| Objective:Based on the samples from Shigatse City in Tibet in the sixth national health service survey,this study investigated the prevalence of hypertension and related factors such as physiology,psychology,behavior,medical security of subjects,as well the follow-up situation of patients with hypertension by using current situation analysis and correlation analysis,thus provided data support and theoretical basis for the prevention,the improvement of the overall health of residents and the reform of the medical and health system in the region.Methods:In this study,people from six sample counties and districts in Shigatse,Tibet Autonomous Region were used as the survey object.Using the method of sample survey,the questionnaire was distributed to 2830 people in the sampled population.Actually,2269 questionnaires were recovered with an effective rate of 80.2%.The questionnaire adopts the "Family Member Personal Situation Questionnaire" formulated by the project team,which covers demographic information,health status,medical insurance coverage,behavioral psychological characteristics and other information.In this study,data on basic demographics,hypertension,daily health,lifestyle behaviors,and medical insurance participation of the 2269 samples actually recovered were derived,and a database was established to exclude all people under the age of 18,pregnant or with insufficient information,The final research objects are 2250 people who were divided into two groups.Measurement data were expressed as mean ± standard deviation((?)±SD),count data were expressed as constituent ratios,the ?2 test was used to compare between groups,and variables with differences between the two groups were included into logistic regression to screen out related factors of hypertension.Inspection level is ? = 0.05.Results:(1)Basic information: Among 2,250 subjects,a total of 393 were hypertensive patients,1857 were in the non-hypertensive group,the prevalence of hypertension is 17.5%.Among men,16.1% were hypertensive patients and among women,18.7% were hypertensive patients.The mean age of hypertension patients was 58.4 ± 12.9 years,which was higher than the mean age of non-hypertension patients 42.4 ± 14.2 years.The prevalence of hypertension in the group of people who had not attended primary school was higher than in that of who had attended primary school or above.The proportion of unmarried people suffering from hypertension was only 9.3%.The prevalence of hypertension in divorced widows or other groups was the highest,at 40.6%,which is significantly higher than the national average of 23.2%.The prevalence of hypertension among students or working people was 13.5%,and that among retirees is 48.4%.(2)Physiological,psychological and behavioral factors: People who were inability to move(including bedridden),inconvenient self-care or in need of care,inconvenience in normal activities,severe physical pain or discomfort or with poor health scores accounted for 13.8%,8.6%,19.1%,18.4%,and 33.3% of all subjects.The prevalence of hypertension in the above five groups of people was higher than that in the normal population,and the differences were statistically significant.The number of people with moderate or severe anxiety or depression accounting for 16.5%,and the prevalence of hypertension in those people was much higher than the normal population.The number of subjects with a history of smoking in the previous year was 402,and the prevalence of hypertension was lower than that of the normal population;1562 subjects had a habit of drinking alcohol in the previous year,and their prevalence of hypertension is also lower than the prevalence of the normal population.The number of people who exercised three or more times per week accounted for 12.5% of all the subjects,and their prevalence of hypertension was higher than those who exercised less than three times a week.Of all the study subjects,70.4% had participated in a physical examination in the previous year,and the prevalence of hypertension in this population was higher than that of those without a physical examination.The number of people who do not brush their teeth every day accounted for 72.0% of all subjects.The proportion of hypertension in this group was higher than that of people who brush their teeth at least once a day.A total of 1181 people were participated in the national critical illness insurance program among all subjects,accounting for 52.5%,217 were hypertensive patients,accounting for 55.2% in all hypertensive patients.The number of people who did not participate in any medical insurance was 26,of which 3 were hypertensive patients,accounting for 11.5%.A total of 1076 people had established health files in the community or hospital,of which 204 are hypertensive patients,accounting for 51.9% of all patients,and a total of 321 people had not heard of health files,accounting for 14.3% of all subjects.Up to 63.6% of patients with hypertension had no health follow-up.Among 139 patients who participated in the follow-up of chronic diseases,the proportion of self-visit to medical institutions for follow-up was 66.2%,the rate of home follow-up was 27.2%,and the proportion of telephone or other follow-up forms was 8.6%.(3)Analysis of influencing factors of hypertension: Variables with different prevalence of hypertension between the two groups were included in multivariate logistic regression analysis.The variables affecting hypertension were age,occupation,normal activities,anxiety or depression,health score,whether they had participated in physical examinations and teeth brushing situation.Among them,the risk of hypertension in people aged 35-59 years old and those over 60 years old of age were 4.720 and 12.938 times that of people aged 18-34 years old respectively;the risk of hypertension in students,working people or farmers is only 0.454 times that of retired people;the risk of hypertension of people with inconvenience in normal activities,poor health scores,and anxiety and depression were 1.471,1.366,and 1.405 times that of normal people respectively;The risk of those who have undergone physical examinations within a year was 1.335 times that of people who had not taken a physical examination within one year;people who don't brush their teeth every day had a risk of hypertension 1.639 times that of people who brush their teeth at least once a day.Education,marital status,behavioral status,self-care,pain and discomfort,smoking history and alcohol consumption history are not factors related to hypertension.Conclusion:(1)The prevalence of hypertension of residents in the 6 counties of Tibet was lower than the national average of hypertension.Hypertension is more likely to occur in older people.The prevalence of divorce,widowed or other groups,and retirees is also higher than the national level.(2)Age,occupation,daily activities,anxiety or depression,health scores,whether they had physical examinations in last year and brushing times are the influencing factors of hypertension.(3)Residents in the 6 counties of Tibet had good medical insurance coverage,but there were still a small number of people who had not participated in the major illness insurance program.The poor follow-up of hypertension deserves further attention. |
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