Prevalence And Influencing Factors Of Hypertension For Rural Inhabitants In A Village Of Guangzhou

ObjectivesIn order to describe and analyze the influencing factors of hypertension, the status of hypertension prevalence, awareness, treatment and control in a village inhabitants aged 15 years old and above. Eventually, we provided the strategy and measurement to prevent and control hypertention of rural inhabitants.Methods(1)Subjects : Cross-sectional survey and qualitative survey was conducted on hypertension and relative influencing factors among local inhabitants aged 15 years old and above in the village. In-depth investigation was conducted on typical cases. And the panel discussion was taken on demand for health services and health service needs.(2)Diagnosis criteria: Diagnosis criteria of hypertension and Body Mass Index (BMI) were according to the criteria recommended by《Chinese Guidelines for the Management of Hypertention, 2005》.(3)Quality control: Quality control included investigator training, field investigation and data analysis. (4)Epidemiology investigation: A households survey was adopted. The survey was conducted from May 1,2007 to July 31,2007.We collected data by questionnaire interview (demographic characteristics, individual disease history, behavior risk factors and dietary factors), anthropometric measurements(height, weight, waist circumference, hip circumference, blood pressure) and lipid test.(5)Statistics methods: SPSS11.5 software was used to analyze prevalence rate, awareness rate, treatment rate, control rate of hypertention and related influencing factors in the village. Ratio comparison was conducted by Chi-Square test, logistic regression analysis was used to screen independent significant factors of hypertention, the size of test was 0.05. Population criteria adopted in standardized ratio's comparison was population data of 2000 in China.Results(1)General features of prevalence of hypertensionA total of 650 subjects in the village. Altogether, 602 respondents(227 males and 375 females) participated in the study, giving a response rate of 92.62%. The crude prevalence rate of hypertension was 26.58%, and the age-adjusted rate of hypertension was 18.91% by the population data of 2000 in China.The prevalence of hypertension steadily increased with age in both sexes. The overall prevalence was slightly higher in males(20.10%) than in females( 18.39%). Below the 35～44 year age group, the prevalence was higher in males, and above that age group, the prevalence became higher in females. The results of lipid tests among 40 persons showed that 9 persons were suffering from high blood lipidThe prevalence of abdominal obesity in the surveyed population aged 15 years and above according to WHR cutoff values is 43.19%. 39.23% of abdominal obesity persons and 14.04% of normal persons were hypertensive. There was a statistically significant correlation in patients between hypertension and abdominal obesity(x~2 = 50.121, P=0.000). On the other hand ,the prevalence of overweight and obesity according to BMI cutoff values is 23.42%. 37.59% of overweight and obesity persons and 23.21% of normal persons were hypertensive. There was a statistically significant correlation in patients between hypertension and obesity ( x~2 = 11.439, P=0.001) .The percentage of hypertension sufferers of I, II and III level whose blood pressure were not controlled to normal level were 62.91%, 23.84% and 13.25% respectively. There was no significant difference in percentage of hypertention classification between male and female.(2)The related influencing factors of hypertensionThere were 11 factors that had statistical significance after single variant analysis. They were age, education level, occupation, marriage status, BMI, WHR, sleep habit, meat intake, sugar intake, soybean intake and water. Multiple logistic regression analysis indicated that 3 factors were significantly associated with hypertension, age, BMI and WHR significantly increased the risk of hypertension.(3)Prevention and cure of hypertensionOnly 26.88% of hypertensives were aware of their condition. Among the total group of hypertensives, only 16.25% were taking prescribed medication to lower their blood pressure (BP) and 5.63% had controlled hypertension. The awareness rate, treatment rate and control rate of hypertension in hypertensive patients of males were 20.07%, 15.79%, 5.26%; These in hypertensive patients of females were 26.21%, 16.50%, 5.23%, respectively. After x~2 Test, there was no significant difference between males and females.(4)The qualitative survey showed that there was a challenge waiting, that of convincing the new patients to regularly take medications for life for a disease, which does not have any presenting symptoms. It is very critical that an aggressive community-based health education and promotion programme be set up to prevent and control hypertension.Conclusion(1)The crude and standardized prevalence of hypertension of inhabitants in the village of Guangzhou were 26.58% and 18.91% respectively, and slightly higher than the national prevalence of hypertension(18.8%). The prevalence of hypertension steadily increased with age in both sexes, the ascending trend was accelerated after 35 years old . It suggests that people aged 35 and above are emphasis population. Taking blood pressure measure in the first diagnosis for these people can heighten the examination incidence of hypertension sufferers and enable sufferers to receive measures of prevention and cure as soon as early.(2)Multivariate analysis showed that obesity independently and significantly associated with hypertension. Effective strategies for primary prevention of obesity should be introduced.(3)Despite the availability of effective pharmacological and non-pharmacological treatment for hypertension, blood pressure control rates were very poor in the village of Guangzhou. This gap between our ability to prevent and treat hypertension and the actual levels of control achieved constituted a significant failing of public health management and health care worldwide. In order to improve hypertension treatment and control in the hypertension prevention and control work, we should take good use of community resource in the village, develop health education work widely and improve consciousness about disease prevention and health.