| Purpose To explore the exposure level of stroke risk factor,the variation characteristics of cerebral hemodynamic indexes,the proportion and distribution of population at high risk of stroke,the influence of risk factors on cerebral hemodynamic indexes in individuals with hypertension,diabetes,and aged≥50 years in Yangpu District community of Shanghai city.We also plan to indendify the change pattern of cerebral hemodynamic indexes in patients with hypertension or diabetes,in order to provide evidence for prevention of stroke in community population.Method We performed a cross-sectional study design and cluster sampling method in this study.Individuals were selected from Changbai and Wujiaochang Town in Yangpu District during October 2013 to december2013.In every community,we select 1200 people who were more than 50 years old,and invested their general situation,and detect the risk factors of stroke investigation,cerebral hemodynamics,and to unify the method of integral on hemodynamics.Finally,2031 people had respond,and the response rate is 84.6%.We described exposure levels of risk factors of stroke,distribution charicteristics of cerebrovascular hemodynamic indexes and the proportion of stroke high risk individals in this population.We divided the patients into different groups according to the risk factors such as hypertension,diabetes,hyperlipidemia,family history of stroke,overweight or obesity,cardiovascular disease,analysed and compared of the risk factors exposure levels and hemodynamic indexes,and described its characteristic.We finally analyzed the incidence of stroke based on the follow-up results,to clarify the relativity on the integral value of cerebrovascular function and other risk factors with the incidence of stroke.Result The exposure rate of hypertension,cardiovascular,diabetes,hyperlipidemia,stroke family history,overweight,obesity,cerebrovascular hemodynamic indexes(CVHI)<75 points,smoking,drinking and other risk factors in male is 57.3%、23.3%、21.0%、17.5%、23.9%、48.2%、42.4%、35.1%、23.4%,meanwhile in female is 48.5%、33.3%、17.0%、23.3%、28.2%、45.5%、41.8%、1.5%、1.5%.In addition to overweight or obesity and drinking outside,other factors between different age groups was statistically significant difference in(P<0.05).Except the obestity and cerebral hemodynamics integral value ratio <75,other factors between different gender while the proportion was statistically significant difference in(P<0.05).Systolic blood pressure,diastolic blood pressure(DBP),body mass index,cerebral hemodynamics integral values mean male were: 137.8±18.5,79.0±10.0,24.0±3.1,72.4±26.5,each age group differences were significant(P < 0.05);women were: 131.1±17.5,76.5±9.1,23.9±5.9,72.0±27.9,except for body mass index,the rest of the factors in each age group had significant difference(P < 0.05).The mean systolic pressure and diastolic blood pressure were significantly higher in male than that in female(P<0.01).Parameters,such as Qmean,Vmean,Vmax,Vmin and DP were decreasing with aging,while,parameters,such as Wv,Zcv,Rv,Dr and CP were rising with aging.In addition to the male right CP,the other indicators of different age groups were statistically significant differences(P<0.05).Male and female gender differences between different age groups were statistically significant indicators were Vmax,Vmin,Qmean,Rv,CP,Qmean,Vmax,Vmin,Wv,,Zcv,DP,CP,respectively.The abnormal rate of cerebral vascular function in male and female was 42.4% and 41.8% respectively,which increased with age.The relationship between the risk factors and cerebral vascular function score was:Cerebrovascular function exposure group was significantly lower than the control group the number of factors is the male hypertension(68.1±27.4;78.2±24.1),hypertension in women(63.5±29.6;80.0±23.4),history of cardiovascular disease in women(68.4±29.0;73.9±27.1),the male history of diabetes(64.5±26.8;74.5±26.0),women’s history of diabetes(59.8±30.9;74.5±26.5),overweight or obese(67.5±27.2;76.9 ±25.4),overweight or obese women(65.8±29.2;77.7±25.3);cerebral vascular function exposure group was significantly higher than the rate of abnormal factors in non exposed group(male hypertension 49.9%,32.4%)and women(55.3%,29.2%)of hypertension,history of cardiovascular disease in women(47%,39.2%),diabetes mellitus(59.1% male,38% female),diabetes mellitus(59.5%,38.2%),male(51.7% overweight or obese,33.8%),women are overweight or obese(53.8%,31.8%).According to hypertension and / or diabetes study group was divided into control group,hypertension group,diabetes group and type 2 diabetes mellitus and hypertension group,4 groups of cerebral hemodynamics integral value respectively(80.4±23.4),(67.9±28.0),(73.0±24.3)and(56.3±30.3),the difference was statistically significant(P < 0.01)cerebral hemodynamics integral value of the abnormal rate was 28.6%,48.9%,41.1% and 67.3%,the difference has statistical significance(P < 0.01).After 1 years of follow-up,the incidence of stroke in the target population was 1.6%,among which 2.5% were male and 1.3% were female.There was a statistical significance(P<0.05)between the upper and lower groups of cerebrovascular function and the incidence of stroke.Risk factors for the incidence of stroke in multivariate Cox regression analysis showed that female,hypertension,cardiovascular disease,diabetes and body mass index is an independent risk factor for stroke,hypertension had the strongest effect.Conclusion The exposure rate of risk factors of stroke in the elderly population is at a high level,with high blood pressure and overweight or obesity,the blood pressure level of men is significantly higher than that of women.The abnormal changes of cerebral blood flow dynamics index increased with age,and showed that the integral value of cerebral blood flow,blood flow and cerebral blood flow was decreased,and the velocity of pulse wave was increased.High risk individuals accounted for 42% of the cerebral blood flow dynamics score,the proportion of high-risk individuals increased with age.Most of the risk factors in the exposure group were significantly higher than those in the non exposed group.Both hypertension and diabetes have resulted in the increase of cerebral vascular hemodynamic abnormalities.The cerebral blood flow dynamics in patients with hypertension and diabetes mellitus is more obvious.The history of hypertension,hypertension,cardiovascular disease,history of diabetes and body mass index were the independent risk factors of stroke.The history of hypertension was the most important.Community stroke prevention in the prevention of stroke risk factors,especially hypertension,cardiovascular disease history,diabetes history and body mass index,cerebral vascular hemodynamic examination can be applied to the risk assessment of stroke. |
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