| BackgroundHypertension is a chronic and non infectious disease without obviously Clinical symptoms, represent that blood pressure is constantly exceeding140/90mmHg.It usually destroyed the heart, brain, kidney and so on, except for the direct destroy. Now, it become the most public problem in worldwide, because of high incidence and unfavorable controlment.Shanghai is a pioneering city of reform and opening, where contain about20.83thousands abroad people. These abroad people make the huge dedications for reform and economic development of shanghai. However, hypertension has been the most common disease for these people, majorly incident in30to59years old and prime life of them. Otherwise, it is difficult to treat these hypertension patients, because there is no sufficient epidemiology datum of those abroad hypertension patients, and which are different from native people.There is difference of treatment model and disease related complication development from different countries and areas in Huashan worldwide medical central. We decide to comparative analysis the disease incidence and target organs destruction and related risk factors to achieve some significant results to guide the rational and personality therapy.ObjectsCollect the clinic information of hypertension patients from various kinds of nationalities who treated in huashan worldwide medical central and reserved intact out-patients datum in four years from2007to2011. Build clinical datum bank, statistic the clinical datum distribution character and target organs destroyed datum, build a logistic multiplicity model to analysis the risk factors for target organs destroy in hypertension patients from various kinds of nationalities.MethodsOn the basis of Retrospective study on clinical datum from hypertension patients from various kinds of nationalities who treated in huashan worldwide medical central and reserved intact out-patient datum in four years from2007to2011, the datum contain patients basic informations(age, sex, nationality, birth, hypertension pathogenesis, initial symptom), Physical examination(body height, body weight, Blood pressure, BMI, personal history(smoking, drinking), family history(hypertension), previous history(hyperlipidemia, diabetes), blood and urine examination(TC, TG, HDL-C, LDL-C, FBG, UA), target organs destroy (EKG, ultrasonic cardiogram, abdomen and blood vessels B-mode ultrasonic, head CT scan/MRI scan and so on). Mantel-Haenszel tests and Fisher exact probabilities were used to analysis the clinical datum distribution character. SPSS13.0statistical software was used in all analysis. PO.05represent the statistic magnificent. Measurement data represented by x±s, ANOVA and t test examined the difference between groups. Enumeration data represented by percentage, chi-square test examined the difference between groups, logistic regression analysis were used to determine the risk factors for target organ destroy.OR and95%confidence intervals(95%CI)were calculated.Results1、In the440hypertension patients treated by our central, patients with no symptoms are80.3percents, the most common initially symptom is headache or dizziness, which contain59patients (13.4%).2、In the440hypertension patients treated by our central, the average age of440hypertension patients is52years old, average course of disease is4.85years. The average age and course of disease were smaller than that of shanghai area reported by " Investigation of hypertension treatment and control in cardiology hypertensive outpatients in shanghai" of2007(average age is65years old average course of disease is12years). At the same time, which was smaller than that of mainland of china reported by " A survey of factors influencing prognosis and control rate for patients with hypertension in mainland china " of2007(average age is59.4years old)3、In the440hypertension patients treated by our central, the average BMI index is26.5kg/m2,139smokers(31.6%),164drinkers(37.3%),59patients with diabetes(13.4%),90patients with HLP(20.5%). Which were all lower than which was smaller than that of mainland of china reported by "A survey of factors influencing prognosis and control rate for patients with hypertension in mainland china"of2007(BMI:24.1kg/m2, HLP:24.5%,diabetes:26.7%and smokers:34.4%).4、In the440hypertension patients treated by our central,28patients had kidney disease(6.4%),69patients had atherosclerosis(15.3%),51patients had LVH(11.6%),18patients with cerebral infarction(4.1%),23patients with cerebral hemorrhage(5.2%),14patients with coronary heart disease (3.2%),76patients with Myocardial ischemia performed by EKG(17.3%), one patient with left heart failure(0.2%). Which were all lower than which was smaller than that of mainland of china reported by "A survey of factors influencing prognosis and control rate for patients with hypertension in mainland china" of2007(kidney disease:22.9%, atherosclerosis:7.1%,LVH:23.6%,cerebral stroke:12.7%, coronaryheart disease:20.1%, left heart failure:6.1%).5、In the440hypertension patients treated by our central, Euramerican’ BMI index is highest in440patients, about27.94kg/m2, Japanese patients’ BMI index is lowest, about25.80kg/m2, p<0.05. taiwain&marco&hongkong of PRC patients’ disease courses were longest, about6.54years, Japanese patients are shortest, about3.7years, p<0.05. the male percents of Japanese are largest, about45.7%, taiwain&marco&hongkong of PRC are smallest, about23%, p<0.05. Japanese had the largest number of drinkers, about62%, taiwain&marco&hongkong of PRC are smallest, about21.6%, p<0.05. Chinese had the largest number of patients with hypertensive family history, about63%, the Euramerican are smallest, about38.7%, p<0.05. Japanese had the highest SBPmax, about160mmHg,Chinese are lowest, about151.12mmHg, p<0.05. Japanese had the highest DBPmax, about103.22mmHg, Euramerican are lowest, about96.59mmHg, p<,0.05. The pulse pressure of Euramerican is largest, about64.48mmHg, Chinese is lowest,57.40mmHg, p<0.05. others contained age, diabetes, HLP, FBG, TC, LDL-C, HDL-C, UA had no statistical difference among Chinese, Japanese, Euramerican and taiwain&marco&hongkong of PRC.6-. In the440hypertension patients treated by our central, Japanese patients are at higher risk of cerebral hemorrhage than Euramerican, taiwain&marco&hongkong of PRC, Chinese.(10.90%vs0.90%vs9.50%vs0.80%, p<0.05. other target organs about kidney, heart, atherosclerosis had no statistical difference among different areas patients.7、Multifactor logistics analysis the risk factors in cerebral hemorrhage of Japanese patients treated by our central, result showed that course of hypertension and TG were independently positive associated with cerebral hemorrhage of Japanese patients (OR=1.128and1.581). There were no statistic significant in other risk factors contained age, smoke, BMI, diabetes.Conclusions1、The symptoms of the hypertension patients treated by our central were insidious. But the age and course of disease were all smaller than that of mainland area. Smoke, diabetes, HLP were all less than that of mainland area, and hypertension related complications contained kidney, heart, cerebral, peripheral vascular were all less than that of mainland area. It showed that the Medical idea, Lifestyle, prognosis of hypertension were all superior to that of mainland residents.2、In the patients treated by our medical central, the TG level of Euramerican was lowest, but it was highest in taiwain&marco&hongkong of PRC who had the worst awareness. It showed that the reversion of TG between the Eastern and Western worlds was coming.3、In the patients treated by our medical central, Chinese patients had the most proportion of history of hypertension. It showed that the Chinese people who had history of hypertension should do Regular Physical Examination.4、In the hypertension patients treated by our central, Japanese group had the most male patients, most drinkers, highest blood pressure, shortest course of disease and highest cerebral hemorrhage. Further Analysis showed that the course of hypertension and hight level of TG were independently positive associated with cerebral hemorrhage of Japanese patients. So Japanese hypertension patients’ should improve their lifestyle, control the blood pressure and TG level strickly and do Regular Physical Examination. |
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