中国西北地区老年高血压人群的健康相关生命质量研究

摘要： 背景 高血压在中国是一个日益严重的公共卫生问题，近年来越来越多的研究开始关注高血压老年人的生命质量，并探讨影响其生命质量的因素，对于制订有效的高血压健康管理计划意义重大。 目的 本研究旨在利用中文欧洲五维度量表（EQ-5D-5L）和中文15D量表测量西北地区高血压老年人的健康效用值（HSU），评估健康相关生命质量（HRQoL），并探讨影响老年人HRQoL的主要因素。 方法 2021年在甘肃省兰州市随机招募2 000名老年人，通过问卷调查、基础体检和实验室检查收集临床资料，采用EQ-5D-5L和15D量表测量HSU。采用亚组分析、Tobit回归和多元线性回归分析探究老年人HRQoL的影响因素。 结果 共有1 784名老年人完整参与本次研究，其中50.9%的老年人血压正常，676名（37.9%）老年人为Ⅰ级高血压，152名（8.5%）为Ⅱ级高血压，48名（2.7%）为Ⅲ级高血压，这些患者的HSU在EQ-5D-5L中分别为0.949、0.942、0.933和0.921，在15D量表中分别为0.875、0.863、0.851和0.840。Tobit回归分析显示，在EQ-5D-5L中，性别、年龄、受教育年限、职业状态和年收入与老年人HSU相关（P<0.05），多元线性回归分析显示，在15D量表中，性别、年龄、受教育年限、高血压和饮酒与老年人HSU相关（P<0.05）。 结论 随着高血压分级的增加，EQ-5D-5L和15D量表的HSU均逐渐降低，表明HRQoL逐渐受损，影响老年人HRQoL的因素包括性别、年龄、高血压、受教育年限、婚姻状况、职业状态、年收入和饮酒。

关键词: 健康相关生命质量, 老年人, 高血压, EQ-5D-5L, 15D量表

Abstract:

Background

Hypertension is a growing public health problem in China. In recent years, more and more studies have begun to focus on the quality of life of hypertensive older adults, and explore the factors affecting their quality of life, which is of great significance for the development of effective health management programs for hypertension.

Objective

To measure the health state utility (HSU) of hypertensive older adults in Northwest China using the EQ-5D-5L scale and the 15D scale, evaluate the health-related quality of life (HRQoL) of them, and explore the main factors affecting HRQoL in the elderly.

Methods

A total of 2 000 older adults were randomly recruited in Lanzhou City, Gansu Province in 2021, the clinical data were collected through questionnaires, basic physical examination and laboratory tests, and HSU was measured using the EQ-5D-5L and 15D scales. Subgroup analysis, Tobit regression analysis and multiple linear regression analysis were used to evaluate the factors affecting HRQoL.

Results

A total of 1 784 older adults participated in this study, 50.9% of them had normal blood pressure, 676 (37.9%) had stage 1 hypertension, 152 (8.5%) had stage 2 hypertension, 48 (2.7%) had stage 3 hypertension, the HSU of these older adults were 0.949, 0.942, 0.933, and 0.921 in the EQ-5D-5L, and 0.875, 0.863, 0.851, and 0.840 in the 15D scale, respectively. Tobit regression analysis showed that gender, age, years of education, occupational status, and annual income were associated with HSU in older adults in the EQ-5D-5L scale (P<0.05), multiple linear regression analysis showed that gender, age, years of education, hypertension, and alcohol consumption were associated with HSU in older adults in the 15D scale (P<0.05) .

Conclusion

The HSU of older adults in both EQ-5D-5L scale and 15D scale gradually decrease with the increase of blood pressure level, indicating a progressive impairment of HRQoL. Factors affecting HRQoL in older adults include gender, age, hypertension, years of education, marital status, occupational status, annual income and alcohol consumption.

Key words: Health-related quality of life, Aged, Hypertension, EQ-5D-5L, 15D scale

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