Study On Hypertension Prevalence And Therapeutic Adherence In Qilihe Rural Area Of Lanzhou

Objectives:1) To explore the blood pressure and the prevalence of awareness, treatment, and control of hypertension among residents aged18years or older in rural areas of Qilihe in Lanzhou, and to identify potential factors associated with hypertension.2) To assess the knowledge of, attitudes towards, and health-seeking practices of hypertension in rural residents, and to explore their routes of knowledge acquisition regarding hypertension;3) To assess therapeutic adherence in people with hypertension and to analyze potential determinents of adhenrence;4) To discuss the appropriate analytical model for predicting hypertension.Methods:Residents aged18years old or older in rural areas of Qilihe in Lanzhou were chosen as the study population. A total of734residents from six villages were enrolled using random cluster sampling to take part in a survey conducted by a team from Lanzhou University School of public Health. The survey contained questions about family and socio-demographic characteristics; participants’ knowledge of, attitudes towards and health-seeking practices of hypertension; and physical measurement such as height, weight and blood pressure. The prevalence of hypertension was measured and then age-and sex-adjusted using data on the rural population from the2000China Population Cencus. Antihypertensive medication adherence was assessed using the Morisky Medication Adherence Scale. Binary logistic regression was employed to analyze the potential factors associated with hypertension, ordinal logistic regression was employed to analyse potential factors that associated with therapeutic adherence, and two-level binary logistic regression was employed to analyse the clustering effect.Results:1) Overall,43.57%of the participants, had hypertension. Among those participants,46.98%were aware of their condition,32.06%were taking antihypertensive medication, and9.84%lowered their blood pressure to target levels. The ajusted prevalence of hypertension was31.92%.2) Less than half of participants answered knowledge questions correctly, while over half answered attitudes questions correctly. The median scores for knowledge and attitudes were both less than one third of the full score; the median score for practices was less than two thirds of the full score.3) Age (OR=1.732, p0.001), education (OR=0.660, p=0.005), BMI (OR-2.241, p<0.001), other history of chronic diseases (OR=1.782, p=0.045), first degree relative with hypertension (OR=1.571, p=0.037), exercise (OR=0.810, p=0.012), sleep quality (OR=0.707, p=0.002) and consumption of vegetables (OR=1.443, p=0.021) were related to hypertension. The goodness-of-fit indices in the binary logistic regression model were-21nL=777.220and AIC=823.220, respectively, and the indices in the two-level binary logistic regression model were-21nL=776.249and AIC=822.249, respectively. There was no significant difference in the clustering effect at the village level.4)31.68%of patients taking antihypertensive medication had high therapeutic adherence. The main self-reported reason for poor therapeutic adherence was,"I don’t think it’s harmful not to take antihypertensive medication." Age (OR=0.700, p=0.024), the number of different antihypertensive medications (OR=0.446, P<0.001) and medicine expenditure (OR=0.255, p<0.001) were associated with therapeutic adherence.Conclusion:Hypertension was highly prevalent in rural areas of Qilihe in Lanzhou, and has become a major public health problem there. The percentages of participants who were aware of their hypertension, who were treated for their hypertension, who lowered their blood pressure to target levels, and who bad therapeutic adherence were unacceptably low. The main factors that affected hypertension and therapeutic adherence were controllable. Comprehensive intervention strategies for controlling the hypertension epidemic include strengthening health education, changing lifestyles, cultivating greater understanding of and public participation in diseases prevention, improving the ability of physicians to diagnose and treat hypertension, and increasing government investment in public health.