Epidemiological Investigation Of Hypertension And Its Subtypes In Rural Dai People In Xishuangbanna,Yunnan Province

Objective : To better understand the prevalence of hypertension among ethnic minorities in Yunnan Province,to identify risk factors for hypertension and its subtypes,and to provide a scientific foundation for its prevention and management.This will allow for the implementation of improvement strategies that are regionally focused and will enhance the prevention and management of hypertension in ethnic minority areas.Methods : In the study,which ran from June to September 2020,a randomized whole-group sampling technique was used to conduct an epidemiological survey of hypertension among 2,149 Dai residents of rural Xishuangbanna who were over 50.Questionnaires and physical exams were used to gather basic data from the participating population,including blood pressure,height and weight,gender and age,previous medical history,personal history,and other pertinent information.According to the 2018 Chinese hypertension guidelines diagnostic criteria(SBP ≥140 and/or DBP≥ 90 mm Hg)and the 2017 ACC/AHA hypertension guidelines diagnostic criteria(SBP≥130 and/or DBP ≥80 mm Hg),respectively,the prevalence of hypertension and its subtypes were counted.Continuous variables were expressed as mean standard deviation and categorical variables One-way ANOVA was used for continuous variables in three or more groups,and the chi-square test was used for comparisons between categorical variables in three or more groups.The tests used for continuous variables between two groups were the t test and the chi-square test,respectively.The risk factors for hypertension were examined using multi-factor logistic regression models.Results:According to the 2018 Chinese hypertension guidelines for SBP≥140 and/or DBP≥ 90 mm Hg,the overall prevalence among rural Dai people aged 50 years or older in Xishuangbanna was 43.2%,the prevalence of each subtype of hypertension was 16.5% for SDH,24.2% for ISH,and 2.5% for IDH.For hypertension composition ratio,the SDH accounted for 38.1%,ISH for 56.0%,and IDH.IDH accounted for 5.8%.According to the 2017 ACC/AHA hypertension guidelines diagnostic criteria of SBP≥ 130 and/or DBP≥ 80 mm Hg to calculate the prevalence of Xishuangbanna Dai,the total prevalence of hypertension was 67.7%,the prevalence of SDH was 37.1%,ISH was 26.5%,and IDH was 4.1%.For hypertension composition ratio SDH accounted for 54.8%,ISH for 39.1%,and IDH for 6.1%.The total prevalence of Dai men in rural Xishuangbanna was higher than that of women(2018 Chinese standard: 45.9% for men vs.41.6% for women,2017 ACC/AHA standard: 72.5% for men vs.64.9% for women,p<0.05).The total prevalence increased with increasing age(p<0.05)and with increasing BMI(p<0.05).Multi-factor logistic regression model analysis of prevalence according to the 2018Chinese hypertension guidelines for diagnostic criteria showed that older age was a risk factor for the prevalence of hypertension and ISH(OR>1,p<0.05);overweight/obesity was a risk factor for hypertension and its subtypes SDH,ISH,and IDH(OR>1,p<0.05);a history of smoking,alcohol consumption,or family history of hypertension had a significantly higher risk of hypertension,SDH,and ISH than those without a history of smoking,alcohol consumption,or family history of hypertension(OR>1,p<0.05);having formal education and high literacy level were protective factors for hypertension prevalence(OR<1,p<0.05).Conclusion:1.According to the 2018 Chinese hypertension diagnostic criteria,the total prevalence of hypertension among rural Dai people aged 50 years or older in Xishuangbanna was 43.2%,of which ISH accounted for 56.0%,and ISH was the most common type.According to the 2017 ACC/AHA hypertension guideline diagnostic criteria,the total prevalence was 67.7%,of which SDH accounted for 54.8%,with SDH being the most common type.According to the 2017 ACC/AHA hypertension guideline diagnostic criteria,the total prevalence of Xishuangbanna Dai was 24.5%higher than the 2018 Chinese hypertension guideline diagnostic criteria.2.The prevalence of hypertension in the rural Dai population in Xishuangbanna,Yunnan,was higher and significantly higher than in other ethnic groups and regions(29.9% for Han Chinese in Yongsheng,Lijiang,Yunnan;23.8% for Han Chinese and13.1% for Tujia in Chongqing;26.7% for Naxi,16.8% for Lisu,and 36.2% for Jingpo in five southwestern provinces).3.Older age is a risk factor for the development of hypertension and ISH.Overweight/obesity was a risk factor for hypertension and its subtypes SDH,ISH,and IDH.The risk of developing hypertension,SDH,and ISH was significantly higher in those with a history of smoking,alcohol consumption,or family history of hypertension than in those without a history of smoking,alcohol consumption,or family history of hypertension.Having formal education and higher literacy level were protective factors for the development of hypertension.