Cohort Study On Hypertension,Diabetes And Their Risk Factors Among Community Residents In Pudong New Area Of Shanghai

The world health organization has taken the monitoring of chronic diseases and their risk factors as priority areas of chronic disease prevention and control in developing countries. According to the Shanghai pudong district health bureau unified deployment, Pudong CDC carried out the monitoring of chronic diseases and their risk factors in 2008 and 2013 respectively, in order to build database of chronic diseases and master the epidemic situation and trend of the main chronic diseases and their risk factors dynamicly.The study has two parts, section 1 describes the epidemic situation of main chronic diseases in Pudong New Area of Shanghai, and Section2 researches the relationship between environmental factors with hypertension and diabetes. The main objective is to investigate and analyze the prevalence and incidence of main chronic diseases such as obesity, hypertension and diabetes of community residents aged over 15 in Pudong New Area of Shanghai, to explore the main risk factors of hypertension and diabetes, to analyze the relationship between obesity with hypertension and diabetes, so as to provide theoretical basis for community prevention and control of hypertension and diabetes.13 monitoring communities were randomly selected from Pudong New Area of Shanghai through multi-stage stratified sampling, and conducted chronic diseases and risk factors monitoring respectively in 2008 and 2013. Residents aged over 15 in these communities were interviewed and measured with height, weight, waist circumference, blood pressure and fasting glucose, in order to describe their prevalence and incidence of overweight and obesity, central obesity, hypertension, impaired fasting glucose and diabetes, to use multi-factor unconditioned Logistic regression to analyze the related environmental factors, to inspect the relationship between BMI, waist circumference and their change with hypertension and diabetes.The age standardized prevalence of main chronic diseases shows that overweight is 31.01%, obesity is 10.28%, central obesity is 38.30%, hypertension is 15.32%, impaired fasting glucose is 6.50% and diabetes is 6.74% in 2008, overweight 32.06%, obesity 15.23%, central obesity 44.59%, hypertension 34.19%, impaired fasting glucose 9.19% and diabetes 7.97% in 2013, incidence density of cohort shows that overweight is 49.13/thousand man-year, obesity is 19.34/ thousand man-year, central obesity is 64.50/thousand man-year, hypertension is 137.28/thousand man-year, impaired fasting glucose is 25.05/thousand man-year, and diabetes is 12.78/thousand man-year. The prevalence of 2008 is higher than that of 2013, and incidence is also high. The prevalence and incidence of men was significantly higher than women, increased with increased age and decreased degree of education, and marriage status also has some influence.The risk factor of hypertension is BMI, while the protective factor is tea history, the relative risk are 1.581 (1.328～1.883) and 0.678 (0.528～0.872) respectively, while the risk factors of diabetes are BMI, hypertension and diabetic history, the relative risk are 1.545 (1.137～2.101)、 1.776 (1.161～2.715) and 1.951 (1.183～3.220) respectively.Community residents’ average levels of blood pressure and fasting blood glucose tend to increase with the increase of BMI and waist circumference grouping, and the prevalence and incidence of each type and period hypertension, impaired fasting glucose and diabetes also gradually increased. The relative risk of hypertension and diabetes are 1.152(1.117～1.188) and 1.118(1.062～1.176), while waist circumference are 1.047(1.036-1.058) and 1.038(1.019～1.057). The attributable risk proportion of BMI for hypertension and diabetes are 13.14% and 10.55%, while waist circumference are 4.49% and 3.66%. The change of BMI and waist circumference is related with hypertension while without diabetes. After control of age, gender, education level, marital status and so on, BMI is related with hypertension and diabetes while waist circumference isn’t.The results of study point out that prevalence and incidence of obesity, hypertension and diabetes are high in community residents aged over 15 of Pudong New Area of Shanghai. And residents of middle and aged, men, lower education or unhappy marriage should be given more attention in the actual community prevention and control of chronic diseases. We should focusing on the related environmental factors of hypertension and diabetes, strengthen the intervention and control of overweight, obesity and abdominal obesity so as to prevent the chronic diseases and their related complications.