
充足316892726.8533.507<0.001
过长73024734.22
高血压家族史无35921 09227.4715.610<0.001
有139051935.57
体质量指数体重过轻2656520.80167.435<0.001
正常体重253260720.87
超重164365436.99
肥胖54228549.60
中心型肥胖否1 44775449.09392.910<0.001
是353585722.28
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广东省成年居民睡眠情况与高血压患病关系:基于2022年中国居民营养与健康状况监测数据分析
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蒋琦 1 , 纪桂元 1 , 黄盼盼 2 , 黄栩滨 1 , 洪晓敏 1 , 李嘉琪 2 , 闻剑 2 , 丁钢强 2, 3, *, *
中国公共卫生 | 调查报告与分析 2025,41(12): 1506-1510
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中国公共卫生 |调查报告与分析 2025 , 41 (12) : 1506 -1510
广东省成年居民睡眠情况与高血压患病关系:基于2022年中国居民营养与健康状况监测数据分析
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蒋琦1, 纪桂元1, 黄盼盼2, 黄栩滨1, 洪晓敏1, 李嘉琪2, 闻剑2, 丁钢强2, 3, *, *
作者信息
  • 1广东省疾病预防控制中心 广东省公共卫生研究院,广州 511430
  • 2广东省疾病预防控制中心营养与食品安全所,广州 511430
  • 3中国疾病预防控制中心营养与健康所,北京 100050
通讯作者:
丁钢强,E-mail:
作者简介:

蒋琦(1984—),工程师,硕士,研究方向:营养与慢性病预防控制

Sleep status and hypertension prevalence among adults in Guangdong province: a cross-sectional analysis of the 2022 China Nutrition and Health Surveillance
Qi JIANG1, Guiyuan JI1, Panpan HUANG2, Xubin HUANG1, Xiaomin HONG1, Jiaqi LI2, Jian WEN2, Gangqiang DING2, 3
Affiliations
  • 1Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
  • 2Institute of Nutrition and Food Safety, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
  • 3National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
  • Corresponding Author:
    DING Gangqiang, E-mail:
出版时间: 2025-12-10 doi: 10.11847/zgggws1146371
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目的

了解广东省成年居民睡眠情况与高血压患病的关系,为高血压的预防控制提供科学依据。

方法

收集2022年中国居民营养与健康状况监测项目中广东省11个监测点4 982名≥18岁成年居民的相关调查数据。应用多因素非条件logistic回归模型分析广东省成年居民有无睡眠问题和睡眠时长与高血压患病的关系。

结果

广东省4982名成年居民中,无睡眠问题者2 393人(49.41%),有睡眠问题者2 589人(50.59%);睡眠时长不足者1 084人(19.65%),睡眠时长充足者3 168人(66.54%),睡眠时长过长者730人(13.81%);患高血压者1 611例,复杂加权后高血压患病率为30.04%。在调整性别、年龄、文化程度、婚姻状况、居住地、是否现在吸烟、饮酒频次、身体活动情况、有无高血压家族史、体质量指数和是否中心型肥胖等混杂因素后,多因素非条件logistic回归分析结果显示,广东省成年居民有睡眠问题的高血压患病风险为无睡眠问题成年居民的1.237倍(OR=1.237,95%CI=1.122~1.364),成年居民≥60岁有睡眠问题的高血压患病风险为无睡眠问题成年居民的1.468倍(OR=1.468,95%CI=1.183~1.823);广东省成年居民睡眠时长过长的高血压患病风险为睡眠时长充足成年居民的1.228倍(OR=1.228,95%CI=1.046~1.442);女性成年居民睡眠时长过长的高血压患病风险为睡眠时长充足成年居民的1.340倍(OR=1.340,95%CI=1.006~1.786),≥60岁睡眠时长过长的成年女性居民高血压患病风险为睡眠时长充足成年居民的1.446倍(OR=1.446,95%CI=1.001~2.088)。

结论

广东省成年居民尤其是≥60岁居民有睡眠问题会增加高血压患病风险,睡眠时长过长亦会增加广东省成年居民尤其是女性和≥60岁居民的高血压患病风险。

高血压  /  睡眠问题  /  睡眠时长  /  成年居民  /  广东省
Objective

To explore the relationship between hypertension prevalence and sleep among adult residents in Guangdong province, providing scientific evidence for the control and prevention of hypertension.

Methods

Data were collected from 4 982 adult residents aged ≥18 years in 11 monitoring sites of Guangdong province in the 2022 Chinese Nutrition and Health Surveillance. The unconditional multivariate logistic regression model was employed to analyze the relationships of sleep problems and sleep duration with hypertension prevalence among adult residents in Guangdong province.

Results

Among the 4 982 adult residents in Guangdong province, there were 2 393 (49.41%) residents without sleep problems and 2 589 (50.59%) residents with sleep problems. Among them, 1 084 (19.65%), 3 168 (66.54%), and 730 (13.81%) residents had insufficient sleep, adequate sleep, and excessive sleep, respectively. There were 1 611 residents with hypertension, and the complex weighted prevalence of hypertension was 30.04%. After adjusting confounding factors such as gender, age, educational background, marital status, place of residence, current smoking, frequency of alcohol consumption, physical activity, family history of hypertension, body mass index, and central obesity, the results of the unconditional multivariate logistic regression analysis showed that the risk of hypertension among adult residents with sleep problems in Guangdong province was 1.237 times (95%CI: 1.122–1.364) that of adults without sleep problems. The risk of hypertension among adult residents aged ≥ 60 years and with sleep problems in this province was 1.468 times (95%CI: 1.183–1.823) that of those without sleep problems. The risk of hypertension among adult residents with excessive sleep was 1.228 times (95%CI: 1.046–1.442) that of those with adequate sleep. For female adult residents with excessive sleep, the risk of hypertension was 1.340 times (95%CI: 1.006–1.786) that of those with adequate sleep. For female adult residents aged ≥ 60 years and with excessive sleep, the risk of hypertension was 1.446 times (95%CI: 1.001–2.088) that of those with adequate sleep.

Conclusions

The risk of hypertension increased in adults with sleep problems in Guangdong province, especially in those aged ≥ 60 years. Excessive sleep duration was also associated with increased risk of hypertension, especially in females and the adults aged ≥ 60 years.

hypertension  /  sleep problems  /  sleep duration  /  adult residents  /  Guangdong province
蒋琦, 纪桂元, 黄盼盼, 黄栩滨, 洪晓敏, 李嘉琪, 闻剑, 丁钢强. 广东省成年居民睡眠情况与高血压患病关系:基于2022年中国居民营养与健康状况监测数据分析. 中国公共卫生, 2025 , 41 (12) : 1506 -1510 . DOI: 10.11847/zgggws1146371
Qi JIANG, Guiyuan JI, Panpan HUANG, Xubin HUANG, Xiaomin HONG, Jiaqi LI, Jian WEN, Gangqiang DING. Sleep status and hypertension prevalence among adults in Guangdong province: a cross-sectional analysis of the 2022 China Nutrition and Health Surveillance[J]. Chinese Journal of Public Health, 2025 , 41 (12) : 1506 -1510 . DOI: 10.11847/zgggws1146371
高血压是全球心血管疾病和全因死亡率的关键可预防风险因素之一。由于人口老龄化和不健康的生活方式等因素,高血压的发病率正在大幅上升[1]。中国20~39岁、40~59岁和60~79岁居民高血压患病率分别从1991年的4.5%、17.4%和43.0%上升到2015年的11.0%、32.6%和53.8%,分别升高144.4%、87.4%和25.1%,尤其在中青年人群中,高血压患病率的增幅最大,且男性高血压患病率普遍高于女性[2]。近年来,除了饮食、吸烟、饮酒和身体活动相关因素外,睡眠作为一种可改变的生活方式因素,与高血压之间的关联亦得到广泛关注[3]。多项研究表明,睡眠时长不足或过长均与高血压发病有关[4–7]。因此,睡眠时长可能在高血压患病中发挥作用。还有研究表明,睡眠时长与其他不健康的睡眠行为(如睡眠问题和睡眠障碍)相结合可增加心血管疾病和高血压的患病风险[8–9]。为了解广东省成年居民睡眠情况与高血压患病的关系,为开展高血压的预防控制工作提供科学依据,本研究收集2022年中国居民营养与健康状况监测项目中广东省11个监测点4 982名≥18岁成年居民的相关调查数据。应用多因素非条件logistic回归模型分析广东省成年居民有无睡眠问题和睡眠时长与高血压患病的关系。结果报告如下。
收集2022年中国居民营养与健康状况监测项目中广东省广州市越秀区和番禺区、韶关市南雄市、深圳市罗湖区和南山区、珠海市斗门区、佛山市顺德区、江门市台山市、云浮市罗定市、惠州市博罗县、阳江市阳东区11个监测点4982名≥18岁成年居民的相关调查数据。内容包括性别、年龄、文化程度、婚姻状况、居住地、是否现在吸烟、饮酒频次、身体活动情况、有无睡眠问题、睡眠时长、有无高血压家族史、体质量指数、是否中心型肥胖和是否高血压等。现在吸烟指调查时在吸烟的人,包括每日吸烟者和偶尔吸烟者[10]。饮酒指喝过购买或自制的各类含有乙醇成分的饮料,包括啤酒、果酒、白酒、黄酒、糯米酒和青稞酒等[10]。身体活动量=身体活动对应的代谢当量(MET)赋值×每周活动天数(d)×每天活动时间(min)[11];对工作、农业及家务、交通和休闲性身体活动中的高强度活动赋值为8.0 METs,中等强度活动赋值为4.0 METs[12];高水平组指每周高强度身体活动≥3 d且每周身体活动量≥1 500 METs·min,或各类身体活动总时间≥7 d,且每周身体活动量≥3 000 METs·min;中等水平组指每周高强度身体活动≥3 d,且每天至少20 min,或中等强度身体活动≥5 d,且每天至少30 min,或各类身体活动≥5 d,且每周身体活动量≥600 METs·min;低水平组指每周身体活动量未达到高水平组和中等水平组水平[13]。本研究中,在问题“过去30 d内,您是否每周至少3 d出现以下睡眠问题”中,回答“打鼾或窒息、憋气”“入睡困难”“中间觉醒 ≥2次”和“早醒,并难以重新入睡”中任意一项为“是”者被判定为有睡眠问题。睡眠时长指一天内包含午休的累计睡眠时长,参照《中国高血压防治指南(2024年修订版)》[14]对睡眠时长的推荐,本研究将睡眠时长<7 h/d、7 h/d~和≥9 h/d分别定义为睡眠时长不足、睡眠时长充足和睡眠时长过长。体质量指数=体重(kg)/[身高(m)]2,其中体质量指数<18.5 kg/m2为体重过轻,18.5~23.9 kg/m2为正常体重,24.0~27.9 kg/m2为超重,≥28.0 kg/m2为肥胖[15]。中心型肥胖指腰围男性≥90 cm、女性≥85 cm[15]。高血压指收缩压≥140 mmHg(1 mmHg=0.133 3 kPa)/舒张压≥90 mmHg,和/或已被乡镇(社区)级及以上医院诊断为高血压且近2周内服用降压药物者[14]。本研究经中国疾病预防控制中心伦理委员会审查批准(批号:2022-008),所有调查对象均签署知情同意书。
采用SAS 9.4软件进行统计分析。以2020年第七次全国人口普查数据[16]中广东省数据进行事后权重调整,按性别、年龄和居住地计算事后分层权重,计算广东省≥18岁成年居民的高血压患病率。定性资料采用相对数描述,率和构成比均经过复杂加权计算,各组内率的比较采用 Rao-Scott χ2检验;有无睡眠问题和睡眠时长与高血压患病关系采用复杂抽样设计的多因素非条件logistic回归模型进行分析。检验水准为双侧检验α=0. 05。
广东省4982名成年居民中,男性2 271人(55.72%),女性2 711人(44.28%);年龄18~44岁1 692人(43.06%),45~59岁1 623人(34.01%),≥60岁1 667人(22.92%);文化程度小学及以下1 542人(22.10%),中学/中专/技校2 264人(47.40%),大专及以上1 176人(30.50%);婚姻状况未婚340人(9.26%),已婚4 237人(84.82%),离异/丧偶405人(5.92%);居住在城市3 718人(74.22%),农村1 264人(25.78%);不吸烟3 934人(78.96%),吸烟1 048人(21.04%);从不饮酒3 585人(66.52%),饮酒<1天/周854人(21.62%),饮酒1~4天/周298人(7.68%),饮酒5~7天/周245人(4.18%);身体活动低水平组1 772人(34.97%),中等水平组1 528人(30.55%),高水平组1 682人(34.49%);无睡眠问题2393人(49.41%),有睡眠问题2589人(50.59%);睡眠时长不足1084人(19.65%),睡眠时长充足3168人(66.54%),睡眠时长过长730人(13.81%);无高血压家族史3 592人(66.74%),有高血压家族史1 390人(33.26%);体重过轻265人(5.19%),正常体重2 532人(47.62%),超重1 643人(34.74%),肥胖542人(12.45%);非中心型肥胖3 535人(71.02%),中心型肥胖1 447人(28.98%)。
广东省4982名成年居民中,患高血压者1 611例,复杂加权后高血压患病率为30.04%。广东省不同特征成年居民比较,不同年龄、文化程度、婚姻状况、饮酒频次、身体活动情况、睡眠时长、体质量指数及有无睡眠问题、有无高血压家族史、是否中心型肥胖复杂加权后高血压患病率不同,差异均有统计学意义(均P<0.01)。
在调整了性别、年龄、文化程度、婚姻状况、居住地、是否现在吸烟、饮酒频次、身体活动情况、有无高血压家族史、体质量指数和是否中心型肥胖等混杂因素后,多因素非条件logistic回归分析结果显示,广东省成年居民有睡眠问题的高血压患病风险为无睡眠问题成年居民的1.237倍(OR=1.237,95%CI =1.122~1.364);分层分析结果显示,≥60岁有睡眠问题成年居民高血压患病风险为无睡眠问题成年居民的1.468倍(OR=1.468,95%CI =1.183~1.823);有无睡眠问题在男性、女性和<60岁成年居民中与高血压患病风险的关联性差异均无统计学意义(均P> 0.05)。
在调整了性别、年龄、文化程度、婚姻状况、居住地、是否现在吸烟、饮酒频次、身体活动情况、有无高血压家族史、体质量指数和是否中心型肥胖等混杂因素后,多因素非条件logistic回归分析结果显示,广东省睡眠时长过长成年居民高血压患病风险为睡眠时长充足成年居民的1.228倍(OR=1.228,95%CI=1.046~1.442)。分层分析结果显示,女性睡眠时长过长成年居民高血压患病风险为睡眠时长充足成年居民的1.340倍(OR=1.340,95%CI=1.006~1.786),≥60岁睡眠时长过长成年女性居民高血压患病风险为睡眠时长充足成年居民的1.446倍(OR=1.446,95%CI=1.001~2.088);睡眠时长在男性和<60岁成年居民中与高血压患病风险的关联性差异均无统计学意义(均P> 0.05)。
本研究结果显示,2022年广东省成年居民高血压患病率为30.04%,较2015年广东省高血压升高了13个百分点。此外,2022年广东省成年居民高血压患病率亦高于2018年全国成年居民高血压患病率的27.5%[17]和浙江省成年人高血压患病率的29.39%[18],与2018年河南省成年人高血压患病率的30.2%[19]相近,但低于2020年湖北省成年居民高血压患病率的33.3%[20]。因此,对高血压相关危险因素的控制和健康宣教工作亟需加强。
有研究表明,睡眠质量越差,高血压患病概率越高[21–22]。近年来睡眠问题、睡眠障碍与高血压之间的关系已经得到广泛认可且越来越受到关注[23]。在调整性别、年龄、文化程度、婚姻状况、居住地、是否现在吸烟、饮酒频次、身体活动情况、有无高血压家族史、体质量指数和是否中心型肥胖等混杂因素后,多因素非条件logistic回归分析结果显示,广东省有睡眠问题成年居民高血压患病风险为无睡眠问题成年居民的1.237倍(OR=1.237,95%CI =1.122~1.364)。这可能与失眠者的自主神经、神经内分泌系统和神经免疫系统会出现失调的症状,如心率升高、去甲肾上腺素和皮质醇分泌增加、白细胞介素–6含量增加[24]以及血流动力学、生物节律[25]的变化导致血压的生理功能改变和病理变化有关。无论其他因素如何,阻塞性睡眠呼吸暂停的存在都与高血压患病率和发病率的增加有关[26]。对402例失眠合并高血压患者的研究亦表明,对治疗组给予改善睡眠的药物28 d之后,治疗组高血压患者的收缩压和舒张压均明显低于对照组[27],这提示通过改善睡眠问题将有助于降低高血压患病的概率。本研究分层分析结果显示,≥60岁有睡眠问题成年居民高血压患病风险为无睡眠问题成年居民的1.468倍(OR=1.468,95%CI =1.183~1.823),这可能是由于老年人更有可能失眠或患有睡眠呼吸障碍,而失眠和患有睡眠呼吸障碍均与较高的高血压患病风险相关[28]。
《中国高血压防治指南(2024)》建议高血压患者要保持健康睡眠,每晚睡眠时长为7~9 h[14]。既往研究[7,18,29–30]对睡眠时长与高血压患病关系的结论不同。北京市成年居民的研究显示,睡眠时长≥9 h/d可增加男性和≥45岁居民的高血压患病风险[7]。浙江省成年人的研究结果显示,与7~8 h/d的睡眠时长相比,睡眠时长< 6 h/d的女性和18~44岁居民患高血压的风险均较高;而睡眠时长≥ 9 h/d的男性患高血压的风险较高[18]。河南省农村的一项研究表明,长时间的夜间睡眠(≥10 h/d)与高血压患病率之间存在关联[29]。一项有关护士人群的纵向研究表明,睡眠时长≥9 h/d与女性护士人群高血压的患病率有关[30]。在调整性别、年龄、文化程度、婚姻状况、居住地、是否现在吸烟、饮酒频次、身体活动情况、有无高血压家族史、体质量指数和是否中心型肥胖等混杂因素后,多因素非条件logistic回归分析结果显示,广东省睡眠时长过长成年居民高血压患病风险为睡眠时长充足成年居民的1.228倍(OR = 1.228,95%CI = 1.046~1.442)。研究结果的不同可能与研究人群文化背景、环境和生活习惯的不同,甚至是参与者的性别差异有关[31]。分层分析结果显示,女性睡眠时长过长成年居民高血压患病风险为睡眠时长充足成年居民的1.340倍(OR = 1.340,95%CI = 1.006~1.786),≥60岁时间过长成年居民高血压患病风险为睡眠时长充足成年居民的1.446倍(OR =1.446,95%CI = 1.001~2.088)。睡眠时长与高血压的关联在青年与老年人之间的不同可能与交感神经激活导致高血压的机制不同有关。在青年人中,高血压大多是由于交感神经激活导致收缩压和舒张压升高;而在老年人中,60%的高血压是由于动脉顺应性丧失所导致的单纯收缩期高血压[32]。此外,老年人慢性病的患病率高于青年人,如高血压、糖尿病和代谢综合征等,而慢性病会增加老年人的死亡率,所以生存偏倚可能是导致青年人和老年人睡眠时长与高血压关联不同的原因[33]。本研究未发现睡眠时长不足与高血压患病之间的关联,可能与本研究未调整其他影响睡眠的混杂因素有关。综上所述,有睡眠问题会增加广东省成年居民尤其是≥60岁居民的高血压患病风险,睡眠时长过长亦会增加广东省成年居民尤其是女性和≥60岁居民的高血压患病风险。本研究调整了可能的混杂因素,能够较好地反映广东省成年居民睡眠问题和睡眠时长与高血压患病之间的关系,对于指导居民保持适宜的睡眠时长和提高睡眠质量具有一定的公共卫生学意义。但本研究仍存在一定的局限性:如,本研究中睡眠时长数据是通过研究对象自我回忆报告获得的,未经过量表测量,因此,可能存在一定的回忆偏倚;睡眠时长包括夜晚和白天的总睡眠时长,轮班工作与睡眠时长和昼夜节律逆转的变化相关已被证明是高血压的风险因素[34],而本研究中未考虑此因素。此外,尽管控制了一些潜在的混杂因素,包括人口学因素、生活行为和生理状况等,但仍可能存在其他如膳食因素和药物使用情况等未进行调整,且有研究表明糖皮质激素可以扰乱睡眠并导致高血压[35],这在本研究中亦未被考虑。因此,在今后的研究方案设计中应考虑尽量完善关于睡眠情况的调查问卷,包括参考相关的科学量表、分别记录夜晚和白天的睡眠时长以及增加睡眠相关药物服用情况的调查条目等。

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2025年第41卷第12期
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doi: 10.11847/zgggws1146371
  • 接收时间:2024-11-08
  • 首发时间:2026-10-25
  • 出版时间:2025-12-10
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  • 收稿日期:2024-11-08
  • 修回日期:2025-01-02
  • 录用日期:2025-08-06
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    1广东省疾病预防控制中心 广东省公共卫生研究院,广州 511430
    2广东省疾病预防控制中心营养与食品安全所,广州 511430
    3中国疾病预防控制中心营养与健康所,北京 100050

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