Intervention Study On People With Prehypertension And Its Cardiovascular Risk Factors In Inner Mongolia

Objective①To observe different intervention means of people with prehypertension andits cardiovascular risk factors in Inner Mogonlia.②To observe the effects of differentintervention means on the systolic and diastolic pressure of people with prehypertensionbefore and after the intervention..③To observe the correlation between the prehypertensionand cardiovascular risk factors.④To observe the risk factors of prehypertension maydevelop into hypertension.⑤To observe the effects of diffetent intervention means on thepeople with prehypertension, which develops into hypertention, diabetes and its endpoints, itprovides evidence for the early prevention and treatment of hypertention and has social andeconomic benefit.Methods The study is multi-center, foreseeing and randomized control study, and1112people, who live in region at least three years aged from20to59, are chosen as subjects, andare divided into four groups randomly, of which278cases are in the non-intervention group,life style group278cases, medication group278cases, life style and medication group278cases. After12-month follow-visit, collects age, height, weight, blood pressure, rhythm andall the cilinical examinations, as well as fasting blood glucose and blood lipids. Keep track ofblood pressure, rhythm and other clinical examinations and collect some cases of hypertention,diabetes and cardiovascular endpoints. And sign of informed consent.Results①After intervention the value has reduced among three groups,(medication andlife style group> medication group>life style group), medication and life style group hasclearer effects, the systolic and diastolic pressure of control group is higher than that beforeintervention. The systolic and diastolic pressure of four groups has statastic difference(p<0.05). Bobferroni method shows that systolic pressure of control group is different fromthat of the other three groups (p<0.05).②After intervention, waistline difference hasstatastic difference (p<0.05), but it is not clear between groups.(p>0.05) After intervention,TG, FPG difference of control group and other groups is significant statastically(p<0.05), compared with medication group, there is no significance (p>0.05). After intervention,hs-CRP control group, life style and medication and life style goup exist statasticsignificance (p<0.05), compared with medication, no significance (p>0.05).③With SBPand DBP as virables, and other research indicators as independent virables, perform partialcorrelation analysis, the results show that there is positive correlation between the SBP andage, rhythm, TG, blood glucose and family history (r=0.067,0.168,0.128,0,061,0,104,p<0.05), there is no correlation between SBP and gender, weight, height, waistline, BMI, TC,HDL-C, LDL-C, FPG, hs-CRP, smoking, drinking, diabetes.(p>0.05). There exists positivecorrelation between DBP and gender, age, rhythm, drinking, family history (r=0.069,0.103,0.128,0.062,0.120, p<0.05) and there is no correlation between BDP and weight, height,waistline, BMI, TG, TC, HDL-C, LDL-C, FPG, hs-CRP, smoking and diabetes.(p>0.05)④With SBP and DBP as virables, other indicators as independent virables, perform multivariatestepwise regression analysis, the results show that major influence factors on SBP are age,rhythm, TG, family history. The major influence factors on DBP are age, gender, rhythm,BMI, drinking, family history.⑤With systolic and diastolic pressure of the subjects whodevelop into hypertention patients as virables, systolic pressure, diastolic pressure, gender,age, weight, BMI, waistline, TG, TC, HDL-C, FPG, hs-CRP, smoking, drinking, familyhistory as independent virable, perform Logistic stepwise regression analysis, to find TC,hs-CRP, smoking, drinking, family history are main risk factors. OR is1.967,1.377,2.197,1.995respectively. BMI, hs-CRP, drinking, family history, and the risingof systolic and diastolic pressure of the subjects are the risk factors of hypentention. OR is1.516,1.814,0.234,2.908,1.749,1.600.⑥When the follow-visit ends,67cases withhypertention,32cases with diabetes, other endpoints12cases. Compared with control group,life style group, medication group and life style as well as medication group cases withhypertension reduce (p<0.05), life style group, medication group and life style as well asmedication group cases with diabetes reduce (p<0.05). In the three groups, the endpoints ofcardiovascular cases no difference.(p>0.05).Conclusion①The incidence of mortality of hypertension cardiovascular diseases hasdropped after intervention of different means.②Life style and medication interventiion ismore effective than that of other two means.③Life style and medication and life style canreduce the lipid, blood glucose and control obesity.④People with prehypertension are moresensitive to C reaction protein, which can be used to predict the hypertension detection index.⑤The SBP of people with prehypertension show positive correlation with age, rhythm, TG, blood glucose, family history. DBP shows positive correlation with age, gender, rhythm, BMI,drinking, family.⑥Age, rhythm, TG and family are the major factors of SBP, and age,gender, rhythm, BMI, drinking and family history are the major factors of DBP.⑦TC，hs-CRP, drinking, and systolic pressure rise are the main risk factors of hypertensiondeveloped by systolic pressure. BMI, hs-CRP, drinking, family history systolic pressure anddiastolic pressure rise are the major risk factors of hypertension developed by diastolicpressure.