| BackgroundIsolated systolic hypertension(ISH) is the most common subtype of hypertension and is an important risk factor of cardiovascular and cerebrovascular diseases. It has been shown in some studies that antihypertensive treatment for patients with ISH could decrease the mortality of cardiovascular and cerebrovascular diseases significantly. However, there have no epidemiological and interventional study focus on rural patients with ISH. The present study investigated the epidemiological status and associated risk factors of ISH in rural of Fuxin and gave patients with ISH some interventional measurement such as health education, lifestyle improvement and drug treatment, which aimed to find a low-cost and effective antihypertensive treatment regimen to increase the control rate of ISH and decrease the incidence of stroke.Method45925 people aged 35 years or older were selected by a cluster sample method from 8 towns in rural Fuxin randomly. The general condition and status of smoking, drinking, dietary habits and usual diseases were investigated by trained doctors using standardized method. Physical conditions such as blood pressure, height, weight and heart rate were measured. The blood pressures were obtained by using of a standardized electric sphygmomanometer after 5 minute sitting rest. ISH was defined as a mean systolic blood pressure (SBP)≥140mmHg, and diastolic blood pressure<90mmHg according to Chinese guideline for prevention and treatment of hypertension(2005 version).Patients who measured up to inclusion criteria and exclusion criteria were assigned to a reinforced intervention group and an ordinary intervention group randomly. Both groups were given health education and lifestyle improvement, and reinforced intervention group was given drug treatment besides. All subjects were made a serum analysis. Blood pressures were measured every 2 months. The decrease of blood pressure and the incidence of stroke were investigated.Data base was set up by Epidata software and was analyzed by SPSS version 11.0 software. Associations between categorical variables were tested by using of the x~2 test. Comparisons between continuous variables between groups were performed by analysis of t test. Multivariate Logistic regression analyses were used to test significant determinants of isolated systolic hypertension vs normotensive.ResultsOverall, this study investigated 4886 people with ISH. The prevalence of ISH was 10.6%, male 10.1% and female 11.2% respectively. The prevalence of ISH increased with age. From 45 years old, the prevalence of female was higher than male. The prevalence of ISH was positively correlated with age, gender, smoking, drinking, BMI, salt intake and nationality by a Logistic regression analysis.Patients were followed up at 15 months. The systolic blood pressure decreased by 144.65 mmHg from 155.72 mmHg in the reinforced intervention group, decreased 11.07mmHg. The control rate achieved to 35.8%. The morbidity of fatal, nonfatal and all stroke were 0.26%, 0.77%, 1.03% respectively in the reinforced intervention group, while in the ordinary intervention group were 0.54%, 1.81%, 2.35%. The present study has shown that antihypertensive drug treatment with common intervention may be effective to prevent stroke. Because of short followed-up time and low control rate, there was no statistical difference between the 2 groups in this study.ConclusionThe present study showed that ISH has a high prevalence in the rural adult population of Liaoning, and ISH was associated with many risk factors. Intervention includes health education, lifestyle improvement and low-cost antihypertensive drugs could decrease blood pressure, increase the control rate of ISH. The morbidity of stroke showed a descending trend. Ongoing follow-up and strengthened intervention were needed to prevent stroke more effectively. |
PDF Full Text Request