| Background: Cerebral vascular accident（CVA）is a major challenge facing preventive medicine and clinical medicine both globally and in my country.Stroke is a type of disease that seriously damages the brain due to the sudden rupture or occlusion of the capillaries in the brain,which prevents blood from entering the brain,including hemorrhagic stroke（HS）and ischemic stroke（IS）.Ischemic stroke is one of the most common neurological diseases among middle-aged and elderly people,with high fatality and disability rates,and brings a serious disease burden to residents.Hypertension（hypertension/high blood pressure,HBP）is the most important independent risk factor for stroke.Monitoring the blood pressure of hypertensive patients is the key to the prevention and treatment of ischemic stroke.Therefore,long-term monitoring of blood pressure in acute hypertensive patients and early prevention and treatment of high-risk groups are also critical to improving the primary prevention of stroke in hypertensive patients.Dyslipidemia is a risk factor for stroke events and is associated with an increased risk of stroke disease.At present,traditional and non-traditional lipid indicators have been used as biomarkers to detect blood lipid levels.Non-traditional lipid indicators are a new type of blood lipid reference indicators developed on the basis of traditional blood lipid reference indicators in recent years,mainly including high density lipoprotein cholesterol/low density lipoprotein cholesterol（HDL-C/LDL-C ratio,triglyceride/high density liptein cholesterol（triglyceride/high density liptein cholesterol,TG/HDL-C）ratio,total cholesterol/high density liptein cholesterol（total cholesterol/high density liptein cholesterol）/low density lipoprotein,TC/HDL-C）ratio,non-high density lipoprotein cholesterol（non-high density liptein cholesterol,non-HDL-C）.At present,a large number of studies have confirmed that non-traditional lipid indicators are related to the occurrence and prognosis of cardiovascular disease（CVD）.).However,at present,the occurrence process of non-traditional lipid indicators in stroke and the impact mechanism on prognosis are still unclear,and domestic research on the influencing factors of non-traditional lipid indicators is also in the initial stage.Objective: In this study,through the data analysis of biochemical indicators and questionnaires of rural middle-aged and elderly people,the general health status of middle-aged and elderly people in Yuexi County,Anqing City was mastered,and the main influencing factors affecting the level of non-traditional lipid indicators in rural middle-aged and elderly people were clarified.Including general psychological factors and behavioral activities and other influencing factors,trying to contribute new indicators for stroke prevention and screening of high-risk groups,and to clarify the impact of various influencing factors on the risk of cardiovascular disease through non-traditional lipid indicators.Methods: From June 2020 to September 2020,a multi-stage random sampling method was used to conduct a current situation study to estimate the sample size,and select Wenquan Town Health Center,Maojianshan Township Health Center,and Hetu Town from Yuexi County according to their geographic locations.Eight township health centers,Changpu Township Health Center,Laibang Township Health Center,Tiantang Township Health Center,Xiangchang Township Health Center,and Lianyun Township Health Center are the investigation sites.30 patients with hypertension currently under management are randomly selected.Conduct on-site investigations.Several hypertensive patients were randomly selected from each township health center for hypertension screening as research subjects for questionnaire survey and biochemical tests.After the data collection was completed,Epi Data3.1 was used to double-enter the data,and SPSS 22.0 software was used for descriptive analysis of the data.Among them,the description of continuous data uses analysis of variance to compare the differences between groups;the description of categorical data is expressed by（%）.Two-sided test was used,and P<0.05 was regarded as statistically significant.Result:（1）Basic information of the research objectIn this study,the missing subjects of baseline blood lipid index data were removed,and middle-aged and elderly hypertensive patients aged ≥ 45 years were selected as the research subjects.A total of 2353 subjects were finally included in the survey.The average age of the total population was 68.0（66.0,74.0）years;the average monthly income was 150.0（110.0,500.0）yuan;the average systolic blood pressure（SBP）was149.0（138.0,161.3）mm Hg;Diastolic blood pressure（DBP）averaged 90.3（83.0,97.3）mm Hg;blood glucose averaged 4.9（4.4,5.5）mmol/L;total cholesterol averaged 4.2（3.6,4.9）mmol/L;triglyceride averaged 1.0（0.8,1.4）mmol/L;high-density lipoprotein average 1.3（1.1,1.6）mmol/L;low-density lipoprotein average 2.6（2.1,3.1）mmol/L;drinking rate 27.3%;smoking rate 32.4%;non-traditional lipids The average ratio of HDL-C/LDL-C was 0.5（0.4,0.7）;the average ratio of TG/HDL-C was 0.8（0.5,1.2）;the average ratio of TC/HDL-C was 3.2（2.5,4.0）;non-HDL-C Levels averaged-0.3（-0.7,0.3）;TG-LDL-C levels averaged-1.5（-2.0,-1.0）.（2）One-way analysis of variance for non-traditional lipid indicatorsThere was no significant difference in the ratio of HDL-C/LDL-C among people with different gender,education level,occupation,and marital status.The difference was statistically significant;the TG/HDL-C ratio of different genders was different between groups,and the difference was statistically significant.There was no statistically significant difference in C ratio;there were differences in TC/HDL-C ratio between groups with different gender and smoking status,and the difference was statistically significant.There was no statistically significant difference in the-C ratio;there were differences in non-HDL-C levels among groups with different gender,education level,and exercise status,and the difference was statistically significant.-HDL-C levels were not significantly different.（3）Influencing factors of non-traditional lipid indicatorsUsing non-traditional lipid indicators as the dependent variable,multiple linear regression analysis found that in the total population,the HDL-C/LDL-C ratio（β =-0.089,P < 0.001）of the group who smoked < 20 cigarettes per day was lower than that of the non-smoking group.The HDL-C/LDL-C ratio of the widowed population（β = 0.047,P =0.023）was lower than that of the unmarried population,and the difference was statistically significant;the HDL-C of the people who exercised more than 5 times a week The ratio of /LDL-C（β = 0.060,P = 0.004）was higher than that in the inactive group,and the difference was statistically significant.In the population,the ratio of TG/HDL-C in women（β = 0.042,P = 0.040）was higher than that in men,and the difference was statistically significant.In the general population,the ratio of TC/HDL-C in women（β = 0.061,P = 0.003）was higher than that in men,and the difference was statistically significant;smoking < 20 cigarettes per day TG/HDL-C The ratio（β = 0.067,P = 0.001）was higher than that of non-smokers,and the difference was statistically significant.In the general population,the non-HDL-C level of female population（β =-0.113,P < 0.001）was lower than that of male non-HDL-C level,and the difference was statistically significant;/HDL-C ratio（β =-0.044,P = 0.034）was lower than that of non-drinkers,and the difference was statistically significant;The non-HDL-C level of the junior high school population（β = 0.067,P = 0.002）was higher than that of the uneducated group,and the difference was statistically significant;the non-HDL-C level of the retired population（β = 0.051,P = 0.014）was higher The non-HDL-C level of the widowed population（β =-0.048,P = 0.019）was lower than that of the unmarried population,and the difference was statistically significant;the non-HDL-C level of the people who exercised more than 5 times a week The level of HDL-C（β = 0.104,P <0.001）was higher than that in the inactive group,and the difference was statistically significant.（4）Influencing factors of non-traditional lipid index stratificationThe HDL-C/LDL-C ratio（β = 0.062,P = 0.027）in female hypertensive patients was higher in the hypertensive patients in the 2-3 times weekly exercise group compared with the hypertensive patients in the inactivity group,and there was a difference Statistically significant（P interaction = 0.014）,the HDL-C/LDL-C ratio（β = 0.014,β =0.014,β = 0.014,P = 0.034）level,and the ratio of HDL-C/LDL-C（β = 0.077,P = 0.027）was increased in male hypertensive patients,and the difference was statistically significant（P interaction = 0.014）;TG/ There was no significant difference in the ratio of HDL-C between the exercise groups and the non-exercise group,and there was no significant difference between genders（P interaction = 0.791）.The difference was not significant,and there was no significant difference between genders（P interaction =0.791）.Compared with the hypertensive patients in the non-exercise group,the non-HDL-C level in the female hypertensive patients（β = 0.119,P < 0.001）levels increased,and the difference was statistically significant（P interaction = 0.014）,and there was no significant difference between genders（P interaction = 0.056）.Conclusion:1.The overall income of middle-aged and elderly people in rural areas of Anqing is lower,and the average income of men is higher;the average systolic and diastolic blood pressure of men is higher than that of women;the average blood sugar level of women is higher than that of men,and the overall blood lipid level of women is higher than that of men.2.Among the middle-aged and elderly hypertensive populations in rural Anqing City,the non-HDL-C level of the light-drinking population is lower than that of the non-drinking population,and a small amount of drinking can reduce the risk of stroke.3.Among the middle-aged and elderly hypertensive populations in rural areas of Anqing City,the HDL-C/LDL-C ratio of the smokers is lower than that of the non-smokers,and the TG/HDL-C ratio of the smokers is higher than that of the non-smokers.Increased risk of stroke.4.Among the middle-aged and elderly hypertensive population in rural areas of Anqing City,the level of non-HDL-C is higher in the population with lower education compared with the population without education,and the risk of stroke is higher than that in the uneducated population.5.Among the middle-aged and elderly hypertensive population in rural areas of Anqing City,the ratio of HDL-C/LDL-C in the exercising population is higher than that in the inactive population,and exercise can reduce the risk of stroke.6.Among the middle-aged and elderly hypertensive populations in rural Anqing City,the non-HDL-C level of the retired population is lower than that of the farmer population,and the risk of stroke is lower;Lower C levels are associated with lower risk of stroke.7.In the middle-aged and elderly hypertensive population in rural areas of Anqing City,both a small amount of exercise and a large amount of exercise in women can increase the ratio of HDL-C/LDL-C and reduce the risk of stroke;a lot of exercise in men can increase HDL-C/LDL The-C ratio level can reduce the risk of stroke;the effect of increasing the HDL-C/LDL-C ratio level is more significant in males than in females. |
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