The Relationship Between Hypertension And The Other Risk Factors And Cardio-cerebralvascular Diseases In Specific Eldly Population

Objective:The evidence that how to improve the treatment for cardio-cerebral vascular diseases is offered by the evaluation of the effects of adopted measures for cardio-cerebral vascular diseases and the relationship analysis between hypertension and cardio-cerebralvascular diseases through the observation of the cardiovascular risk factors and its change in the elderly.Methodology:1.Subjects: There were 2325 elderly in cardres sanitaviums under investigation in 2003, of which 2145 were male and 180 were female. In 2006, a total of 2404 were under investigation, of which 2203 were male and 201 were female.2. Epidemiological investigation: A questionnaire called "The cardio-cerebralvascular disease and risk factors survey" was developed. Face-to-face interviews were employed in the investigations. The questionnaire included demographic information (e.g., name, gender, age), lifestyle (e.g., the habits of smoking, drinking, exercising, sleeping, etc.), medical and treatment history, and so forth.The physical examination included the measures of blood pressure, height, weight, waist circumference, hip circumference, total cholesterol, triglycerides, low density lipoprotein-C, and high density lipoprotein-C fasting blood glucose, postprandial 2 hour glucose Etc. 3. The interventions measure of cardio-cerebralvascular diseases included health education, health promotion, face to face standardization of drug treatment guidance, subordinating medical institutions to train doctors, and carrying out long-term monitoring and tracking for High-risk population.4. Statistical methods: SPSS13.0 software was adopted to analyze the data. Numerical variable were assessed by one-way ANOVA. Values were recorded as mean±standard deviation. Count information were expressed as sample rate, and assessed by Chi-square test. The relationship between cardio-cerebralvascular diseases and risk factors was evaluated by non-conditional Logistic regression analysis, where P <0.05 as statistically significant.Results:1.the incidence of cardio-cerebralvascular diseases and various risk factors: the rates of having coronary heart disease, stroke, high blood pressure, Glucose abnormalities was 28.1%, 10.3%, 44.0%, and 22.0%. The rates of having those diseases were increased to 30.1%, 11.3%, 47.8%, and 23.7% three years later. The differences of the prevalence of coronary heart disease, high blood pressure were statistically significant(P<0.05). The rates of having lipid abnormalities, smoking, drinking, overweight and obesity were 49.7%, 23.6%, 37.4%, 48.0% and 11.7%, and decreased to 48.4%, 20.5%, 35.0%, 45.8%,9.3%. The differences of the prevalence of smoking and obesity were statistically significant(P<0.05). The 3-year accumulated coronary heart disease rate was 4.0% (94 respondents), and stroke event rate was 3.0% (70 respondents).2. The relationship between cardio-cerebralvascular diseases and risk factors: In this study, the percentage of having combined two risk factors is the highest, followed by the percentage of having three risk factors. The ratios obtained in 2003 were 27.3% and 25.0% respectively. The differences between each group were statistically significant (P<0.05).The differences were found to be statistically significant (P<0.05). According to the logistic regression analysis the main risk factors of CHD included hypertension, Glucose and lipid abnormalities, smoking (P<0.05). Moreover, the main risk factor of stroke include hypertension, Glucose and lipid abnormalities (P<0.05). In the investigation of risk factors, high blood pressure had the biggest impact on coronary heart disease and stroke. OR values were 2.886 and 3.747.3. The relationship between hypertension in the elderly combined with different number of risk factors and cardiovascular diseases: As blood pressure increased, the number of cases of which combined with other risk factors, the prevalence of CHD, and stroke has gradually increased, The differences were statistically significant (P<0.05). In the same number of risk factors level, with the increased level of blood pressure, the prevalence of coronary heart disease and stroke increased gradually.4. When elderly hypertensive patients with two risk factors, the prevalence of coronary heart disease and stroke were highest (18.3% and 6.9%), with the other group comparing of the prevalence of CHD and stroke; these differences were statistically significant (P<0.05). The greatest impact of the prevalence of CHD and stroke in elderly hypertensive patients were dyslipidemia and overweight or obesity; the prevalence were 21.3% and 8.7%.Conclusions:1.In this population, the incidence of coronary heart diseases and stroke were higher than other people, and most of them have at least one risk factor. Risk factors could be controlled and the occurrence of cardio-cerebralvascular diseases could be delayed by implementing the interventions measure of cardio-cerebralvascular diseases.2. Hypertension, glucose abnormalities and lipid abnormalities were also as the risk factors of CHD and stroke in eldly population. High blood pressure is the most important risk factor among all the factors.3. In the group of Hypertension in the elderly, when the blood pressure increased, the prevalence of CHD and stroke increased gradually. The elderly hypertensive patients with two risk factors could face the highest prevalence of coronary heart disease and stroke. The biggest impact of the prevalence of CHD and stroke in the elderly hypertensive patients were dyslipidemia and overweight or obesity.