Study On The Prevalence And The Related Factors Of Hypertension Among The Residents In Jiayuguan

BackgroundHypertension,a silence killer,is difficult to detect because of no symptoms for it.Among the world,there are 12.8%of deaths caused by raised blood pressure.In 2010,24.6%of overall deaths,29.1%of deaths of non-communicable disease and 64.0%of deaths of CVD(cardiovascular disease),were resulted by hypertension in China.Attributable Risk Proportions of hypertension were all over 50%in the deaths of HHD(hypertensive heart disease),Stroke and IHD(ischemic heart disease).ObjectivesIn this study,we want to have a comprehensive grasp of the prevalence and the related factors of hypertension in Jiayuguan.As baseline data for future related research,the investigation will indicate the future research direction and the weak link of hypertension prevention and control.Also,we intend to mine the health information of Jiayuguan city residents deeply,for optimizing the management of chronic diseases in Primary Care Health Services and providing more scientific evidence to the government for formulating health relevant policies.Objects&Methods· Objects:We investigated the residents;,who are 25 years old and above and have been in Jiayuguan over 6 months.· Sample size and sampling method:We sampled 10003 objects randomly on the basis of the population composition of Jiayuguan city and communities/towns for 3 stages.Stage 1:We counted the population composition of city residents by age data;Stage 2:We calculated every age group's samples in each community by the information from community Health Service Centers and Township Health Centers.Stage 3:According to the sampling of stage 1 and 2,investigators used stratified random sampling to choose 6%objects by SPSS 17.0 for Household Survey or Concentrated Survey..Research method and content:We made the questionnaire survey and took the medical examination.The questionnaire contains things about general demographic characteristics,disease history,family history,personal habits(smoking,drinking&eating),health knowledge,health behavior and the condition of prevention/treatment in patients with hypertension or diabetes.Medical examination involves measuring blood pressure,blood glucose level,height,weight and waist circumference.The data were recorded into the questionnaire.· Data entry and analysis:We adopted Epidata3.1 software for data parallel double entry,and SPSS 17.0 software for data analysis.The methods of statistic and analysis were t-test,?2-test,single factor/multi-factors analysis and so on.Inspection level took a=0.05.The prevalence was standardized by age data from the sixth national population census in 2010.Results· Epidemiological characteristics of hypertension:Among the ages 25+residents in Jiayuguan,the crude prevalence rates of hypertension of both sexes,male and female were 23.9%,26.4%and 21.6%.And the age-standardized prevalence rates of both sexes,male and female were 26.7%,28.4%and 25.4%.The difference between male and female was statistically significant(?2=30.365,P<0.001).Before the age of fifty,there was significant difference between them in each age group,and the prevalence rate of male was higher than female.Moreover,no significant difference between them was showed in each age group after age fifty.The prevalence rate of Han inhabitants(24.1%)was higher than Minority dwellers(18.4%),and there was statistical significance(?2=4.05,P=0.044).The prevalence among the residents who were in different educational level indicated statistical significance(?2=646.18,P<0.001),and the prevalence of illiterate/semi-illiterate level was the highest one(53.9%)while the rates of above junior high school educational levels were lower than the average.There was significant difference between different marital status groups(?2=139.91,P<0.001),and the prevalence rate of divorced/widowed group was 45.6%,which was higher than other groups such as married group(23.2%)and spinsterhood group(12.6%).Different occupation groups and family population groups both showed statistical significance(?2=10.56,P=0.005;?2=9.04,P=0.011),but the differences were small and the prevalence rates were all around the average level.In addition,the more annual income of family,the lower prevalence rates.And the significant difference was among them(?2=87.01,P<0.001).The difference between community and township was statistical significance(?2=0.57,P=0.450),and the rate of community was higher than township.Although the different prevalence rates of 3 townships were no statistical significance(?2-101.04,P=0.134),between 6 communities were significant differences(?2=96.31,P<0.001).· Hypertension related influencing factors in Jiayuguan:We used multi-factor Logistic regression analysis for seeking influencing factors by two groups,BMI group and WC(waist circumference)group.BMI group showed that age(OR=1.077,95%CI:1.071?1.082),gender(OR=1.266,95%CI:1.096?1.370),race(OR=1.607,95%CI:1.101?2.348),educational level(OR=0.930,95%CI:0.881?0.982),family history(OR=1.468,95%CI:1.380?1.563),diabetes(OR=1.600,95%CI:1.317?1.944)and BMI(OR=1.948,95%CI:1.804?2.103)were associated with the prevalence of hypertension.The AR%of BMI was highest(48.67%),and the one of educational level was lowest(-7.53%).The other group indicated that age(OR=1.076,95%CI:1.071?1.082),gender(OR=1.294,95%CI:1.159?1.445),race(OR=1.601,95%CI:1.091?2.349),educational level(OR=0.926,95%CI:0.877?0.978),family history(OR=1.498,95%CI:1.407?1.594),diabetes(OR=1.696,95%CI:1.397?2.058)and waist circumference(OR=1.642,95%CI:1.540?1.751)were related to the prevalence of hypertension in the target population.The AR%of diabetes was highest(41.04%),and the one of educational level was lowest(-7.99%).· The prevention and control situation among the residents in Jiayuguan:The rates of awareness,treatment and control of hypertension of the residents in Jiayuguan were 59.8%,56.4%and 39.9%.There were 68.1%of patients received both of drug and non-drug treatments,26.0%just chose drug therapy and 5.5%non-drug therapy only.Among 1007 patients who had received non-drug treatment,75.7%of them changed their diet,68.8%took physical exercise,the persons of controlling body weight(25.3%),abandoning smoking(15.9%)and limiting alcohol(13.3%)were less.Meanwhile,between 1287 patients who chose drug therapy,74.1%of them might forget the medicine,and 53.3%were inattention to medicine.The reasons for drug withdrawal were three.First of all,a part of them(46.9%)were aware of symptom improvement.Secondary,some patients(40.2%)felt worse by drug therapy.Last,a little of them(4.4%)couldn't have the obvious effect.78.8%of hypertension patients measured blood pressure regularly,and 61.5%did that once a week at least.Doctor(91.3%),TV(30.6%)and Family Members(20.5%)were the top three approaches for receiving the information of hypertension among the patients.In addition,44.4%of them wanted more knowledge of hypertension,42.8%were lack of information 6.7%felt enough for themselves and 6.0%urgently need to know the raised blood pressure.Conclusions· Among the ages 25+ residents in Jiayuguan,the prevalence level was in the middle level all over the country,and upper-middle level in Gansu province.The situation of hypertension was serious.· The difference of hypertension prevalence rate between community and township were no obvious.But the significant differences between communities were showed.While a trend of younger hypertension patients come,we need more attention to it.· The higher educational level was the protective factor for preventing hypertension.Aging,hypertension family history,diabetes and obesity were the risk factor for hypertension.We should focus on the obesity,because of the large obesity proportion in Jiayuguan.' Although there were some advantages of health education,the popularity rate of health knowledge was low.We should pay more attention to the mental health.The residents in Jiayuguan need raised the awareness of reducing salt intake.· The prevention and control effect of hypertension in Jiayuguan was in the upper middle level all over the country,and high level in Gansu province.But the problems of prevention and control of hypertension havent been solved.So we need make more effort to improve that.