| Objective: This study aimed to investigate the changing trend and influencing factors of dietary knowledge,attitude and practice among Chinese residents from 2004 to 2015,to investigate the changing trend and influencing factors of hypertension prevalence,awareness,treatment and control rate,and to examine the relationship between dietary knowledge,attitude,practice and hypertension,so as to improve the management of hypertension from the perspective of diet.Methods: China Health and Nutrition Survey(CHNS)was used in this study.CHNS was a longitudinal follow-up survey conducted by the Chinese Center for Disease Control and Prevention in collaboration with the Center for Population Research at the University of North Carolina.It aimed to monitor the impact of China’s social and economic transformation and socio-demographic policies on the health and nutritional status of residents.Data on residents’ dietary knowledge,attitude,practice,blood pressure,weight and height were collected through questionnaires and anthropometric measurements.Residents aged 18 and older were extracted from 5 waves of CHNS from 2004 through 2015.The sixth national census in 2010 was used to standardize the prevalence,awareness,treatment,and control rate of hypertension.CochranArmitage trend test was used to analyze the changing trends of residents’ dietary knowledge,attitude,and practice,as well as the changing trends of hypertension prevalence,awareness,treatment,and control rate.Multilevel logistic regression model was fitted to analyze the influencing factors of residents’ dietary knowledge,attitude and practice,as well as the influencing factors of hypertension prevalence,awareness,treatment and control rate,and to analyze the relationship between dietary knowledge,attitude,practice and hypertension.Results:(1)The residents surveyed were 8434,8597,8101,12073,and 10902 in 5 waves,respectively.The rate of dietary literacy among Chinese residents had been increasing from2004 to 2015.In 2004,2006,2009,2011,and 2015,the rates were 0.4%,39.7%,40.1%,44.6%,and 43.9%,respectively.Multilevel logistic regression analysis showed that residents with following characteristics were more likely to have a higher dietary literacy: female,middleaged,elderly,junior high school,college and above,medium family annual income per capita,high family annual income per capita,living in urban areas,living in central regions,living in eastern regions,medium urbanization,high urbanization and overweight/obesity,while the single and smoking residents were more likely to have a lower dietary literacy.The rate of positive dietary attitude among Chinese residents had been increasing from 2004 to 2015.In2004,2006,2009,2011,and 2015,the rates were 78.3%,84.7%,84.5%,87.1%,and 88.1%,respectively.Multilevel logistic regression analysis showed that residents with following characteristics were more likely to have a positive dietary attitude: elderly,Han ethnic group,junior high school,college and above,medium family annual income per capita,high family annual income per capita,living in urban areas,living in eastern regions,medium urbanization,high urbanization and overweight/obesity,while the single and drinking residents had a lower rate of positive dietary attitude.The rate of healthy dietary practice among Chinese residents had been increasing from 2004 to 2015.In 2004,2006,2009,2011,and 2015,the rates were56.8%,83.6%,81.7%,82.3%,and 78.8%,respectively..Multilevel logistic regression analysis showed that residents with following characteristics were more likely to have a healthy dietary practice: female,middle-aged,elderly,junior high school,employment medium family annual income per capita,high family annual income per capita,living in urban areas,living in central regions,living in eastern regions and overweight/obesity,while residents living in high urbanization areas Han ethnic group,single,thin,and smoking were more likely to have a lower rate of healthy dietary practice.(2)From 2004 to 2015,the standardized hypertension prevalence increased from 21.5%to 27.1%,the standardized awareness rate increased from 33.7% to 38.4%,the standardized treatment rate increased from 24.5% to 31.5%,the standardized control rate increased from 9.9%to 12.8%,the standardized treatment rate among who had been aware of hypertension increased from 72.7% to 82.0%,the standardized control rate among who received treatment of hypertension increased from 28.4% to 33.2%.Multilevel logistic regression analysis showed that the aged,Han ethnic group,living in central regions,living in eastern regions overweight/obesity,and drinking were risk factors for hypertension,while higher education,employment,and thin were the protective factors for hypertension.Multilevel logistic regression analysis showed that female,elderly,high family annual income per capita,living in urban areas,living in eastern regions and overweight/obesity were the promoting factors of hypertension awareness rate,while employment,thin,smoking,and drinking were the obstacle factors of hypertension awareness rate.Multilevel logistic regression analysis showed that the aged,high family annual income per capita,living in urban areas,living in eastern regions and overweight/obesity were the promoting factors for the treatment rate of hypertension patients,while employment,and drinking were the obstacle factors for the treatment rate of hypertension patients.Multilevel logistic regression analysis showed that female,gender,the aged,college and above,high family annual income per capita,and living in urban areas were the promoting factors for the control rate of hypertensive patients,while thin and smoking were the obstacle factors for the control rate of hypertensive patients.Multilevel logistic regression analysis showed that the aged,high family annual income per capita,living in urban areas and overweight/obesity were the promoting factors for the treatment rate among who had been aware of hypertension while employment,thin and drinking were the obstacle factors for the treatment rate among who had been aware of hypertension.Multilevel logistic regression analysis showed that Han ethnic group,college and above,high family annual income per capita,living in urban areas and drinking were the promoting factors for the control rate among who received treatment of hypertension,while overweight/obesity and smoking were the obstacle factors for the control rate among who received treatment of hypertension.(3)After adjusting for confounding factors such as gender,age,ethnicity,residence,geographical location,education,working,family annual per capita income,marital status,BMI,smoking,and drinking,the multilevel logistic regression analysis showed that the dietary knowledge literacy,positive attitude and healthy practice of hypertensive residents were 1.13 times,1.04 times and 1.14 times than those of non-hypertensive residents,respectively;The awareness rate of hypertensive residents with dietary knowledge and healthy practice was 1.27 times and 1.48 times than those without it,respectively;The treatment rate of hypertensive residents with dietary knowledge and healthy practice was 1.31 times and 1.62 times than those without it,respectively,The control rate of hypertensive residents with dietary knowledge and healthy practice was 1.04 and 1.26 times higher than those without it,respectively.Conclusion:(1)The rates of dietary knowledge,positive attitude and healthy practice among Chinese adults had increased,but the knowledge literacy was still at a low level.The prevalence of hypertension among Chinese adult residents had increased.Although the awareness,treatment,control rate also increased,they were still at a low level.Hypertensive patients with dietary knowledge and healthy practice had higher awareness,treatment and control rate.(2)Dietary education is an important non-pharmacological treatment that accompanies the whole process of hypertension management.The comprehensive management of hypertension should focus on males,middle-aged and elderly,primary school and below,low family annual income per capita,rural areas,western regions. |
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