Prevalence And Risk Factors Of Prehypertension And Hypertension In Jiangxi Province, China

Background and Objective:A new report shows cardiovascular disease has become the leading cause of death among residents in China.Hypertension is a well-known risk factor for cardiovascular disease,which can cause coronary heart disease,stroke,myocardial infarction,heart failure,kidney disease and other serious complications.Moreover,individuals with prehypertension frequently progress into hypertension and are at high risk of developing cardiovascular disease and stroke.Although many studies have focused on prehypertension and hypertension in China,no large-scale survey is conducted on the prevalence and correlates of prehypertension and hypertension in southern China,especially in Jiangxi Province.Additionally,previous studies mostly focused on the relationship between age,sex,smoking,drinking,body mass index(BMI),abdominal obesity and hypertension.Few studies discussed the relationship between visceral adipose index(VAI),body fat percentage(BFP),heart rate and blood pressure.Therefore,this study aimed to estimate the prevalence and risk factors of prehypertension and hypertension among 15 years or older population in Jiangxi Province.Moreover,scientific references on the primary prevention and intervention strategies for treating hypertension were provided.Subjects and Methods:Four cities in urban areas and four counties in rural areas were selected using the probability proportional to size method in Jiangxi Province,China.A total of 15,364 participants living in Jiangxi Province for 6 months and aged 15 years or older were randomly selected to participate this survey from November 2013 to August 2014.As a result,15,296 participants were conducted and the response rate was 99.56%.All data were established using Epi Data version 3.02 software.After alignment correction,a statistical analysis was performed using the Statistical Package for Social Science software 17.0(SPSS,IL,USA)and Microsoft Excel 2007.Continuous variables were presented as mean ± standard deviation or median(IQR)as appropriate and compared using the t test or the Mann–Whitney U test,which depended on whether the quantitative data were consistent with the normal distribution.Multivariate logistiregression analysis was performed to evaluate significant risk factors foprehypertension and hypertension.A P value less than 0.05 was considered statistically significant.Results:(1)The prevalence of prehypertension,and hypertension among 15 years or older population in Jiangxi Province was 32.33%,29.00%,respectively,and standardized prevalence was 27.75%,14.12%.(2)The awareness,treatment,and control rates among all hypertensive participants were 64.77%,27.07%,and 12.58%,respectively.The awareness rate was 67.13% in urban and 61.35% in rural areas,with a significant difference in both regions(?~2=15.666,P<0.001).The treatment rate was 33.74% in urban and 17.32% in rural areas,with statistical significance(?~2=145.989,P<0.001).The control rate was 14.80% in urban and 9.33% in rural areas and there had a statistical difference(?~2=29.136,P<0.001).Although the awareness rate in males and in females was 63.88%,65.46%,no significant difference was observed(?~2=0.216,P>0.05).The treatment rate was 27.07% in males and 26.61% in females,with no difference(?~2=1.188,P>0.05).The control rate in males(12.34%)was higher than that in females(12.76%),but there was no statistical difference(?~2=0.169,P>0.05).The awareness and treatment rate increased with age increasing(P<0.01).(3)The prevalence of prehypertension was 39.16% in males and 27.57% in females,which standardized prevalence was 36.99%,21.13%.The overall prevalence of prehypertension was significantly higher in males than that in females(?~2=325.631,P<0.001).The prevalence of hypertension was 30.07% in males and 28.26% in females,which standardized prevalence was 15.51%,13.23%.The overall prevalence of hypertension was significantly higher in males than in females(c 2=106.658,P<0.001).The prevalence of prehypertension in males declined with age increasing.While the prevalence in females increased before aged 55 years,however,the prevalence in females decreased after that.The prevalence of hypertension increased with age increasing in both genders(P<0.001).The prevalence of hypertension in females before aged 65 years was lower than that of males,which became in turn in aged 65 years or older.(4)The prevalence of prehypertension in urban and rural areas was 30.09% and 34.45%,respectively,which standardized prevalence was 26.57%,29.21% and no significant urban–rural difference was observed(?~2=0.146,P=0.703).The prevalence of hypertension was 33.76% in urban and 24.04% in rural areas,which standardized prevalence was 29.21%,12.71%,with a significant difference in both genders(?~2=145.462,P<0.001).(5)As BMI or waist circumference increased,the prevalence of hypertension increased in both genders.The prevalence of prehypertension increased at first and then decreased in both genders in the same BMI category with an increase in waist circumference.However,the prevalence of prehypertension and hypertension increased in both genders in the same waist circumference category with BMI increasing.The highest combination of waist circumference and BMI categories(BMI ?28 kg/m2 and waist circumference ?95 cm for males and ?90 cm for females)was associated with a greater risk of having hypertension in males and in females,which was 51.63% and 52.73%,respectively.The prevalence of prehypertension in females was the highest at the group of BMI?28 kg/m2 and waist circumference ?90 cm,up to 55.15%.However the prevalence of hypertension in males was the highest and was 38.33% at the group of BMI ?28kg/m2 and waist circumference <80 cm.(6)A multivariate logistic regression analysis showed males had a greater correlation of developing hypertension compared with females(OR=2.729,P<0.001),and participants living in urban areas were associated with hypertension(OR=1.322,P<0.001).Unlike hypertension,the difference did not exist in prehypertension.Moreover,participants aged 45~54,55~64,65~74,and ?75years had a greater correlation of developing prehypertension and hypertension compared with participants aged 15–24 years(P<0.001).Compared with BMI<24.0kg/m2,people with BMI ?24.0 kg/m2 had a greater risk of developing prehypertension and hypertension and the ORs with an increase in BMI.Abdominal overweight was associated with a greater likelihood of having prehypertension and hypertension,while abdominal obesity was only associated with a greater risk of hypertension.Interestingly,the probability of having prehypertension and hypertension increased with an increase VAI.However,the multivariate logistic regression analysis showed a significant increase in ORs with an increase in BFP in the prehypertension group(P<0.05).Additionally,people with a high rest heart rate were more likely to develop prehypertension and hypertension(P<0.001).Unlike prehypertension,menopause were associated with a greater likelihood of having hypertension(OR=1.327,P<0.001).Surprisingly,smoking and drinking were not significantly associated with hypertension(all P>0.05).Conclusions:1.The prevalence of prehypertension and hypertension among 15 years or older population in Jiangxi Province was 32.33%,29.00%,respectively,and the standardized prevalence was 27.75%,14.12%.Males and people living in urban areas had a greater correlation of developing hypertension.2.The awareness,treatment,and control rates among all hypertensive participants were 64.77%,27.07%,and12.58%,respectively,which were higher in urban areas and elderly group.3.Males,living in urban areas,increasing age,menopause,high BMI,abdominal overweight,abdominal obesity,high VAI and high rest heart rate were risk factors of hypertension.While high BMI,abdominal overweight,high BFP,high VAI and high rest heart rate were correlated with prehypertension.