The Prevalence Survey Of Hypertension In Different Age Groups In Tianjin

Objective:To analyze the risk factors of hypertension in different age groups of urban and rural residents in Tianjin.To analysis the prescriptions of hypertension and explore the predictive value and cut-off value of different obesity indices for hypertension in different age groups,in order to improve the control rate of hypertension in Tianjin.Methods:A total of 33997 patients aged 35-75 years were enrolled in 13 community health service centers and primary hospitals in Tianjin.The patients were divided into youth group(≤40),middle-aged group(41-65)and elderly group(>65),then were conducted questionnaire,physical examination and blood biochemical test.The demographic characteristics were analyzed and risk factors were analyzed by univariate and stepwise multivariate logistic regression analysis and Spearman’s rank-correlation.The prescriptions of 7451 patients with hypertension were analyzed.ROC and AUC were used to compare the predictive value and cut-off value of BMI,WC and WHtR to hypertension.Results:1.In different groups,the prevalence rate of hypertension was 18.65%,51.80%and 76.61%;the awareness rate was 26.99%,56.14%and 69.63%;the treatment rate was 23.51%,53.84%and 67.62%respectively.Logistic regression analysis showed that obese,abdominal obese,male,diabetes mellitus and dyslipidemia were the top five factors affecting hypertension in youth group.In middle-aged group,stroke and cardiovascular disease were closely related to hypertension,while abdominal obesity,obese and diabetes mellitus were the main risk factors for hypertension.In the elderly group,central obesity,obese and diabetes mellitus had significant effects on hypertension,while stroke and cardiovascular disease were closely related to hypertension.2.The drug prescription analysis showed that in the total population,young,middle and old groups,the proportion of single drug use was 62.97%and 63.49%,59.26%and 63.49%and the highest rate of taking was CCB.The rate of two drug classes was 24.51%,29.63%,25.13%and 23.15%and The drug use rate of CCB combined with ACEI/ARB was the highest.The rate of three drug classes was 4.08%,4.94%,4.36%and 3.52%,and the the highest was ACEI/ARB,CCB combined with diuretics.The rate of four drug classes was low.As for hypertension grade,in grade 1,grade 2 and grade 3,the rate of singe drug were 63.53%,62.69%and 58.38%,respectively;the rate of two drug classes was 24.62%、23.97%、25.05%;while the rate of three drug classes was 3.86%、4.39%、5.34%,respectively.In the grade 2 and grade 3,the rate of combine drug was still low.3.Analysis of predictive value in hypertension of different obesity indicesshowed that the cut-off points of BMI in the young,middle and elderly groups were 27.45kg/m~2,26.15kg/m~2 and 25kg/m~2 in men,26kg/m~2,25.85kg/m~2 and25.85kg/m~2 in women respectively.The cut-off points of WC in different age groups were 86.9cm,90.1cm and 91.9cm in males and 83.5cm,85.45cm and 87.3cm in females,respectively.The cut-off points of WHtR were 0.51,0.52 and 0.54 in men and 0.52,0.53 and 0.54 in females.The AUC of WC(0.635-0.731)and WHtR(0.631-0.730)was higher than that of BMI(0.607-0.701)in all groups,meanwhile in the middle age group and young women,the AUC of WHtR was higher than that of WC.4.The Spearman’s rank-correlation showed that age was positively correlated with hypertension grade,diabetes mellitus WC and WHtR while was negative correlation with BMI and hypertension grade was positively correlated with and combined drug,BMI,WC and WHtR.Conclusion:1.The prevalence rate of hypertension in the middle and old age population is high,but the awareness rate and treatment rate of young people are low and the overall control rate is low.The rate of single drug use is high,among which the rate of CCB drug use is the highest while the rate of combined drug use in youth was slightly higher than that in the middle and old age,and the common combination of two drugs was common,among which CCB combined with ACEI/ARB was the highest.In the grade 2 and grade 3,the rate of combine drug was still low.2.The risk factors of different age groups are not exactly the same.The BMI cut-off value of central obesity index decreased with age,and WC and WHtR increased with age,whose value of predicting hypertension was better than BMI,and the predictive value of WHtR in middle-aged and young women was higher than that of WC.