Objective: To investigate the association between the combination of different health-related behaviors and the risk of stroke in people with hypertension. Methods: The data in this study were obtained from the China National Stroke Screening Survey (CNSSS). The case group was the people with hypertension who were also diagnosed as the first-ever stroke cases (total stroke and ischemic stroke) during 2013-2014 screening period. Their corresponding controls (1∶3 frequency-matched for age group and urban/rural ratio) were randomly selected from individuals with hypertension without stroke. The information on demographic data, stroke history, influence factors and health-related behaviors (non-smoking, normal body mass index maintenance and physical activity) was obtained using standardized face-to-face questionnaires. Univariate analysis included t-test and Chi-square test. Multivariate analysis included unconditional logistic regression. Results: There were 603 total stroke cases (1 909 controls) and 536 ischemic stroke cases (1 608 controls) in men with hypertension, and 600 total stroke cases (1 800 controls) and 534 ischemic stroke cases (1 602 controls) in women with hypertension. We found that women with three health-related behaviors had lower risk of total stroke (OR=0.29, 95%CI: 0.11-0.79) and ischemic stroke (OR=0.28, 95%CI: 0.10-0.77). Only the combination of non-smoking and physical activity was significantly associated with the decreased risk of total stroke (OR=0.30, 95%CI: 0.11-0.78) and ischemic stroke (OR=0.32, 95%CI: 0.12-0.87). We had not found significant association between the combination of different health-related behaviors and risk of total stroke and ischemic stroke (P>0.05) in men. Conclusion: This study indicated that health-related behavior intervention might be more effectively to prevent stroke in women with hypertension, especially the smoking control and physical activity.
目的： 探讨高血压人群不同健康相关行为组合与脑卒中发病风险的关联。 方法： 本研究使用的数据来自中国脑卒中筛查项目数据库。以中国脑卒中筛查项目2013-2014筛查年度内首次发生脑卒中的高血压患者为病例组（1 203例），以年龄和城乡分布为匹配因素进行1∶3频数匹配，对照人群为相同筛查年度从未患过脑卒中的高血压患者。通过问卷调查收集研究对象的基本人口学信息、脑卒中病史及相关影响因素[健康相关行为包括不吸烟、保持健康体重指数（BMI）和体育锻炼]。采用非条件logistic回归模型分析健康相关行为与高血压人群脑卒中发病的关联。 结果： 男性脑卒中患者603例（对照1 909例），其中缺血型脑卒中患者536例（对照1 608例）；女性脑卒中患者600例（对照1 800例），其中缺血型脑卒中患者534例（对照1 602例）。在女性中，具有3个健康相关行为者总脑卒中（OR=0.29，95%CI：0.11~0.79）和缺血型脑卒中（OR=0.28，95%CI：0.10~0.77）的发病风险较低；在不同健康相关行为的两两组合中，不吸烟和体育锻炼者总脑卒中（OR=0.30，95%CI：0.11~0.78）和缺血型脑卒中（OR=0.32，95%CI：0.12~0.87）的发病风险较低。在男性中，具有健康相关行为与总脑卒中和缺血型脑卒中的发病风险关联均无统计学意义（P>0.05）。 结论： 脑卒中的行为干预措施可能对女性高血压患者更有效，尤其是控制吸烟和增强体育锻炼。.
Keywords: Hypertension; Lifestyle; Stroke.