| Background: Hypertension is closely related to renal function.It is an independent risk factor for chronic kidney disease(CKD)and one of the main factors for CKD progression.CKD patients are often complicated with other diseases,such as hypertension,diabetes,etc.The risk of hypertension complicated with CKD is increased,and hypertensive nephropathy is one of the most important primary diseases of end-stage renal disease.In recent years,the incidence of metabolic diseases such as central obesity and hypertension has been increasing in China,and the proportion of the causes of CKD is also increasing,which has reached a point that cannot be ignored.However,the early symptoms of CKD are hidden and difficult to detect,and renal function is often seriously damaged at the time of diagnosis.The estimated glomerular filtration rate of mild decline has predictive value for the progression of renal disease.Therefore,as a high-risk group,hypertensive patients explore the risk factors of mild decline in renal function in hypertensive patients and carry out early intervention,which is of great significance for preventing the occurrence and development of CKD.Objective: The purpose of this study was to investigate the general status of patients with hypertension in Yuexi County,including general demographic data,behavioral lifestyle,renal function decline,etc.,and to analyze the influencing factors of mild renal function decline.It provides a reference for hypertensive patients to reduce the early damage of renal target organs,early prevent the decline of renal function and the occurrence and development of chronic kidney disease,improve the self-management level of hypertensive patients,reduce the occurrence of cardiovascular and cerebrovascular events,reduce the risk of death and medical burden,and provide reference for managers to formulate and implement hypertension strategies.Methods: A simple random sampling method was used to study the current situation from June 2020 to September 2020.Yuexi County of Anqing City was selected as the research base.Seven towns(Hetu Town,Laibang Town,Wenquan Town,Maojianshan Town,Tiantang Town,Lianyun Town and Xiangchang Town)were randomly selected from 24 towns in Yuexi County.In each township,30 % of the hypertension patients registered according to the basic public health service project were randomly selected.Under the premise of obtaining the consent of the respondents,the respondents were mobilized by township hospitals,village cadres and village doctors to organize the respondents to the local township hospitals.Blood pressure measurement,physical examination,questionnaire survey and biochemical index detection were performed by the investigators.Estimated glomerular filtration rate(e GFR)was calculated using the CKD-EPI formula proposed by the American Collaboration on Chronic Kidney Disease Epidemiology.60 m L /(min·1.73 m2)≤ e GFR < 90 m L /(min·1.73 m2)was the mild renal function decline group.The e GFR > 90 m L /(min·1.73 m2)was defined as normal renal function group.Epi Data 3.1 was used to establish a database for double entry of the collected data.SPSS 22.0 and Empower 2.0 software were used for statistical analysis.T test and chi-square test were used to compare the differences between groups of hypertensive patients with different renal function status.Multivariate binary logistic regression was used to analyze the influencing factors of mild renal function decline in hypertensive patients in Yuexi County.Bilateral tests were performed,and the test level was α= 0.05.Results: A total of 1959 hypertensive patients were included in the final analysis.The age of 1959 hypertensive patients was(69.2±7.0)years old,concentrated between60-80 years old,of which 1005(51.3%)were 60~70 years old and 671(34.3%)were70~80 years old.There were 976 males(49.8%)and 983 females(50.2%).The BMI was(22.9±3.5)kg / m2.There were 1044 people with normal weight(53.3%)and588 people with overweight(30.0%).There were 482 people(24.6%)had family history of hypertension.There were 563 drinkers(28.7%).There were 626 smokers,accounting for 32 %.512 people exercise every week,accounting for 26.1 %.152(7.8%)had diabetes,66(3.4%)had hypercholesterolemia,120(6.1%)had hypertriglyceridemia,387(19.8%)had low HDL-C and 83(4.2 %)had high LDL-C.There were 1231 people in the mild renal function decline group,accounting for 62.8 %,and 728 people(37.2%)had normal renal function.Univariate analysis showed that there were significant differences in age,partner status,history of hypertension,degree of obesity,central obesity,fat intake,sleep time,prevalence of low HDL-C and high LDL-C among hypertensive patients with different renal function status.Multivariate Logistic regression analysis showed that age,obesity,sleep time,fat income,low HDL-C,high LDL-C and central obesity were the influencing factors of mild renal function decline in hypertensive patients(all P<0.05).Conclusion: The detection rate of mild decline in renal function in patients with hypertension in Yuexi County was higher.Advanced age,high BMI,central obesity,high LDL-C,low HDL-C and short sleep time are risk factors for mild renal function decline in patients with hypertension in Yuexi County.Low fat intake is a protective factor for mild renal function decline in patients with hypertension in Yuexi County.It is suggested that patients with hypertension should focus on the elderly population while controlling blood pressure,pay attention to controlling body weight and blood lipid levels,advocate low-fat diet,and maintain good sleep to reduce the early damage of kidney target organs and prevent the occurrence and development of CKD. |
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