Evaluation Of Lifestyle Modification On Blood Pressure Control In Mid-western Rural Area Of Shandong Province

BackgroundHypertension is a major global chronic non-communicable disease. One-quarter of theworld’s adult population were hypertension, and this is likely to increase to29%by2025. The prevalence of hypertension in developed nations is37.3%compared with22.9%in developing nations. Hypertension is a major public health problem in theworld. With the rapid development of economic, the incidence of hypertension alsogrows rapidly. According to National Health and Nutrition Survey in2002, Shandongsuffered a level of27.5%hypertension prevalence in adults aged18and above, higherthan the national level (18.8%). More and more attention has been drawn on theincreasing burden caused by non-communicable disease, establishing a scientific andeffective prevention and control countermeasures has already been a public healthproblems to solve. Domestic and foreign research had shown that family history,overweight, high salt intake, excessive drinking were risk factors for hypertension.Comprehensive lifestyle modification is best solutions for hypertension preventionand control.ObjectiveTo determine the change of blood pressure and evaluate the effect of communitycomprehensive lifestyle modification on blood pressure control in mid-western ruralarea of Shandong province. Additionally, to explore a suitable intervention model, decreasing the disease burden, providing some experience for rural interventionstrategies.MethodsA non-communicable disease control project was launched in mid-western rural areaof Shandong province from2007to2010. Health education focusing on a balance diet,physical activity promotion and tobacco&alcohol control was performed among theintervention population. The baseline survey was performed using the multi-stagerandom sampling methods in8counties of mid-western rural area in2007and2010.Participants aged25and above were recruited to undergo a questionnaire survey,physical examination and blood pressure measurement. The final evaluation surveyincluded the intervention group and control group which were selected fromintervention and non-intervention areas, respectively. The effect was evaluatedcompare the difference between two surveys.ResultsI The total number of participants were16351in the baseline survey (57.21%female), The corresponding figure were3810in the2010intervention group (58.57%female) and2013in the2010control group (57.21%female). The mean age ofbaseline population sample was51.21, the2010survey53.98,53.25separately after3years.II There was no significant difference in sex and age of2007baseline and2007intervention,2010intervention group and2010control group. Mean systolic bloodpressure (SBP) and diastolic blood pressure (DBP) in the baseline population in2007were134.46and83.50mmHg, respectively, and those in2010were132.47and80.80mmHg in the intervention group and, and133.45and81.12mmHg, in the controlgroup. Significant decreases in SBP and DBP were found between the baseline in2007and the intervention group in2010. Insignificant decreases were found betweenthe intervention and control population in2010.III The mean blood pressure of hypertensive in2007baseline is153.05/91.68mmHg,150.47/87.50mmHg in the2010intervention group and153.23/88.59mmHg in the2010control group, the decrease has significant difference between the pre-andpost intervention group, the decrease SBP also has significant difference in theintervention and control group, instead of the decrease DBP.IV The normal BP proportion, high-normal BP proportion, the percentages withstages1,2, or3hypertension in2010intervention group were respectively19.19%、48.61%、18.82%、9.69%,3.70%, the percentages with stages1,2, or3hypertensionhas increased than the2007baseline. Compared to the2010control group, the2010intervention group hypertension percentages was lower.V The awareness, treatment and control rate of hypertension increased significantlyby24.82%、34.83%、15.34%in2010intervention group than the2007baseline, andhigher than2010control group.VI Reugular physical excise and low sodioum and fat dietary intake were approvedto have siginificant effect on hypertension control by unconditional logistic regressionanalysis.ConclusionsCommunity comprehensive lifestyle modification exerts significant effects on bloodpressure control, epecially better for male, older age group and hypertensive.Awareness, treatment, and control rates of hypertension as well as knowledge relatedwith hypertension get improved in intervention group, better in male, older age group,senior education and above, lower group. We summarize the intervention experience,and provide evidence for promoting lifestyle modification in community andformulating rural hypertension intervention strategies.