| Part one:The investigation of hypertension prevalence and risk factors analysis for resident of Haizhu, Guangzhou.[Background]Hypertension is a common cardiovascular disease, serious harm human health, in the meantime, also a significant public health problem word wide. It also is one of the important risk factors of cerebral apoplexy, and Cerebral Apoplexy brings a heavy burden for families and community health care system because of the high morbidity and mortality. The report of the cardiovascular disease in China at2007indicated that our country has about200million patients with high blood pressure, about1/5of the total number in globe, and a prominent feature of hypertensive population in our country is most of them have the mild-to-moderate hypertension (90%), including mild hypertension for more than60%, and data shows that, by using of antihypertensive drugs treatment for mild hypertension does not reduce the cardiovascular disease morbidity and mortality. Even the pathogenesis of the hypertension is not clear yet, but there are some conclusions of the research of the hypertension’s risk factors.<China’s high blood pressure prevention and control guidelines> indicated that high sodium and low potassium diet is one of the most important risk factor which caused patients with high blood pressure be attacked by hypertension. Overweight and obesity will become another important risk factor of the growth of prevalence rate of hypertension in China. The latest research indicated that smoking, alcohol consumption, high fat diet, lack of exercise and family history of hypertension are the important risk factors of the morbidity of hypertension. Besides those, gender, age, body mass index, work and life pressure or in a wide range of occupational stress and education level are also important risk factors. In those factors, gender, age, and family history are not changeable; but high salt, high fat diet, exercise, smoking and alcohol consumption are changeable. Even if Hypertension is a chronic disease, but also it can be effective prevented and controlled. By adjusting the education measure based on the local conditions to the citizen, enhancing self-care ability of the citizen, advocating healthy and civilized life, consciously changing the behavior which relate to those risk factors, improving the awareness, treatment and control of high blood pressure, which can effectively improve the quality of people’s lives, reduce morbidity, and prolong life.[Objective]To assess the prevalence rate of hypertension in the invested area and analyze the correlative risk factors through this epidemiological investigation.[Method]Fengyang street, located in Haizhu community of Guangzhou, the population of permanent residents are the research objects. Inclusion criteria:18-65years old; No verbal communication barriers.There are20community residents’ committees,18021households, ordered by house’ number, extracted several households based on each committee’s population structure. Totally,1000households have been extracted, then according to Kish Grid table extracted one person in the family as the respondents.Provided and retrieved1000questionnaires totally. Rejected some disqualified questionnaires,972persons were investigated finally. There were481males with average age of45.07±13.343, and491females with average age of44.06±12.394.Recorded every interviewee includes baseline information, smoking, alcohol consumption, blood pressure, life stress, diet, physical exercise, high blood pressure status and contact.High blood pressure and diabetes will be subjected as above a level2hospitals diagnosis. Smoking:at least once per day, and at least over one year. Drinking:at least once per month, last more than six months at lifetime. Physical exercise frequency:often, three times per week and above; Occasionally, exercise1-2times per week; Almost no, exercise less than4times a month.By using Excel to install the database, inputted and checked data by two operators. Statistics and analysis use SPSS13.0software. The measure figures were tested by t test while the counting numbers Were tested by χ2test. Correlative risk factors were analyzed by multi-factor Logistic regression.[Result](1) There were154hypertension Cases out of total number972, in this investigation, the prevalence rate is15.8%.(2)The prevalence rate for male is16.8%, the prevalence rate for female is14.9%. There was no significant difference between those two rates.(3)There was no correlation in different life stress with hypertension respectively (P>0.05).(4)With the age increased, the prevalence rate of hypertension got higher.(5)There was significant correlation of different cultural Ievels(x2=49.292, P<0.01), which means that with the improvement of educational level, the prevalence rate of high blood pressure decreased obviously.(6) There was significant correlation of different monthly family income(χ2=16.679, P<0.05), which means that in addition to the lowest income level low hypertension rate, the others with the improvement of income level, presents downtrend hypertension prevalence rate.(7) There was correlation in different food tastes with hypertension respectively(χ2=20.816, P<0.01), among those salty diet has the highest hypertension prevalence rate.(8)The result of multi-factor analysis demonstrated that there are significant correlations of age, salty food, spicy diet, physical exercise, life stress, alcohol consumption (P<0.05), which means age, big life pressure, salty food, spicy diet, diabetes, and less exercise are the risk factors of hypertension, no drinking is the protective factor of hypertension; there are no significant correlations of monthly family income, smoking and eating sweet (P>0.05).[Conclusion]The prevalence rate in Fengyang street, Haizhu community of hypertension between18and65years old is15.8%. There are no significant correlations of sex, monthly family income, smoking and eating sweet respectively. Correlative risk factors of hypertension includs age, big life pressure, salty food, spicy diet, diabetes, less exercise, and alcohol consumption. For a risk factor for high blood pressure can be changed, a healthy and civilized lifestyle can be simple summarized as:rational diet, quit alcohol, weight control, exercise, and psychological adjustment. Adjusting the life and diet, controlling calorie intake, low salt, low sugar, low fat diet, eating more fruits, vegetables, fish and bean products, appropriate increase activity, weight control, but also stay away from alcohol and tobacco, having a regular life and peace of mind optimism. A health civilized lifestyle is not only conducive to the prevention of high blood pressure, for patients with high blood pressure, also have very positive meaning, abandon the bad lifestyle not only can make drug treatment more effectively, but also help lesions in reverse and reduce complications. Part two:Cerebrovascular disease knowledge, attitude and behavior research[Background]Stroke, also known as cerebrovascular accident, is caused by various factors in the brain, such as artery stenosis, artery occlusion, and artery rupture, triggered acute brain blood circulation which caused by dysfunction of nervous system diseases. Stroke has the characteristics of higher incidence, morbidity and mortality, which has the third mortality rate in the world, also the highest morbidity among adults. Stroke seriously harms the patient’s life health and quality of life, brings heavy burden of medical, economic, and social to family and society. In2006the ministry of health and ministry of science and technology hold the third time to review the cause of death sampling survey showed that cerebrovascular disease has become the first cause of death, accounting for22.45%of all deaths. It was the second cause of death which only below malignant tumors in the urban residents, however it was the first cause of death in rural residents. According to estimate the number of new patients who have the stroke increases about2million people every year; About1.5million people die each year because of cerebral apoplexy; survived patients about600-7million. According to statistics, among survived stroke patients, about three quarters of them lost the ability of labor in different degrees,40%were severe disability. At present our country spent nearly20billion Yuan a year because of the Stroke, aloes caused heavy economic burden to countries and many families. The stroke can be prevented; affecting stroke onset of traditional risk factors can be separate as preventable and unpreventable. Unpreventable risk factors include age, gender, race, ethnicity and family history, etc. preventable risk factors include high blood pressure, high cholesterol, diabetes, obesity, smoking, and drinking, etc. INTERSTROKE study showed that90%of the stroke related to ten major factors which include high blood pressure, diabetes, hyperlipidemia, heart disease, smoking, drinking, eating, abdominal obesity, physical activity and psychological factors. From the global experience centralized management mode for communities is an important strategy to prevent stroke and also is the effective measure to improve the level of human health. And cerebrovascular disease related knowledge, attitude and behavior (KAB) levels is the key to successfully prevent stroke in community.[Objective]Understanding citizens’cerebrovascular disease related knowledge, attitude and behavior (KAB) of the present situation in fengyang Street Haizhu community, o provide guidance for the community health education and prevention.[Method]By stratified random sampling of18-65years old citizen who is located in fengyang Street, Haizhu community, and non verbal communication barriers, and have a good understanding.Using stratified random sampling method. There are20committees in Fengyang Street, Haizhu community, based on each population structure, picked up1000household randomly; one of each household member was surveyed under Kish Grid Table. The ages of respondents are between18and65years old. By using investigators who are the post graduate students or Fengyang Street’s functionaries door to door investigate each respondent. During investigation procedure, reviewed the respondent if there were anything incomplete in the questionnaires. [Result](1)972persons were investigated into the analysis. Average age is (44,56±12.876), among people, there are481males, average age is (45.07±13.343) years old, accounts for the population surveyed49.5%;491are females, average age44.06±12.394years old (50.5%of people surveyed).(2) The education level, from did not receive formal education, primary school, middle school, high school/secondary, junior college, bachelor degree or above for the proportion are0.9%,9.7%,21.2%,32.1%,21.2%and12.9%separately.(3) Family income in2011, from the low level, middle level, middle level and upper level, the proportion of higher levels are14.3%,34.1%,27.1%,10.9%,27.1%separately.(4) The total smoking rate is22.2%, smoking quit rate is1.3%, the passive smoking is53.0%, drinking alcohol rate is27.7%,13.8%respondents eat an animal’s inside more than three times per week,13.1%diet salty taste, but most people have a good eating habit; The rate of prevalence of hypertension, coronary heart disease, and high cholesterol, diabetes are15.8%,5.2%,38.5%and5.2%respectively. Only33.3%declared that have regular physical exercise, the main reason of not participate in physical exercise is lack of time.(5)68.2%of the patients with high blood pressure measured blood pressure regularly,64.3%of patients will take antihypertensive drugs on time, reasonable diet, physical activity, weight control, quit alcohol rate is generally lower,12.3%of the patients with high blood pressure do not make any processing.(6),76.4%of people think that smoking is related to the occurrence of a stroke,19.0%of people do not know the relationship between smoking and stroke;13.1%said partial salty taste,72.4%of people would like to eat more light a bit;96.8%of people believe that regular moderate exercise is good for themselves; only70.3%of the respondents know the standard blood pressure rate. Only19.9%said they would actively to understand aspects of stroke health knowledge; Only48.5%of the people by the unit of organization or yourself regularly to medical examination from regular medical institutions, only38.0%of people will go to check if their bodies are uncomfortable; Only28.4%said they would take part in the prevention and control activities of brain stroke,29.4%said will not go to,42.2%said they would not go.(7)47.8%of the people hope that they can learn about cerebral blood disease by radio or television program,63.5%wanted to get to know through the network,65.2%people hope that through the medical staff on or outpatient consultation to understand.(8) Age, gender, level of education, and know not related to high blood pressure and the ideal blood pressure (P>0.05), the stroke awareness, and regular physical examination, blood pressure measurement conditions and the ideal of the blood pressure was statistically associated (P<0.05), suggesting than often focus on stroke knowledge awareness can make the standard blood pressure to rise, but did not measured the blood pressure and not regular check-up in a year has the low awareness of standard blood pressure.[Conclusion]The stroke related knowledge, attitude and behavior level is low in this community; needs to be educated to improve the life style behaviors. And community health behavior changing is a difficult, long and complicated project, needs all departments at all levels and the vast majority of community residents to join, and to implement step by step. |
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