Epidemiological Investigation Of Hypertension In Adults In Central Urban Communities Of Shanghai China

OBJECTIVES:Hypertension is an important public health problem in urban China with a rapidly increasing prevalence noted in recent years. This study estimates the prevalence, awareness and control of hypertension in central urban area populations of4large communities in Changing District, Shanghai, China.METHODS:Multistage cluster sampling was used as cross-section investigation among adults25years and older in4central urban communities of Changing District (Zunyi, Xinhua, Chenjiaqiao and Beixinjing) in Shanghai, China. A total of21930urban residents aged25years and older were interviewed and examined. Blood pressure (BP) measurements were obtained using a standardized mercury sphygmomanometer after a5-min seated rest. Information on patient history of hypertension was obtained using a standard questionnaire. Hypertension was defined as mean systolic BP (SBP) at least140mmHg and/or diastolic BP (DBP) at least90mmHg, and/or self-reported current use of antihypertensive medication. Information on demographic and socioeconomic factors, health-related behaviors, anthropometric measures, morbidities, and self-rated health was collected through household interviews. Polytomous multiple logistic regression analysis was performed with use of a multinomial logit model.RESULTS:(1)Overall,39.23%of the population had hypertension. The prevalence in females is significantly higher than male (40.1%vs.38.2%, P<0.05); in patients younger than60years old, there is no significant difference of hypertension prevalence (18.5%vs.18.2%P>0.05), while in patients aged60years and over, the prevalence of hypertension in females is significantly higher than male (57.2%vs.55.4%, P<0.05). The prevalence of hypertension increases with increase in age.(x2=3771.750, P=0.000). (2)Among hypertensive patients,84.66%were aware of their hypertension. The awareness rate of hypertension also increases with increase in age (x2=112.508, P=0.000). The awareness rate of female is significantly higher than male (87.2%vs.81.4%, P<0.05).(3)Among hypertensive patients,56.8%achieved BP control (<140/90mmHg), which is not relative to age (x2=1.127, P>0.05). The control rate of female is significantly higher than male (57.6%vs.54.0%, P<0.05)(4)Regression analysis showed that the risk of hypertension was significantly (P<0.05) lower among employed and among groups with lower salt intake and BMI. Family history of hypertension increased risk of hypertension by a factor of2.6and family history of cardiovasculardiseaseincreased risk by a factor of1.1. The risk of hypertension was2.8times higher among diabetes mellitus patients,2.1times higher among hyperlipidemiapatients,3.1times higher among strokepatients,2.7times higher among organicheartdiseasepatients and1.4times higher among malignant tumor patients.CONCLUSIONS:(1)In the study population, the prevalence, awareness and control rate of hypertension are high. Prevalence and awareness are especially high in elderly people, while prevalence, awareness and control rate are especially high in females.(2)In central urban areas of Shanghai, China, it was observed that the prevalence of hypertension was associated with age, gender, family history of hypertension, family history of cardiovascular disease, employment status, and BMI. Diabetes mellitus, hyperlipidemia, stroke, organic heart disease, and malignant tumor are concomitant diseases of hypertension.