Hypertension Epidemiological Study Among Rural Residents In TaiYi Mountainous Areas Of Shandong Province, China

[Background] Hypertension is a kind of common and chronic cardiovascular diseases (CVD) which is harmful to people's health. Its long-term development can cause damages of heart, brain, kidney and so on. Many countries pay more attention to high incidence, disability and mortality of hypertension. In addition, the relationships between high-normal blood pressure and hypertension or cardio-cerebral vascular diseases are intimate, so strengthening the epidemiological study of high-normal blood pressure is very important theoretically and actually. With the development of society and economy in China, great changes have taken place in population structure, economic status, behavior and life styles, prandium mode and many other aspects in rural areas, which results in significant raise of prevalence of hypertension in rural areas. Although the levels of economy have been raised in many developing rural areas, health awareness couldn't increase. The difference of prevalence of hypertension between city and rural areas decreases gradually. Hypertension has become one of main diseases that affect peasant health. China is a large agriculture country with 0.9 billion peasants, and the study of prevalence of hypertension and it's influenced factors in rural areas is one of main tasks to carry out the plan of primary health care and health for all. Descriptive epidemiology study was used to identify epidemiological distribution characteristics of high-normal blood pressure and hypertension and their influence factors for residents in midwestern rural areas in Shandong province of China, consequently providing scientific evidence for prevention and control of hypertension.[Objectives] The major purposes of this study are to explore the levels of blood pressure, epidemiological distribution of high-normal blood pressure and hypertension and their related influenced factors, consequently providing scientific evidence for the determination of high risk population and surveillance population and making strategies for prevention and control of high-normal blood pressure and hypertension that will be really fit for the research areas. The specific objectives of this study are as following:●To identify the levels of blood pressure for adults in TaiYi mountainous areas of Shandong province;●To estimate the epidemic status of hypertension among rural residents in TaiYi mountainous areas of Shandong province;●To analyze main risk factors of hypertension and provide scientific evidence for health policy and intervention measures for the research areas.●To analyze the relation of different blood pressure levels and abnormal ECQ To explore a new method for prevention and control of hypertension.[Methods] This study is a clinical epidemiological study. Multi-stage stratified randomized sampling was used in this study. According to development levels of society, economy and geographic setting, Tengzhou,Shanting,Sishui,Zhoucheng,Pingyi,Yishui,Mengyin,Juxian,Junan,Wulian,X intai,Anqiu,Linqu,Qingzhou,Yiyuan were sampling. To follow random sampling principle, one town was randomly sampled in each county samples, and one village was randomly sampled in each town samples.700 subjects were taken according to production teams in each village.10625 subjects were collected in 15 areas by stratified multi-stage cluster sampling, including data gathered from questionnaires, interviews, physical examinations and measurement of blood pressure, to analyze risk factors of hypertension by logistic regression.10625 subjects were collected in 15 areas by stratified multi-stage cluster sampling, including data gathered from questionnaires, interviews, physical examinations and electrocardiogram examination, to analyze risk factors of hypertension by logistic regression.Analysis of variance or t-test was used for comparison of mean of systolic blood pressure (SBP) or diastolic blood pressure (DBP) among different groups. Countryside population data of the fifth population census was used for standardizing rates. Chi-square test was used for comparison of prevalence of hypertension among different groups. Chi-square trend test was used for trend analysis of prevalence. Single-factor and multi-factors Logistic regression analysis were used to explore risk factors of hypertension.[Results]1. The mean of SBP and DBP was 128mmHg and 81mmHg respectively in the target population. Both means of SBP and DBP increased progressively with age for men and women. Compared with healthy population, the blood pressure was higher for the population of overweight, obesity, abdomen obesity or diabetes mellitus. Both means of SBP and DBP increased progressively with the growth of body mass index (BMI), waist.2. The standardized prevalence rate of hypertension were 28.09%,27.56% in men and 28.44% in women. The prevalence rate of hypertension increased with age for men and women. The prevalence rate of hypertension for grade 1,2 and 3 were 18.4%,8.9% and 4.1% respectively. The prevalence rate of isolated systolic hypertension (ISH) was 11.4%. The prevalence rate of hypertension for different grades increased progressively with the growth of age.3. The awareness, treatment and control rates were 32.2%,19.6% and 5.2%.The awareness and treatment rates of women were higher than these of men. The control rates were no difference between men and women.The awareness and control rates were difference among different agr groups.4. With the increase of blood pressure, findings of cardiac arrhythmia such as atrial fibrillation, ST-T changes, premature ventricular arrhythmia and bundle branch block increased. There are statistically significant difference of cardiac arrhythmia among blood pressure classifications.Prevention and control in hypertension should be reinforced.5. Multinomial Logistic regression analysis indicates that age, BMI and waist, more quantity of drinking in everyday, family history of hypertension, diabetes mellitus (DM) were the common risk factors of hypertension. More vegetable intake and more fruit intake in everyday were also protective factors of hypertension.[Conclusions]1. The mean of SBP and DBP and prevelence of hypertension were close to the nationwide level. The treatment and control rates were relatively low than the nationwide level. Timely and effective prevention measures played an important role in preventing healthy and sub-healthy people from becoming hypertension.2. The prevalence of hypertension in rural areas was high,it has become the main public heath problem in the investigation areas. Obesity, DM and unhealthy behavior and life styles were the main risk factors of hypertension.3. The rate of abnormal ECG especially ventricular arrhythmia were significantly increased with the rising of blood pressure. The detection rate of abnormal ECG increased when blood presure reached the high-normal blood presure.[Suggestions]1. The health administrative authorities should take hypertension prevention and control strategies and measures for developing rural areas, including strengthening propaganda of hypertension prevention and control, advocating healthy behavior and life styles, establishing surveillance system of hypertension, DM and obesity, determinating different surveillance frequencies according to health levels and strengthening administration of hypertension patient to prevent cardio-cerebral vascular diseases and other complications.