동맥혈압의 가족집적현상(familial aggregation)에 대한 연구

Abstract

[한글]

우리나라에서 혈압의 가족집적현상을 분석하고자 경기도 강화군 강화읍에서 1986년 현재 국민학교 1학년에 재학중인 아동 486명 전수와 이들의 3대에 걸친 가족 2,089명에 대한 혈압 및 이와 관련된 사항을 1986년 7월 9일부터 동년 8월 18일까지 가정방문 조사하여 분석한 결과 다음과 같은 결과를 얻었다.

첫째, 조사대상가족에서 혈압의 가족집적현상이 있었다.

둘째, 가족구성원간 혈압에 유의한 상관이 있는 관계를 보면 수축기혈압에서는 기준아동-모(r=0.19), 기준아동-남매(r=0.21), 남매-부(r=0.21), 남매-모(r=0.15), 부-모(r=0.09) 및 조부-조모(r=0.22)이었으며, 이완기혈압에서는 기준아동-모(r=0.08), 기준아동-남매(r=0.11), 남매-부(r=0.17), 남매-조부(r=0.30), 남매-조모(r=0.17), 부-모(r=0.21),부-조부(r=0.18), 모-조부(r=0.22) 및 모-조모(r=0.13)의 관계이었다.

셋째, 부모가 고혈압일수록 남매간의 혈압의 상관관계가 높았으며 기준아동의 혈압이낮은 군에서는 다른 군에 비해 가족구성원 계층간의 혈압의 상관관계가 낮았다.

넷째, 공유하는 환경의 정도에 따라 혈압이 영향을 받았는데 부부사이에는 결혼기간이긴 경우에서, 남매간에는 나이차가 작을수록 혈압의 상관관계가 통계학적으로 유의하게높았다.

다섯째, 기준아동의 혈압은 부모의 혈압보다도 남매의 혈압으로서 설명할 수 있는 부분이 더 많았다.

여섯째, 혈압의 가족집적현상에 기여하는 유전적인 요인은 혈압전체의 분산 중 수축기혈압에서 최대 22.3%, 이완기혈압에서 최대 21.4%를 설명할 수 있다.

이상과 같이 우리나라에서 혈압의 가족집적현상의 정도는 외국의 다른 연구에비하여 비교적 낮았고, 가족집적현상에 유전적 요인이 기여하는 정도가 비교적 적었다.

또한 아동의 연령에 따라 가족집적현상에 차이가 있었는데 이는 아동이 성장함에 따라혈압의 가족집적현상에 영향을 미치는 유전적인 요인과 환경적인 요인의 상대적인 중요성이 변화할 수 있는 가능성을 보여준다.

[영문]

The purpose of this study is to examine familial aggregation of blood pressure in Korea for the early detection and possible prevention of hypertension. Data was collected from 486 families with first grade children who attended primary schools in Kangwha County based on a household interview and health examination survey conducted from July 9 to August 18, 1986. Blood pressure of 1972 family members from 3 generations was measured by mercury sphygmomanometers with the appropriate size of cuff. Height, weight, pulse rate, and arm circumference were also measured followed by an interview concerning preferences of salty foods and any anti-hypertensive drugs.

The following results of analysis were obtained:

(1) Familial aggregation of blood pressure was identified based on binomial goodness-of-fit test and analysis of variance.

(2) Significant correlations were found in systolic blood pressure for the following family members: index child-mother (r=0.19), index child-sibling (r=0.15), sibling-father (r=0.21), sibling-mother (r=0.15), father-mother (r=0.09), and grandfather-grandmother (r=0.22) relationship.

(3) Similarly, significant correlations in diastolic blood pressure were found in the following family members: index Child-mother (r=0.08), index child-sibling (r=0.11), sibling-father (r=0.17), sibling-grandfather (r=0.30), sibling-grandmother (r=0.17), father-mother (r=0.21), father-grandfather (r=0.18),

mother-grandfather (r=0.22), and mother-grandmother (r=0.13).

(4) Correlations of blood pressure among siblings were higher in families with hypertensive parents than with normotensive parents.

(5) Correlations of blood pressure among family members were lower in the families with index child whose systolic blood pressure was low than the families with index child whose systolic blood pressure was middle or above.

(6) Significantly higher correlations were found among the spouses with long marital period than the spouses with short marital period. Also the smaller the difference in age between siblings, the more significant correlation was shown. This shows that aggregation of blood pressure was also influenced by the degree of shared environment.

(7) The proportion of blood pressure of index child which could be explained by parental blood pressures was relatively small compared with the proportion explained by blood pressure of siblings.

(8) The genetic component in familial aggregation of blood pressure was estimated approximately 22.3% of total variance in systolic blood pressure and 21.4% in diastolic blood pressure, respectively.

As an implication for the further study, there is a need for the follow-up study on children's blood pressure since familial aggregation varies according to ages of offsprings.