Comparison Of Prevalence Of Common Chronic Diseases In The Middle And Old Age Residents In Urban And Rural Areas Of Gongshu District, Hangzhou City

[Objectives] To compare the prevalence and multimorbidity of common chronic diseases in the middle and old age residents in urban and rural areas of Gongshu district, Hangzhou city by way of physical examination and to present fundamental data for shaping specific health management strategy.[Methods] Cluster sampling of residents over 45 years in Xiaohe Jiedao and one Kangqiao town of Gongshu district was adopted in physical examination. Conventional medical physical examination, medical technology examination and laboratory examination were made. The prevalence and multimorbidity of the top ten chronic diseases were compared by age, gender and residency group. For hypertension, diabetes and overweight or obesity in the urban or rural areas, univariate and multivariable logistic regression were used to analyze the independent influences of relevant health risk factors in family health records. Based on results of the study, framework of regional health management was presented.[Results] Among 10567 subjects, there are 8432 (79.80%) people with diseases or abnormal indicators. The prevalence rate of hypertension was highest (38.79%), next is over weight or obesity with the prevalence rate of 38.27%. The prevalences of abnormal electrocardiogram measurement, fatty liver, hyperlipoidemia, hyperglycemia (diabetes) were 34.68%, 30.12%, 23.84%, and 13.79% respectively. The old age group had statistically higher prevalence of the common ten chronic diseases in general than that of the middle age group. The prevalences of hypertension, abnormal electrocardiogram, hyperlipoidemia, hyperglycemia (diabetes), intrahepatic calculi or cholecystolithiasis, hepatic cyst in the old age group were higher than those in the middle age group. The differences of prevalences in over weight or obesity, fatty liver, cholecystitis or gall polyp, under-weight were not statistically significant. The total prevalence rates were different across gender with higher prevalence for female. The detected prevalence rates of fatty liver, hyperlipoidemia, intrahepatic calculi or cholecystolithiasis, cholecystitis or gall polyp and under-weight in female is higher, and rates of hypertension, abnormal electrocardiogram, hepatic cyst were lower than in male. The detected rates of over weight or obesity and hyperglycemia (diabetes) were not showed significant difference across gender. The prevalence rates of common chronic diseases were apparently higher in urban residents than in the rural counterparts regardless of men and women. All detection rates for common chronic disease in Xiaohe Jiedao were higher than that in Kangqiao Town except under-weight. Among the middle and old age respondents, 77.36% had at least one chronic disease and 19.42% had four and over selected chronic diseases. Female participants had higher morbidity and multimorbidity than male ones in middle age residents, while in old age residents, male participants had higher morbidity and multimorbidity than female ones. The multimorbidity in the old age group was higher than in the middle age group. As logistic regression analysis showed, inheritance, gender, poor diet habit, negative life events, over drink, little physical exercises were health risk factors of hypertension, diabetes and Overweight or obesity. Overweight or obesity is not only a separate common chronic disease, but also an important risk factor of hypertension and diabetes.[Conclusions] Health status of the middle and old age residents in urban and rural areas of Gongshu district in Hangzhou city was not optimistic. The common chronic diseases were hypertension, overweight or obesity, abnormal electrocardiogram, fatty liver, hyperlipoidemia, hyperglycemia, and metabolic syndrome. Besides the decline of physiological function, the main health risk factors came from bad lifestyle such as unbalance diet, little physical exercises, smoking, excessive drinking and psychological stress. The health management in community should focus on the most important health risk factors, which are clear causal, changeable, preventable, and curable. When the health management is conducted in community health service, a great attention should be paid to patients who are metabolic confusion and patients in early stage. Specific strategies like combination of prevention and treatment, doctor-patient interaction, and non-medicine treatment which includes diet and exercises management, energy balance and so on could be realized.