| ObjectiveTo explore the correlation between multiple risk factors,Traditional Chinese medicine(TCM)constitution types and hypertension in young and middle-aged people and to screen out inde-pendent risk factors,so as to provide data support and theoretical basis for early prevention and treatment of hypertension.MethodsThis study adopted a hospital-based case-control study to collect 486 outpatient and inpatient patients as well as patients’ families and nearby community residents who voluntarily partici-pated in this study from January to December in 2018 at Dongzhimen hospital of Beijing uni-versity of traditional Chinese medicine.There were 243 cases in case group and control group,respectively.The general information of respondents,the related risk factors for hypertension and TCM constitution types were obtained through face to face questionnaire survey.Then,all qualified questionnaires were checked and input into Excel 2016 to establish a primary data-base.All collected datas conduct descriptive statistics,chi-square test and logistic regression analysis with SPSS25.0.Results1.General information:486 qualified subjects were included in this study,243 in case group and 243 in control group.In the case group,162 males and 81 females were enrolled.The control group included 145 males and 98 females.There was no significant difference between the two groups’ genders by chi-square test(P>0.05).Median and quartile were used to describe the age distribution characteristics of the two groups,the case group was 52(45,56)years old,and the control group was 52(46,56)years old.Non-parametric test was used for the ages of the two groups,the ages of the two groups were comparable(P>0.05).2.Correlation between hypertension and multiple risk factors in middle-aged and young people:the logistic regression results using Enter method showed that the OR values corresponding to heavy taste,number of chronic diseases≥1and<3,number of chronic diseases≥3,family history of hypertension,cervical spondylosis and moderate intensity exercise were statistically significant.Severe taste(OR=3.56,95%CI:1.487-8.523),number of chronic disea-ses≥1and<3(OR=4.246,95%CI:2.256-7.989),num-ber of chronic diseases≥3(OR=5.918,95%CI:2.585-13.548),family history of hypertension(OR=4.902,95%CI:2.72-8.832)and cervical spondylosis(OR=2.534,95%CI:1.461～4.394)were risk factors for hyper-tension in young and middle-aged people.Moderate intensity exercise(OR=0.376,95%CI:0.184～0.765)was the protective factor.Variables screened by logistic stepwise regression,according to the size of OR value,the influence degree of various influencing factors on the middle-aged and young hypertension order from large to small is:number of chronic diseases≥3(OR=8.922,95%CI:4.254～18.713),obesity(OR=7.135,95%CI:1.427～35.719),number of chronic diseases>1 and<3(OR=5.201,95%CI:2.894-9.347),family history of hypertension(OR=4.403,95%CI:2.529～7.666),heavy taste(OR=3.876,95%CI:1.678～8.955)and cervical spondylosis(OR=2.406,95%CI:1.432～4.042)are independent risk factors for hypertension in young and middle-aged people.Moderate intensity exercise(OR=0.345,95%CI:0.172～0.692)was the protective factor.3.Correlation between hypertension and TCM constitution types in middle-aged and young people:univariate logistic regression was performed for 9 constitutions and their collateral matter in TCM constitution classification and judgment table,and the results showed that balanced yin-yang constitution,phlegm-dampness constitution were correlated with hyper-tension in middle-aged and young people(P<0.1),OR value and 95%CI were 0.347(0.256～0.547)and 13.917(6.247～31.002),respectively.After regressive diagnosis,it was found that there were collinearity problems in balanced yin-yang constitution,phlegm-dampness constitution and merge-constitution.Stepwise regression was further performed to select variables to solve the problem of co-llinearity,and the phlegm-dampness constitution and merge-constitution were included(P<0.05),OR value and 95%CI were 16.938(7.505～38.225)and 1.8(1.184～2.737),respectively.In order to rule out the influence of the presence of the merge-constitution on the actual clinical situation,the merge-constitution were divided into constitutional elements and then combined with a single constitutional type for univariate logistic regression analysis.The results showed that the balanced yin-yang constitution element and phlegm-dampness element were the influential factors of hypertension in young and middle-aged people(P<0.1),OR value and 95%CI were 0.374(0.256～0.547)and 4.746(3.128～7.202),respectively.Regression diagnosis showed that there was no collinearity among independent variables.Logistic stepwise regression was used to select independent variables,and only phlegm-dampness factors were included in the equation,OR value and 95%CI was 4.746(3.128～7.202),phlegm-dampness was an independent risk factor for hypertension in young and middle-aged people.4.Correlation between the hypertension of phlegm-dampness constitution and multiple risk factors in young and middle-aged people:univariate logistic regression showed statistically significant differences in age,waist circumference and BMI(P<0.1),which were correlated with the occurrence of the hypertension of phlegm-dampness in young and middle-aged people,OR value and 95%CI were 0.282(0.138～0.557),2.062(1.317～3.228),and 1.636(1.073～2.494),respectively.Independent risk factors were screened by Logistic stepwise regression,and the results showed that the OR value corresponding to waist circumference and age was statistically significant(P<0.05),the OR value and 95%CI of abdominal obesity were 5.104(1.707～15.263),and the OR value and 95%CI of age were 0.219(0.100～0.481).Conclusions1.Heavy taste,obesity,family history of hypertension,more than one chronic disease and cervical spondylosis are independent risk factors for hypertension in young and middle-aged people,while moderate intensity exercise is a protective factor.2.Phlegm-dampness is a risk factor for hypertension in young and middle-aged people,merge-constitution may be a dangerous constitution and balanced yin-yang constitution may be a protective factor.3.Abdominal obesity is an independent risk factor for the hypertension of phlegm-dampness in young and middle-aged people.Young people with hypertension are more likely to develop phlegm-dampness than middle-aged people. |
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