| Objective:Cardiovascular disease is mainly a group of heart and blood vesselsabnormal circulatory system diseases, including rheumatic heart disease,hypertensive disease, ischemic heart disease, cerebrovascular disease,pulmonary heart disease and pulmonary circulatory diseases, congenitalheartdisease and peripheral vascular disease etc. Hypertension, coronary heartdisease, stroke pose the most serious health threats to human. During1950s tothe1960s, the pandemic of cardiovascular disease in some Western countrieshas accounted for half of the death of the whole society, has been cased asignificant burden to the economy and the labor reservation and caused thehighly attention of the medical professionals and even the society as a whole.So, to study the epidemiologic features of cardiovascular disease and relatedpreventing methods have become a common urgent consensus among themedical professionals. Among the them, the “Framingham study” led byDauber in1948and “the seven countries research” led by Ancel Key in1950were the two most important research, both of them are the foundationalresearch of epidemiology of cardiovascular research and were considered ascornerstone and milestone event. In China, the epidemiological studies ofcardiovascular disease began in the1950s and have a fast development in the1970s. With the large-scale epidemiological surveys conducted by themedical professionals and the epidemiological researchers, a lot of useful datahave been obtained which played a very important role in the prevention andtreatment of cardiovascular disease in China.According to the2011cardiovascular disease annual report：there areabout2.3million patients of cardiovascular disease in China and about3.5million patients die from cardiovascular disease every year which accounting for41%of the total causes of death each year. This cause up to130billionyuan cost for cardiovascular disease. Compared with the statistic data of2006and2008from the Ministry of Health; cardiovascular disease morbidity andmortality remains high, and poses a increasing trend. This epidemiologicalsituation warns us an urgent prevention and treatment of cardiovasculardisease.At the same time, numerous studies at home and abroad have shown thatmultiple risk factors can cause or aggravate cardiovascular disease. The mainmajor cardiovascular risk factors includes: age, gender, family history, highblood pressure, lipid abnormalities, abnormal glucose metabolism, smoking,overweight/obesity, lack of exercise, unhealthy diet, psychological stress etc.In the1990s, the World Health Organization (WHO) launched a10-yearcardiovascular disease investigation worldwide and recommended to preventcardiovascular disease through controlling these risk factors.The survey of cardiovascular disease and risk factors among thepopulation is not rare, however the research conducted for medical doctorsreally uncommon. The medical professional plays an critical role inmaintaining health with higher awareness of cardiovascular disease and riskfactors, however, the special work objects and the special work environmentof the work also contributed to the relative increase of cardiovascular riskfactors, such as psychological stress, lack of exercise, irregular diet etc. Thesefeatures are particularly evident in the hospitals staffs. In this study, weconduct analysis of cardiovascular disease distribution and major risk factorsdata from one Hebei Province hospital staffs to investigate the epidemicfeature of cardiovascular disease, in order to make targeted prevention andcontrol of cardiovascular disease among medical staffs and avoid the waste ofmedical resources.Methods1Survey objects: in2011, the2190staff took part in all the physicalexamination in one Hebei provincial hospital (total hospital staff3012). Allthe objects were divided into different groups according to the age, the gender and the work type. The age groups: younger than30years,30-45years,46-60years old, elder than60years old; the gender group: male and female groups;the working type groups: doctors, nurses, medical technicians andadministrative staff.2Survey content:①Physical Examination: Blood pressure, height, weight;and calculate body mass index (BMI): weight (kg)/height (m)2;②laboratory tests: fasting venous blood was collected, and measure serum lipids,blood glucose;③take face-to-face inquiry survey: the disease history ofcoronary heart disease, stroke, high blood pretension, blood lipidabnormalities, hyperglycaemia and family history (recognized by professionalexamination); calculate the treatment of hypertension rate and control rate,staff smoking status and exercise.3Statistical analysis: SPSS19.0was used for statistical analysis. The countdata describes a percentage; risk factors were analyzed using non-conditionallogistic regression analysis; proportions were compared using chi-square test,the statistics difference was set at P<0.05. Pairwise comparison among fourgroups，and test level is0.0071，the statistics difference was set at P<0.0071.Results:1Total3012hospital staffs,2190were selected in this study,822staff wereexcluded. The composition of the two groups in age, gender and occupationhave no statistical different (P>0.05). So the sample reflects the entire staffsituation.2The prevalence of cardiovascular disease2.1The standardized prevalence（age-adjusted rate）of coronary heartdisease and hypertension (8.9%,28.7%） among the staff in our study werehigher than the national average; however the prevalence of stroke（age-adjusted rate）（9.4‰） had no statistical difference compared with thenational level; The hypertension treatment and control ratio（87.6%,40.6%）were significantly higher than that of national level. 2.2The prevalence of coronary heart disease, hypertension and strokeincreased with age; the prevalence in male group is higher than that in femalegroup (P<0.05, pairwise comparison among four groups，P<0.0071）.2.3The prevalence of coronary heart disease, hypertension, and stroke weredifferent in different occupation groups(P<0.05): The prevalence of coronaryheart disease and stroke in doctor group was higher than nurse group; Theprevalence of hypertension in the doctor group is highest, the differences havestatics significance(P<0.0071).3Logistic regression analysis of cardiovascular risk factors: the occurrence ofcardiovascular disease was positively related to age, gender, dyslipidemia,hyperglycemia, smoking, overweight/obesity, lack of exercise, howeverfamily history has no relevance. The rank of above risk factors associatedwith cardiovascular disease from strong to weak order is: dyslipidemia,hyperglycemia, overweight/obesity, smoking, age, gender, lack of exercise（OR：19.030,7.426,5.954,4.464,2.314,2.119,2.044）.4Distribution of cardiovascular disease risk factors4.1Age groups: The prevalence of hypercholesterolemia, hypertrigly-ceridemia, elevated LDL-C and hyperglycemia increased with age, especiallyelder the age of45. The incidence of smoking was the highest between30to60years old, and the incidence of overweight/obesity was the highest elderthe age of45, and the differences have statistical significance (P<0.0071). Nosignificant difference was observed in the lack of excercise among differentage groups (P>0.05).4.2Gender: The incidence of hypercholesterolemia, low HDL-C,hyperglycemia, smoking, and overweight/obesity in the male group wassignificantly higher than that of the female group (P<0.05). Otherwise, theincidence of hypertriglyceridemia, elevated LDL-C and lack of exercise werenot found significant difference between different gender groups (P>0.05).4.3occupation groups: The prevalence of hypertriglyceridemia and lowHDL-C in the doctor group were obviously higher than that in the nurse group,medical technician group and administrative staff group. The incidence of hyperglycemia in the doctor group was higher than that in the nurse group andmedical technician group, and the incidence of overweight/obesityis higher than nurse group and administrative staff group. The incidence ofhypercholesterolemia, elevated LDL-C, smoking and lack of exercise indoctors and administrative staffs was higher than that of nurses and medicaltechnicians, the differences have statics significance (P<0.0071).Conclusion:1The prevalence of cardiovascular disease among the employees of thistertiary hospital is critical, we should strengthen the control of cardiovascularrisk factors.2Dyslipidemia, hyperglycemia, overweight/obesity, smoking, age, gender,lack of exercise are the cardiovascular risk factors in this tertiary hospital;46-60age group, male, doctors have more severe cardiovascular risk factors,more attention should be paid in prevention practice. |
PDF Full Text Request