Effects of Demographic Characteristics, Health-Related Behaviors and Lifestyle Factors on the Prevalence of Hypertension for the Middle-Aged and Elderly in the Guangxi Hei Yi Zhuang and Han Populations

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Abstract

Background/Aims: Hei Yi (meaning black worship and black dress) Zhuang is the most conservative group among the 43 ethnic subgroups of Zhuang in China due to its unique culture and customs. The prevalence of hypertension in this population has not been well defined. Therefore, the present study was undertaken to compare the effects of the demographic characteristics, health-related behaviors and lifestyle factors on the prevalence of hypertension in the middle-aged and elderly of the Guangxi Hei Yi Zhuang and Han populations. Methods:A total of 657 people of Hei Yi Zhuang aged 40 and over were randomly selected from 7 villages in Napo County of China. Information on the demographic characteristics, health-related behaviors and lifestyle factors was collected by questionnaire. Blood pressure, height, weight, waist circumference, serum lipid and apolipoprotein levels were measured, and body mass index (BMI) was calculated as a measure of weight relative to height. The results were compared with those of 520 Han who live in the same district. Results: The prevalence of hypertension and isolated systolic hypertension in Hei Yi Zhuang was significantly higher than in Han (32.9 vs. 24.6%, p < 0.01, and 16.7 vs. 5.2%, p < 0.001, respectively). The systolic blood pressure levels and pulse pressure in Hei Yi Zhuang were also significantly higher than in Han (129 ± 20.1 vs. 125.8 ± 17.4 mm Hg, p < 0.01, and 51.5 ± 16.1 vs. 47.1 ± 12.0 mm Hg, p < 0.01, respectively). The prevalence of hypertension was positively correlated with triglycerides, male, age, and alcohol consumption in Hei Yi Zhuang, whereas it was positively correlated with total cholesterol, male, age, alcohol consumption and BMI in Han. The rates of awareness, treatment and control in Hei Yi Zhuang and Han are 7.9 vs. 19.5%, 4.2 vs. 13.3% and 1.4 vs. 9.4% (p < 0.01 for all), respectively. Conclusion: The current study reveals a significant difference in the prevalence of hypertension, blood pressure levels, and the relative factors between the Hei Yi Zhuang and Han ethnic groups, which may have been due to differences in geographical characteristics, lifestyle, sodium intake, education levels, and even genetic factors.

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Prevalence, Awareness, Treatment, and Control of Hypertension in China

Dongfeng Gu, Kristi Reynolds, Xigui Wu … (2002)

The objective of this study was to estimate the prevalence and distribution of hypertension and to determine the status of hypertension awareness, treatment, and control in the general adult population in China. The International Collaborative Study of Cardiovascular Disease in ASIA (InterASIA), conducted in 2000-2001, used a multistage cluster sampling method to select a nationally representative sample. A total of 15 540 adults, age 35 to 74 years, were examined. Three blood pressure measurements were obtained by trained observers by use of a standardized mercury sphygmomanometer after a 5-minute sitting rest. Information on history of hypertension and use of antihypertensive medications was obtained by use of a standard questionnaire. Hypertension was defined as a mean systolic blood pressure > or =140 mm Hg, diastolic blood pressure > or =90 mm Hg, and/or use of antihypertensive medications. Overall, 27.2% of the Chinese adult population age 35 to 74 years, representing 129 824 000 persons, had hypertension. The age-specific prevalence of hypertension was 17.4%, 28.2%, 40.7%, and 47.3% in men and 10.7%, 26.8%, 38.9%, and 50.2% in women age 35 to 44 years, 45 to 54 years, 55 to 64 years, and 65 to 74 years, respectively. Among hypertensive patients, only 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved blood pressure control (<140/90 mm Hg). Our results indicate that hypertension is highly prevalent in China. The percentages of those with hypertension who are aware, treated, and controlled are unacceptably low. These results underscore the urgent need to develop national strategies to improve prevention, detection, and treatment of hypertension in China.

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Inflammation, abdominal obesity, and smoking as predictors of hypertension.

Kari Punnonen, Jukka T. Salonen, Riitta Salonen … (2004)

Development of hypertension has been linked to chronic low-grade inflammation. However, it is not known whether this connection is mediated by features of the metabolic syndrome or smoking, or their changes, which themselves have been linked to inflammation. We studied the predictive value of highly sensitive C-reactive protein (hs-CRP), smoking, and abdominal obesity to the development of hypertension in an 11-year follow-up of a population-based study cohort comprising 379 middle-aged normotensive men. During the follow-up, 124 men (33%) developed hypertension. Men with hs-CRP > or =3.0 mg/L were 2.8x (95% confidence interval, 1.2 to 6.6) more likely to develop hypertension than with hs-CRP <1.0 mg/L even after adjustment for features of the metabolic syndrome, lifestyle factors, and their changes. Cigarette smoking was also associated with development of hypertension independently of inflammation and other confounders. Waist girth increased more in men who quit smoking than in other men. An increase in waist girth during follow-up strongly predicted incident hypertension. The decrease in smoking was not associated with a lower risk of hypertension in age-adjusted analyses. Hypertension is preceded by low-grade chronic inflammation in middle-aged white men independently of smoking or features of the metabolic syndrome. Furthermore, smoking may be a risk factor for hypertension. Although stopping smoking is beneficial with respect to health outcomes, the subsequent increase in weight and waist girth associated with smoking cessation may offset the decrease in the risk of hypertension that one may otherwise expect.

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Change in body mass index and its impact on blood pressure: a prospective population study.

K Midthjell, Tom I L Nilsen, W Drøyvold … (2005)

Overweight and obesity increase the risk of elevated blood pressure, but the knowledge of the effect of weight change on blood pressure is sparse. To investigate the association between change in body mass index (BMI) and change in diastolic blood pressure (DBP), systolic blood pressure (SBP), and hypertension status. Two population-based cross-sectional studies, one in 1984-86 and the other in 1995-97. The Nord-Trondelag Health Study (HUNT). We included 15,971 women and 13,846 men who were 20 y or older at the first survey, without blood pressure medication at both surveys and without diabetes, cardiovascular disease or dysfunction in daily life at baseline. Weight, height and blood pressure were measured standardised. Change in BMI was categorised as stable (initial BMI+/-0.1 kg/m2 each follow-up year), increased or decreased, and BMI was categorised by using World Health Organisation's categorisation (underweight BMI: or =30 kg/m2). An increase in BMI and a decrease in BMI were significantly associated with increased and decreased SBP and DBP, respectively, compared to a stable BMI in both genders and all age groups, although the strongest effect was found among those who were 50 y and older. The adjusted odds ratio for having hypertension at HUNT 2 was 1.8 (95% confidence interval (CI): 1.5, 2.2) among women and 1.6 (95% CI: 1.4,1.8) among men aged 20-49 y who increased their BMI compared to those who had stable BMI. A similar, but weaker association was found among women and men aged 50 y or more. The mean change in both SBP and DBP was higher for those who changed BMI category from first to the second survey than for those who were in the same BMI class at both surveys. Our result supports an independent effect of change in BMI on change in SBP and DBP in both women and men, and that people who increase their BMI are at increased risk for hypertension.

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Journal

Journal ID (publisher-id): KBR

Journal ID (nlm-ta): Kidney Blood Press Res

Journal ID (doi): 10.1159/issn.1420-4096

Title: Kidney and Blood Pressure Research

Publisher: S. Karger AG

ISSN (Print): 1420-4096

ISSN (Electronic): 1423-0143

Publication date Subscription-year: 2006

Publication date (Print): December 2006

Publication date (Electronic): 22 December 2006

Volume: 29

Issue: 5

Pages: 312-320

Affiliations

^aDepartment of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital, ^bDepartment of Molecular Biology, Medical Scientific Research Center, ^cDepartment of Pathophysiology, School of Premedical Sciences, and ^dDepartment of Clinical Science, Experiment Center, First Affiliated Hospital, Guangxi Medical University, Nanning, and ^eHealth Bureau of Napo County, Guangxi Zhuang Autonomous Region, Baise, China

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Publisher ID: 97019 Other ID: Kidney Blood Press Res 2006;29:312–320

DOI: 10.1159/000097019

PubMed ID: 17106209

SO-VID: f9733cf0-4051-468b-bf69-c81bf3fde23e

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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Effects of Demographic Characteristics, Health-Related Behaviors and Lifestyle Factors on the Prevalence of Hypertension for the Middle-Aged and Elderly in the Guangxi Hei Yi Zhuang and Han Populations

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Karger: Nephrology

Most cited references 33

Prevalence, Awareness, Treatment, and Control of Hypertension in China

Inflammation, abdominal obesity, and smoking as predictors of hypertension.

Change in body mass index and its impact on blood pressure: a prospective population study.

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