| Objective This study was to investigate the epidemiological characteristics of hypertension and subclinical target organ damage (TOD) among urban adult residents in Tianjin and to evaluate the relationship of serum aldosterone level with subclinical TOD.Methods Using a multi-stage random sampling method, two community health service centers were selected from each urban administrative district of Tianjin, and two or three districts were randomly selected from each center. Individuals aged 18 and over were investigated with questionnaire and physical examination. Participants with uncomplicated hypertension were invited for further investigations to examine for target organ involvement, including left ventricular hypertrophy (LVH), carotid plaque or intima-media thickening (IMT), microalbuminuria (MAU) and estimated glomerular filtration rate (eGFR). Logistic regression was used to evaluate the relations between subclinical TOD and serum aldosterone level.Resu I ts A total of 7852 persons with hypertension were screened out in 28515 target objects. The prevalence of hypertension was 27.5% and standardized rate was 17.2%. The prevalence rates were 27.6% in males and 27.5% in females, but the difference was not statistically significant. The prevalence of hypertension was significantly different among the age groups (male:x2=2012.412,p=0.000; female:x2=3 148.872, P=0.000;x2=5091.616, P=0.000). In both males and females prevalence of hypertension was increased with increasing BMI (male:x2=628.622, P=0.000; female:x2=1275.525, P=0.000). Patients with higher levels of education had a lower prevalence of hypertension (male,x2=413.368, P=0.000, female,x2=1339.858, P=0.000). Hypertension prevalence rate among smokers was higher than in non-smokers (male,x2=19.129, P=0.000, female,x2=146.605, P=0.000). Hypertension awareness, treatment, and control rates were 65.8%,53.1% and 14.9% respectively. A total of 1547 subjects with uncomplicated hypertension underwent further investigations to examine for target organ involvement. The prevalence rates of LVH, carotid plaques, carotid IMT, MAU and eGFR<60 ml-min-1·(1.73 m2)-1 were 37.7%,38.2%,35.4%,33.7% and 4.4%, respectively. In the whole population, the most common phenotype of TOD was carotid plaque and/or carotid IMT (52.8%). The prevalence rates of the patients categorized according to the absence or the presence of one marker, two or three markers of TOD were 20.5%,34.7%,33.7% and 11.1%, respectively. According to the logistic regression analysis adjusting for age, gender, current smoking, current drinking, previous antihypertensive treatment, body mass index, mean systolic blood pressure, mean diastolic blood pressure, duration of hypertension and other risk factors, plasma renin activity (OR 0.870,95% CI 0.791?0.958, P= 0.005) and plasma angiotensin?(OR 1.005,95%CI 1.001-1.009, P= 0.021) levels were independently associated with LVH, serum aldosterone level was independently associated with carotid IMT or plaque (OR 1.025,95% CI 1.000-1.050, P= 0.048) and MAU (OR 1.049,95% CI 1.024-1.074, P<0.001).Conclusion (1) There were a lower prevalence of hypertension, higher rates of hypertension awareness and treatment, but the hypertension control rate was still unsatisfactory in Tianjin. (2) Subclinical TOD is fairly common among urban adult residents with hypertension in Tianjin. (3) Hypertensive related damage in one organ may be associated with similar alterations in other organs. (4) The most common phenotype of TOD was carotid plaque and/or carotid IMT (52.8%). Carotid ultrasound check is very important in china. (5) MAU may have greater value for early detection of renal dysfunction. (6) RAAS, especially serum aldosterone, plays an important role in the pathogenesis of subclinical TOD. |
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