Urban-rural Comparison On The Prevalence And Its Influencing Factors Of Hypertension Among Adults In Changchun

ObjectivesTo examine the different disease characteristics of hypertension and itsinfluencing factors among adults between urban and rural areas of Changchun Citythrough analyzing prevalence and distribution of hypertension from Changchun City,and to provide evidences for making targeted prevention and control strategies inurban and rural areas.MethodsCommunity residents who were aged18~79years old and had lived inChangchun City for6months were recruited. By the multi-stage and stratified randomcluster sampling method,5662residents were selected to carry out physicalexaminations and investigations face-to-face． Information obtained from thequestionnaire included socio-demographic characteristics, behavior characteristics,dietary characteristics and family history of circulation system diseases. Theanthropometric measurements included height, weight, waist circumference and bloodpressure. Data were entered into computer using EpiData (Version3.1) and wereanalyzed using SPSS (Version21.0). Complex weighted computation was used toanalyze all of the statistics. According to the general population structure,comparisons of prevalence between urban and rural areas were standardized withmethod of direct standardization. The Rao-Scott χ2test was used to assess differencesin categorical variables based on the complex sampling model. Logistic regressionanalysis was used to test significant determinants of hypertension.Results(1) The total prevalence of hypertension among adults of Changchun City was28.8%. There were2,320urban residents and2,842rural residents in the survey.Besides, the prevalence and standardized prevalence of hypertension in urban areaswere27.5%and25.8%respectively, and in rural areas were30.4%and29.5% respectively. The prevalence of hypertension among rural adults was higher than thatamong urban adults.(2) The prevalence of hypertension among urban and rural adults weresignificantly different in different age groups (Urban:χ2=110.044, P<0.001；Rural:χ2=53.338, P<0.001) and increased with age. The prevalence of hypertensionamong urban males and females was32.5%and22.5%respectively. The prevalenceof hypertension among rural males and females was33.9%and27.0%respectively.The prevalence of hypertension among urban and rural adults was significantlydifferent in different gender (Urban:χ2=36.064, P<0.001; Rural: χ2=13.028, P<0.001).(3) The multivariate Logistic regression showed that higher age group35~44years old (Urban:OR=4.332,95%CI:2.410~7.790; Rural:OR=3.687,95%CI:1.761~7.721),45~54years old (Urban:OR=9.918,95%CI:5.636~17.453;Rural:OR=6.761,95%CI:3.262~14.014),55~64years old (Urban:OR=16.504,95%CI:9.301~29.284; Rural:OR=14.021,95%CI:6.820~28.825),65~79years old(Urban:OR=31.002,95%CI:16.737~57.425; Rural:OR=26.168,95%CI:12.367~55.370), male (Urban:OR=1.946,95%CI:1.600~2.368; Rural:OR=1.358,95%CI:1.113~1.657), the family history of circulation system disease(Urban:OR=1.788,95%CI:1.465~2.181; Rural:OR=1.431,95%CI:1.166~1.755),overweight (Urban:OR=1.809,95%CI:1.414~2.313; Rural:OR=1.759,95%CI:1.390~1.225), obesity (Urban:OR=2.862,95%CI:2.003~4.088; OR=4.022,95%CI;2.765~5.852), and abdominal obesity (Urban:OR=1.760,95%CI:1.368~2.265; Rural:OR=1.945,95%CI:1.529~2.474) were common risk factors of hypertension amongresidents both in urban and rural areas; the protective factors for residents in urbanareas were non-Han people (OR=0.585,95%CI:0.348~0.983), sometimes exercise(OR=0.710,95%CI:0.548~0.921) and sometimes eating dairy products (OR=0.556,95%CI:0.410~0.754); the risk factors for residents in rural areas were high schooleducation (OR=1.438,95%CI:1.091~1.895) and rarely eating fresh fruit products(OR=1.701,95%CI:1.344~2.151).ConclusionThe prevalence of hypertension in Changchun city in2012was higher than thatin China2002, but was lower than that in Jilin province. And the prevalence ofhypertension in rural areas was higher than that in urban areas. The prevalence ofhypertension was significantly different in different age groups, gender, educational status and family income per capita. The prevalence of hypertension was significantlydifferent in different ethnicity, marital status and occupation in urban areas, but therewas no difference in rural areas. Besides, increasing age, male, the family history ofcirculation system disease, overweight, obesity and abdominal obesity were commonrisk factors of hypertension among residents both in urban and rural areas. Theprotective factors for residents in urban areas were non-Han, exercise sometimes, andsometimes eating dairy products. And the risk factors for residents in rural areas werehigh school education and rarely eating fresh fruit products. There were significantdifferences in the prevalence and risk factors of hypertension among adults betweenurban and rural areas of Changchun City. Targeted prevention and control measuresshould be developed according to the different disease characteristics and correlatesbetween urban and rural areas.