| The prevalence of hypretension (HT) in China is increasing rapidly, particularly among rural population, which is due to the development of social economics, unhealthy lifestyle, the aging of the population and other factors. In addition, prehypertension (pre-HT) increases the risk of stroke, coronary heart disease, and myocardial infarction.An epidemiological investigation for prehypertension and hypertension was carried out from July to August in 2007 and 2008 in a rural population aged 35～74 years in Henan. The purpose of this study is to learn the distribution and risk factors of prehypertension and hypertension and their clustering status so that to provide a scientific basis for prevention and control of prehypertension and hypertension in the rural population.A total of 16953 representative participants aged 35～74 years in Xin'an county of Henan were selected randomly by cluster sampling technique from July to August in 2007 and 2008. Data were collected by questionnaire interview which includes demographic characteristics (sex, age, marital status, educational level, and per capita annual income etc.), lifestyle and behaviour risk factors (smoking, alcohol drinking, diet, and physical activity), and information regarding family history of hypertension. Anthropometric measurements included height, weight, waist circumferences (WC), and blood pressure). Fasting plasma glucose (FPG), total cholesterol (TC), triglyeride (TG), and high density lipoprotein cholesterol (HDL-C) were also measured. Cross-sectional and case-control study designs and statistical methods were used to analyze the data.1. Totally 16953 individuals were investigated. The males were 6615 (39.02%), and the females were 10338 (60.98%); the average age was (52.74±10.36) years old; the Abstract proportion of junior middle school education level and above was 48.79%, and the proportion of divorced/widowed was 7.38%.2. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) were (127.1±20.7) mmHg, (79.4±11.6) mmHg, and (47.8±13.0) mmHg, respectively. All the above values for females were significantly higher than that for males'(P<0.05). SBP and PP levels increased with age in both the males and females (P<0.05).3. The crude prevalence of pre-HT was 29.27%, and the age-adjusted rate was 29.27% by the population data of 2000 in China. The crude prevalence of HT was 33.15%, and the age-adjusted rate was 29.82%. The prevelence of pre-HT in men was significantly higher than that in women, whereas, the prevelence of HT was significantly lower than that in women (P<0.05). Data also indicates that the prevalence of HT increased with the increasing of age (P<0.05).4. Age, BMI, WC, WHtR, FPG, TC, TG, and LDL-C were positively correlated to SBP, DBP, and PP (all P<0.05), but HDL-C was negatively correlated to DBP (P<0.05). The factor analysis revealed that the first factor contained BMI, WC and WHtR; the second factor contained TC, HDL-C, and LDL-C; the third, fourth and fifth factor was TG, age, and FPG, respectively.5. Logistic regression analysis revealed that the following factors increased the risk of pre-HT significantly:family history of hypertension (father OR=1.39,95%CI: 1.21-1.60; mother OR=1.36,95%CI:1.21-1.53; both father and mother OR=1.50, 95%CI:1.25-1.79), former smoking (OR=1.40,95%CI:1.17-1.68), overweight (OR=2.02,95%CI:1.85-2.20), obesity (OR=2.93,95%CI:2.58-3.33), impaired fasting glucose (IFG) (OR=1.58,95%CI:1.37-1.82), diabetes mellitus (DM) (OR=1.38,95%CI:1.18-1.61), and dyslipidemia (OR=1.21,95%CI:1.12-1.31). However, physical activity (moderate OR=0.86,95%CI:0.78-0.96; severe OR=0.81, 95%CI:0.75-0.89) was negatively related to pre-HT. The population attributable risk proportion (PARP) of overweight, obesity, IFG, DM, and dyslipidemia to pre-HT were 27.30%,24.20%,4.90%,3.23%, and 8.71%, respectively. The independently significant risk factors for HT were family history of hypertension (father OR=2.60, 95%CI:2.25-3.01; mother OR=2.70,95% CI:2.40-3.04; both father and mother OR=4.09,95%CI:3.45-4.86), overweight (OR=2.94,95%CI:2.68-3.23), obesity (OR=7.45,95%CI:6.57-8.45), IFG (OR=1.90,95%CI:1.65-2.19), DM (OR=2.12, 95% CI:1.84-2.44), and dyslipidemia (OR=1.58,95%CI:1.46-1.71), but current smoking (OR=0.44,95%CI:0.36-0.52) and physical activity (moderate OR=0.82, 95%CI:0.73-0.92; severe OR=0.67,95%CI:0.61-0.74) were negative influencing factors for HT. The PARP of overweight, obesity, IFG, DM, and dyslipidemia to HT were 41.75%,51.60%,7.40%,8.99%, and 20.59%, respectively.6. The prevalence rates of overweight, obesity, IFG, DM, dyslipidemia, and lack of physical activity were 36.92%,16.53%,8.92%,8.84%,45.01%, and 30.73%, respectively. The prevalence of risk factors' clustering was 56.69%. With the increasing of risk factors clustering number, the levels of SBP, DBP, and PP increased (P<0.05). Compareing with the individuals having no risk factor, the OR (95% CI) of developing pre-HT for those having 1,2,3, and 4 risk factors were 1.24 (1.08-1.43), 1.58 (1.37-1.82),2.07 (1.75-2.45), and 2.50 (1.98-3.16), respectively; the OR (95%CI) of developing HT were 1.57 (1.32-1.88),2.78 (2.34-3.31),4.40 (3.64-5.32), and 5.58 (4.37-7.13), respectively.1. There is a serious prevalence status of prehypertension and hypertension in this rural population. Males aged 35～and females aged 45～are at high risk for prehypertension, whereas, males and females aged 65～74 are with high risk for hypertension.2. The major independent risk factors for prehypertension and hypertension are family history of hypertension, overweight, obesity, IFG, DM, and dyslipidemia, while the independent protective factor is physical activity.3. The common risk factors for prehypertension and hypertension have high exposed clustering status in the rural population.
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