Prevalence Of Risk Factors Of Cardiovascular Disease Among A Rural Population And Validation Of A Novelty Screening Tool For Abnormal Glucose Metabolism

PART I PREVALENCE, AWARENESS, TREATMENT,CONTROL OF HYPERTENTION IN RURAL XIANGHEObjective: To investigate the prevalence, awareness, treatment,control and associated risk factors of hypertension in a rural population inXianghe.Methods: A total of830adults (aged>=35) from Xianghe wereexamined during2011.7-2011.8. Blood pressure was obtained using astandardized sphygmomanometer after a5-minute sitting rest. Informationon gender, age, education level, marital status, smoking, drinking, income,family history of hypertension and use of antihypertensive medications wasobtained.Results:42.4per cent of all subjects had hypertension. Amonghypertensives,54.8per cent were aware of their high blood pressure,50percent were taking antihypertension medication and11.9per cent achieved blood pressure control (<140/90mm Hg). Lower age and education level,smaller body mass index, negative family history of hypertension wereassociated with poor awareness of hypertension and worse compliance withtreatments. Older age, positive family history and alcohol consumptionwere associated with poor blood pressure control.Conclusions: Hypertension is highly prevalent in Xianghe rural area.The percentages of those with hypertension who are aware, treated, andcontrolled are low. These results underscore an urgent need forcomprehensive strategies to improve prevention, detection, and treatmentof hypertension in rural China. PART II PREVALENCE OF CARDIOVASCULAR DISEASEAND ITS RISK FACTORS IN RURAL XIANGHEObjective: To investigate the prevalence of cardiovascular disease(CVD) and its risk factors, and evaluate10-year risk of ischemiccardiovascular disease (ICVD) among a rural population in XiangHe.Methods: A cross-sectional design was used in this study. During2012.8-2012.10,2532adults (>=35) were surveyed by face-to-faceinterview, physical examination and biochemical test(2h-OGTT and bloodlipid test). Subjects aged35to59were evaluated using the National10-year Risk Assessment for ICVD.Results: The prevalence of stroke and coronary heart disease was2.2%and6.9%respectively, the age-and sex-standardized was1.3%and5.9%respectively. The prevalence of hypertension, diabetes, dyslipidaemia,overweight, obese and central obesity was59.9%,26.9%,68.6%,40.9%,14.8%and49.5%respectively, the age-and sex-standardized was43.8%，19.9%，56.5%，35.1%，15.6%，41.9%respectively. Up to41.4%malerespondents smoke. There are1336subjects aged35-59,14.1%respondents’(aged35to59)10-year ICVD risk was higher than10%.Conclusions: CVD and its risk factors were highly prevalent inXianghe, and10-year risk of ICVD was high in respondents aged35-59. Strategies for early detection and intervention are urgent needed toattenuate the CVD risk factors (such as diabetes) in rural China. PART III VALIDATION OF EZSCAN AS A SCREENINGTOOL FOR ABNORMAL GLUCOSE METABOLISMObjective: To evaluate the performance of EZSCAN as a screeningtool for impaired glucose metabolism (IGM), including impaired glucosetolerance, impaired fasting glucose and undiagnosed diabetes in a Chinesepopulation.Methords:876subjects participated in the study during2012.8-2012.10. All subjects underwent tests of EZSCAN, glycatedhemoglobin, fasting plasma glucose (FPG), and oral glucose tolerance test(OGTT). T test, chi-square test and Mann-Whitney U were used tocompare mean values. Correlation between electrical skin conductance(ESC) and glucose level was evaluated by Pearson correlation coefficient.EZSCAN performance was assessed by receiver operating characteristiccurve. Bland-Altman was used to evaluate the reproducibility of EZSCANtest.Results: Among the876subjects,53%had normal glucose tolerance(NGT), and47%had IGM. The ESC for the hands and feet was72±10μSand75±7μS, respectively, in NGT group; and64±13μS and67±11μS,respectively, in IGM group. The ESC at hands and feet was significantlycorrelated with both2h-OGTT and FPG (p<0.001). NGT groupdemonstrated a EZSCAN score of33±11%, which is significantly lower than that of IGM group (44±12%, p<0.001). The cut-off point of EZSCANfor IGM detection was40%with a sensitivity of80%and a specificity of72%. The coefficient of variation of EZSCAN for detection of IGM was5.9%. The result of EZSCAN test is not affected by gender difference.Conclusions: EZSCAN is a useful screening tool for identifyingsubjects at increasing risk for impaired glucose metabolism in prediabetesand diabetes. Diagnostic laboratory test should be performed in subjectswith EZSCAN scores greater than40%.