| Objectives:This study was to examine and compare the prevalence,awareness,treatment and control status of hypertension,levels of hypertension-related knowledge,influencing factors of hypertension and patients’ self-management behaviors between the aged 35 years and over permanent residents of Dai and Jingpo unique ethnic minorities of Mangshi in Yunnan province,in order to provide a theoretical basis for the prevention and control of hypertension for the local health department.Methods:This study was a cross-sectional survey study.with stratified multi-stage sampling,a representative sample of 2764 Dai and Jingpo ethnic minority permanent residents aged 35 years and over who was from 12 townships of Mangshi in Yunnnan province were selected and investigated with a face-to-face questionnaire survey and physical examination.The basic demographic characteristics and information including the prevalence and control status of hypertension,related-knowledge and patients’ self-management behavior of each respondent were collected by a questionnaire survey;blood pressure,height and weight,waist circumference and hip circumference measured by a physical examination.SPSS 17.0 software was used to statistical analyze the data,direct method was used to calculate the standardized rate.And the methods including t-test was used to compare with different measurement data,chi-square test and rank sum test were selected to compare the rate or percentages between different groups,multivariate logistic regression analysis was used to analyze the influencing factors of hypertension.And test level was 0.05.Results:A total of 2800 people were investigated,2764 valid questionnaires were obtained,and the effective rate was 98.71%.The overall prevalence,awareness,treatment and control rate of hypertension aged 35 years and over of Dai and Jingpo ethnic minorities in Mangshi were 46.1%,37.7%,25.4%and 5.2%(standardized rates were 43.3%,29.5%,19.3%and 3.9%),respectively.The overall prevalence rate of hypertension was higher in the older,lower education level,lower income level and better accessibility of medical services(p<0.05),awareness rate was higher in males,the older,lower income level and better accessibility of medical services(p<0.05),reatment rate was higher in females,the older,lower income level and better accessibility of medical services(p<0.05).For Dai and Jingpo ethnic minority residents,the standardized prevalence rate was 50.7%,35.9%,awareness rate was 32.3%,25.6%,the treatment rate was 25.8%,10.7%,control rate was 4.2%,3.9%,respectively.Dai ethnic had a higher prevalence rate than Jingpo ethnic(p<0.01),and the prevalence of Dai with different age,educational level,income level and accessibility of medical services was higher(p<0.05);Dai ethnic had the higher awareness rate and treatment rate of hypertension also(p<0.01),but significantly difference had no found in the control rate of hypertension between two ethnic groups(p>0.05).For Dai ethnic,males,older age,lower education level and lower income level people had higher prevalence rate(p<0.01);females,older age,lower educational level and lower income level people had higher awareness rate(p<0.05);females and older age people had higher treatment rate(p<0.01);older age people had higher control rate of hypertension(p<0.05).For the Jingpo ethnic,females,older age,lower education level and lower income level people had higher prevalence rate(p<0.01);older age people had higher awareness,treatment and control rate of hypertension(p<0.05).About the hypertension-related knowledge,the understanding rate of hypertension treatment method of Dai and Jingpo ethnic were 35.6%,4.0%,the rate of know hypertension that cannot be cured were 8.8%,1.2%,the rate of konw hypertension needs medication through life time was 17.4%,2.0%,the rate of know hypertension that can prevent was 15.7%,1.7%,the rate of know hypertension prevention methods was 15.2%,1.4%,respectively.Dai ethnic had better understanding rate on above the five aspects of hypertension-related knowledge(p<0.01).Among Dai ethnic,the understanding rate of hypertension treatment was higher in the males,aged 65 years and over,better accessibility of medical services(p<0.05),the rate of know hypertension that cannot be cured was higher in the males(p<0.05),the rate of know hypertension needs medication through life time was higher in the better accessibility of medical services(p<0.05),the rates of know hypertension that can prevent and preventive method were higher in males,higher education level and income level,and better accessibility of medical services(p<0.01);Among Jingpo ethnic,the understanding rate of hypertension needs medication through life time was higher in the aged 45-and 55-age group(p<0.05),the rates of know hypertension that can prevent and prevention methods were higher in the higher income level(p<0.05).And higher education level residents had the higher understanding rate on above the five aspects of hypertension-related knowledge(p<0.05).About health-related behavior,the proportion of daily meal on time perday,intake of pickled products and more oil food was more than 3 times perweek,and sitting time in daily work(8 hours)was more than 4 hours in Dai ethic were higher than Jingpo ethic(p<0.001),BMI and rates of overweight,obesity and central obesity in Dai were also higher(p<0.001);whereas,Dai ethic had the lower rate of high salty diet,smoking,current smoking,drinking,frequency of physical activity was more than 4 times perweek and proportion of high-intensity physical activitys than Jingpo(p<0.001).The multivariate logistic regression showed that,age,family history of hypertension,obesity,central obesity and frequency of preserved food were the influencing factors of hypertension among Dai people.Older age(OR=1.047,95%CI:1.037～1.058),family history of hypertension(OR=1.586,95%CI:1,121～2.245)、obesity(OR=1.547,95%CI:1.112～2.153),central obesity(OR=2.427,95%CI:1.883～3.127)、frequency of preserved food three or more times per week(OR=1.605,95%CI:1.115～2.310)were risk factors of hypertension.Age,education,marital status,obesity and central obesity were the influencing factors of hypertension among Jingpo people.Older age(OR=1.036,95%CI:1.025～1.047)、obesity(OR=2.025,95%CI:1.230～3.334),central obesity(OR=1.727,95%CI:1.355～2.200)were risk factors of hypertension;and higher education level(OR=0.750,95%CI:0.583～0.965),married(OR=0.588,95%CI:0.360～0.961)were protective factors of hypertension.And age,obesity and central obesity were the common risk factors of hypertension among two ethnic minorities.About the self-management behaviors of hypertension patients,the rate of hypertension medication adherence among Dai and Jingpo ethnic patients were 75.9%and 38.6%,rate of self-monitor of blood pressure were 69.1%and 36.6%,respectively.And Dai ethnic had higher rate on above the two aspects(p<0.01).Compared with the same ethnic group,females of Dai patients had higher rate of hypertension medication adherence(p<0.01);and Jingpo patients aged 65 years and over had the highest rate of hypertension medication adherence(p<0.05),and higher education level patients with a higher rate of self-monitor of blood pressure(p<0.05).Dai and Jingpo patients with hypertensive to take blood pressure control measures in two weeks before the investigation were 36.7%,24.4%,respectively,and Dai patients had a higher proportion than Jingpo(p<0.01).The proportion of increasing exercise,lower salt intake of Dai patients was higher than Jingpo(p<0.05).Significantly difference were not observed in the rates of taking control or lose weight,reducing drinking and quitting smoking(p>0.05).Compared with the same ethnic groups,males of Dai patients had a higher rate of reducing drinking and quitting smoking(p<:0.01),whereas a lower rate of salt intake than that females(p<0.01);males of Jingpo patients pay more attentions to increase exercise than that females(p<0.05),and higher income level patients pay more attentions to control weight or lose weight(p<0.01).Conclusions:Compared with Jingpo ethnic,the prevalence,awareness and treatment rate of hypertension among Dai residents were higher,the knowledge of treatment and prevention about hypertension was better,and the formation rate of self-management behavior was higher than Jingpo ethnic.In generally,the status of prevalence,awareness,treatment and control rate of hypertension among Dai and Jingpo ethnic minorities aged 35 years and over of Mangshi in Yunnan province was not optimistic.There was a high prevalence of hypertension,whereas a low awareness,treatment and control rate among Dai and Jingpo ethnic minorities.And with low levels of hypertension-related knowledge in the residents and lack of self-management behaviors in the patients.Older age,family history of hypertension,obesity,central obesity and frequency of preserved food could increase the risk of hypertension,whereas high education level and married could decrease the risk of hypertension.In the future work,the areas including Mangshi where different minority nationalities live together should be taken as the key areas of prevention and treatment of hypertension,and combined with the prevalence of ethnic minorities in the region,the key population of hypertension prevention and treatment should be determined.The older,lower education level,lower income level and obesity residents should be pay more and closer attentions,especially to the Dai males and Jingpo females,and focus on improving awareness,treatment and control rate of young people.It is urgent to take measures to enhance the understanding of hypertension treatment and prevention knowledge among the females,younger,lower education level and lower income level people.To reduce the smoking and drinking rate of males,reduce the passive smoking rate,obesity and central obesity rate of females,strengthen the education of patients with intervention,especially to strengthen the blood pressure monitoring behavior of patients with lower education level,and the medication adherence rate of younger and male patients.Encourage male patients to take blood pressure control measures,guide the patients to establish good self-management behavior,enhance self-management skills,reduce and prevent high blood pressure from occurring and its complications,improve the quality of life of residents and hypertension patients. |
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