Epidemiological Investigation And Analysis Of Hypertension In Rural Population Of Shuocheng District Correlation Between RDW And Mortality In CCU Patients

Objective:1.Through this epidemiological survey,the prevalence rate,awareness rate,treatment rate,control rate and hypertension related risk factors of hypertension among rural residents in Shuozhou City of Shanxi Province were understood,and the prevalence status and change trend of hypertension in the northern rural areas of our province were clarified,so that some rural residents can accept more targeted hypertension prevention and control guidance,so as to be more effective and objective to effectively manage hypertension in rural population and improve its control rate.2.Red blood cell distribution width is an economic and convenient test index,which can be carried out by rural health centers.By exploring the correlation between red blood cell distribution width and mortality rate of critically ill patients in cardiac intensive care unit,the efficiency of red blood cell distribution width in risk prediction of cardiovascular disease can be verified,so as to further explore its feasibility in auxiliary clinical medical activities.Methods:1.This survey adopts the method of multi-stage cluster random sampling.One township is selected in the urban area of Shuozhou City,and then two villages are further selected.Questionnaire survey and physical examination are conducted for the rural residents from June to July in 2019 and June to August in 2020 respectively,and the residents’ disease data are collected,so as to obtain the prevalence rate,treatment rate,control rate and analysis the related risk factors of hypertension in this area.2.A retrospective cohort study was conducted to collect the above data on the prevalence,biochemical indexes during admission and survival within 28 days after discharge of adult patients who were admitted to CCU for more than 24 hours and had RDW test records.According to the best cut-off value(15.1%)of RDW,the subjects were divided into low RDW group(RDW < 15.1%)and high RDW group(RDW ≥15.1%).The mortality of the two groups was compared,and then univariate and multivariate logistic regression and Cox regression were used to analyze and evaluate the relationship between RDW and CCU mortality.Results:1.826 cases were investigated,including 396 males and 430 females,aged(53.46 ±16.97)years,systolic blood pressure(128.58±17.43)mm Hg and diastolic blood pressure(80.80±16.93)mm Hg.The total prevalence of hypertension was 28.7%(standardized prevalence 28.7%),53.2% in males and 46.8% in females.There was no significant difference in the prevalence between men and women(χ 2=1.231,P=0.267).The awareness rate,treatment rate and control rate of hypertension were 58.6%,50.6% and35.9% respectively;It was found that the main risk factors of hypertension were age,diabetes,excessive waist circumference,BMI and family history.2.A total of 5924 first-time CCU patients,including 3384 males(57.1%)and 2540females(42.9%),were enrolled and collected.The ROC curves of in-hospital mortality and 28 day mortality after discharge were drawn with RDW variables for 5924 patients,and the optimal cut-off value was 15.1%.Then the subjects were divided into low RDW level(< 15.1%)group and high RDW level(≥15.1%)group.After the comparison of general conditions,logistic multivariate regression analysis,Cox regression to establish the death prediction model,and PSM analysis to establish the 1:1 matching model,it was found that the mortality of patients with high RDW was higher than that of patients with low RDW in all analysis methods,which had statistical significance(P < 0.001).Conclusion:1.The prevalence of hypertension in rural residents in Shuocheng district is high,and it is found that it is related to a variety of risk factors.However,the risk factors of hypertension are basically preventable and controllable.It is necessary to further strengthen the development of primary medical care and improve the prevention and treatment level of hypertension in rural areas。2.The maximum red blood cell distribution width of patients in cardiac intensive care unit is an independent risk factor for in-hospital death and death within 28 days after discharge.As an economic and convenient laboratory index,red blood cell distribution width has a broad application prospect for risk prediction of patients with cardiovascular disease.