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Study On The Risk Factors Of Hypertension And The Evaluation Of The Comprehensive Intervention In The Rural Community Of Jiaxing

Posted on:2007-02-20Degree:MasterType:Thesis
Country:ChinaCandidate:W L GuFull Text:PDF
GTID:2144360182987092Subject:Epidemiology and Health Statistics
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Background and ObjectiveCardocerebrol vessel disease (CAVD) is a kind of severe life-threaten diseases. Hypertension is considered the strongest predictor of stroke and heart disease .The increase speed of incidence of hypertension in rural is more quick than that in city. This study is aimed to explore the risk factors of hypertension in rural area, and carry out and evaluate the comprehensive intervention in the place.Subjects and MethodsThe subects aged 25 to 74 years were selected from Zhangziyu (intervention community) and Lianglinqiao(control community). The baseline investigation was carried out in 1998, and the follow-up survey was done in 2003. The face-to-face interviev was used in the investigations. The questionnaire included general factors, and lifestyle, behavior, family history, family planning, medical history etc. The physical examination included blood pressure measure, stature and avoirdupois measure. The levels of serum glucose and lipids were done in our lab. A surveillance system was established to identify and ascertain any patient with an incident CAVD. Behavior intervention, drug intervention and health education were given to patients and high-risk population. Surveillance on blood pressure and health education were given to health population. Skillful practitioners from CAVD prevention office of Jiaxing, Jiaxing second hospital and Tanghui hospital were in charge of behavior and drug interrentions. Practitions from 5 sub-hospitals from Tanghui hospital made up of the detectingmanage group were responsible for measuring blood pressure and body weight, as well as propagandism of treatment and prevention knowledge for CAVD.The results of baseline and final investigation between two groups was compared;the evaluation index included epidemic index such as prevalence of hypertension, average blood pressure, and the grades of blood pressure. The percentages of awareness, takeing medication and control of hypertension, behavior index such as smoking, drinking, and accepting health education were also analyzed. Other index such as body mass index, biochemistry and mobility of complication were also involved.All of the data from baseline and follow-up surveys were checked, coded, and entered twice into computers by specially trained workers. Differences in means were tested by use of the 2-sample t test, and differences in frequencieswere tested with the %2 test. Logistic regression analyses were performed todetermine whether imbalance in any of the risk factors for hypertension might explain the intervention effect. Adjustment was made for age, baseline systolic and diastolic blood pressures, smoking, alcohol use, and BMI. The data were analyzed with SPSS 11.0 and SAS 8.2.ResultsIn 1998, the prevalence rate of hypertension in population of Jiaxing rural area was 24. 83% (age-standardized 20.86%) that increased with age. The prevalence rate of the male was significant higher than the female. The average systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 127. 0 mmHg and 76. 5 mmHg respectively. The percentages of awareness, taking medication and control of hypertension were 19.40%n 7.96% and 1.74% respectively.The risk factors of hypertension were drinking, obesity, cholestrol (TC), triglyceride (TG) and age;the OR were 2. 175(95%CI 1.64 to 2.886), 1. 999(95%CI 1.645 to 2.43), 2. 922(95%CI 1.398 to 6.107), 1.66(95%CI 1.217 to 2. 265), and 1. 086(95%CI 1.073 to 1. 1) respectively. The higher income classes and intakingof staple food were protective factors;the OR were 0. 809(95%CI 0. 669 to 0. 979) and 0.797 (95%CI 0.64 to 0.992) respectively.The effect of intervention was evaluated. In 1998, the prevalence rate of hypertension of intervention group was 30. 04%( age-standardized 24. 28%), and the rate was 20.35% (age-standardized 17.44%)in control group .There exsitedsignificant difference between the two groups(^2 =16.9, P =0.000038). In2003, it was 40. 92%( age-standardized 32.58%) and 41.62% (age-standardized 38. 55%), there exsited no significant difference between two group .The average age of the patients in intervention group was 60 years old in 1998, 55 years old in 2003. That in control group was 55 and 56. 7 years old respectively.In 1998, the average SBP and DBP in intervention group were significant higher than those in control group;while in 2003 they were significant lower in intervention group than those in control group. In 2003, the SBP and DBP in intervention group went up 3 mmHg and 1. 8 mmHg respectively, and they were 12. 2 mmHg and 7. 4 mmHg in control group. In 2003, the average SBP of patients in intervention group dropped 4 mmHg, while that in control group went up 1. 6 mmHg. The average DBP of patients in intervention group dropped 1. 1 mmHg, while that in control group went up 4. 4 mmHg.The proportion of person with normal blood presure in intervention group had decreased by 5%, while that in control group increased by 3%.The smoking rate had dropped significantly in two groups;the dropping range of smoking rate in intervention group was wider than that in control group. The drinking rate significantly dropped after comprehensive intervention in intervention group, but there was no significant difference comparing with control group.In 2003, the average levels of TC and blood glucose of the normal population and patients in intervention group were higher than those in 1998, but the average levels of high-density lipoprotein (HDL-C) dropped significantly. The levels of TG did not change. In the same time, the average levels of TC and blood glucoseof the normal population and patients in control group were higher than those in 1998, but the value of TG dropped significantly, and the average value of HDL-C did not change.In 1998, the percentages of awareness, taking medication and control of hypertension in intervention group were lower than those in control group. While in 2003, these three indexes in intervention group were higher than those in control group, increased 16.67%, 7.92%, 1.25%, to 52.72%, 33.89% and 4.60%, respectively, in intervention group compared with the control group.From 1999 to 2003, the numbers of incidence and mortality of CAVD in intervention group were fewer than those in control group.ConclusionsAge was the risk factor of hypertension in the Jiaxing rural population;the prevalence rates of hypertension in male and female were increased with the ages. Family economic income is the influent factor to hypertension. The lower the income was, the higher the prevalence of hypertension was. Drinking and overweight increased the risk of hypertension, while family medical history was not the main risk factor. The higher the blood lipids were, the higher the prevalence rate of hypertension was.Through comprehensive intervention, the rates of smoking and drinking dropped, while the rate of health education acceptance went up.Community comprehensive intervention is an effective way to increase the percentages of awareness, taking medication and control of hypertension, to control the standard of blood pressure of population and to decrease the standard of blood pressure of the patients, and to decrease the prevalence of complications.
Keywords/Search Tags:hypertension, risk factors, comprehensive intervention, effect evaluation, rural population
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