| ObjectiveTo investigate the prevalence of hypertension among Han and Manchu adults in Hebei Province.To explore the risk factors of hypertension and the interaction between risk factors on hypertension.MethodsA cross-sectional study was conducted from July to August 2017 in Shijiazhuang,Chengde,and Xiong’an New Area,Hebei Province.The sample of Han and Manchu residents aged 20 to 80 years old was selected using a multistage stratified cluster sampling method.A total of 5956 people,including 3768 Han and 2188 Manchu,were included for analysis.Data was collected by questionnaires and anthropometric measurement.Participants were determined to be hypertensive if they had a systolic blood pressure(SBP)≥140 mmHg and/or a diastolic blood pressure(DBP)≥ 90 mmHg and/or a history of hypertension and/or were currently taking antihypertensive medications.Sex and age standardized prevalence were calculated based on the data of 2020 China census population.Multivariate logistic regression model was used to analyze the association between ethnicity,sex,age,residence,body mass index(BMI),socioeconomic status(education,economic status)and lifestyle factors(smoking,drinking,physical exercise and physical labor)with hypertension.The risk of hypertension with age and BMI was explored using a restricted cubic spline function.The interaction between the risk factors on hypertension was analyzed using the addictive interaction model.The interaction between different factors was evaluated according to relative excess risk due to interaction(RERI),attributable proportion due to interaction(AP)and synergy index(SI).ResultsThe crude prevalence of hypertension among Han and Manchu adults aged 20 to 80 years in Hebei Province in 2017 was 38.57%,and the prevalence of hypertension after sex and age standardization was 37.58%.The crude prevalence of hypertension was 45.67%in men and 33.87%in women.After age standardization,the prevalence of hyertension was higher in men than women(42.60%vs.32.33%,P<0.001).The crude prevalence of hypertension was 39.78%in Han people and 36.47%in Manchu.After standardization by sex and age,there was no statistical difference in the prevalence of hypertension between Han and Manchu people(38.68%vs.35.67%,P=0.088).The prevalence of hypertension was 32.35%in urban and 43.51%in rural areas in Hebei province,and was higher in rural than that in urban areas after sex and age standardization(40.23%vs.34.11%,P<0.001).After adjusting for age,sex,current residence,BMI,socioeconomic status,and lifestyle factors,there was no statistical difference in the risk of hypertension between Han and Manchu people(OR=0.94,95CI%:0.82～1.07,P=0.333).The risk of hypertension was lower in women than men(OR=0.50,95%CI:0.41～0.62),higher in rural than urban areas(OR=1.34,95%CI:1.15～1.57),and higher in those with a family history of hypertension than those without(OR=3.39,95%CI:2.76～4.17).The risk of hypertension was lower among those with middle school to high school,college and above than those with elementary school and below(middle school to high school:OR=0.82,95%CI:0.70～0.96;college and above:OR=0.70,95%CI:0.55～0.90).The risk of hypertension was lower among those with annual personal income≥20,000 yuan than among those with annual personal income<20,000 yuan(OR=0.83,95%CI:0.72～0.97).There was no statistically significant association between smoking status(never smoked,quit smoking,and current smoking),smoking amount,smoking years and smoking index with hypertension.Excessive alcohol consumption was associated with an increased risk of hypertension.The risk of hypertension was positively associated with age and BMI.The risk of hypertension for the age groups 30 to 39 years old,40 to 49 years old,50 to 59 years old,60 to 69 years old,and 70 to 80 years old were 2.07 times(95%CI:1.48～2.91),5.42 times(95%CI:3.98～7.49),12.51 times(95%CI:9.20～17.28),22.74 times(95%CI:16.36～32.08),and 38.89 times(95%CI:26.01～58.93)respectively compared to the age group of 20 to 29 years old.The risk of hypertension for overweight and obese people were 2.14 times(95%CI:1.85～2.47)and 4.18 times(95%CI:3.50～4.99)respectively compared to people with a normal weight.There was a positive additive interaction between family history of hypertension and overweight/obesity on hypertension with RERI of 7.91(95%CI:4.59～11.24),AP of 0.53(95%CI:0.43～0.62),and SI of 2.29(95%CI:95%CI:1.81～2.9).There was a positive additive interaction between overweight/obesity and excessive alcohol consumption on hypertension with RERI of 1.67(95%CI:0.49～2.85),AP of 0.36(95%CI:0.18～0.54),and SI of 1.85(95%CI:1.26～2.72).There was no additive interaction between family history of hypertension and excessive alcohol consumption on hypertension.ConclusionThe prevalence of hypertension among adults aged 20 to 80 years in Hebei Province was not statistically different between Han and Manchu people,and was higher in men than women and higher in rural than urban areas.The prevalence of hypertension increased with age and BMI in different ethnicities,genders and current residence.Higher educational level and higher economic income were associated with a decreased risk of hypertension.Family history of hypertension and excessive alcohol consumption were associated with an increased risk of hypertension.There was no statistically significant association between smoking status(never smoked,quit smoking,and current smoking),smoking amount,smoking years and smoking index with hypertension.There was a positive additive interaction of family history of hypertension and overweight/obesity,and overweight/obesity and excessive alcohol consumption on hypertension. |
