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      Prevalence, awareness, medication, control, and risk factors associated with hypertension in Yi ethnic group aged 50 years and over in rural China: the Yunnan minority eye study

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          Abstract

          Background

          Hypertension is an important public health issue in China, but there are few studies examining hypertension in ethnic groups in Yunnan, China. This study, Yunnan Minority Eye Study (YMES), was initially designed to determine the prevalence and impact of eye diseases, including hypertension and diabetes mellitus. As a part of YMES, the prevalence, awareness, treatment, and control of hypertension and the associated risk factors among the Yi ethnic population in rural China are reported.

          Methods

          A population-based survey was conducted in 2012 with adult participants over 50 from rural communities in Shilin Yi Autonomous County, Yunnan Province, located in southwest China. A random cluster sampling method was used to select a representative sample. The participants’ blood pressure, height, weight, and waist circumference were measured. Hypertension was defined as mean systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of antihypertensive medications.

          Results

          A total of 2208 adults were assessed. The prevalence of hypertension was 38.5%, and the age- and gender-adjusted prevalence was 37.0%. The proportion of patients who were aware of their hypertension among those diagnosed with hypertension was 24.8%. Of those aware of having hypertension, 23.6% took antihypertensive drugs. Among all hypertensive patients, only 7.2% had controlled their hypertension (<140/90 mmHg). Risk factors for hypertension were older age, smoking, alcohol consumption, family history of high blood pressure, overweight, and obesity. Protective factors included being slim and higher education.

          Conclusions

          Hypertension was highly prevalent among this population of the Yi ethnic group in China. The ratio of awareness, treatment, and control of hypertension were considerately low. Hypertension education and screening programs in rural China are recommended to improve the health status of this population.

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          Most cited references21

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          Global burden of hypertension: analysis of worldwide data

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            2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension.

            Hypertension is estimated to cause 4.5% of current global disease burden and is as prevalent in many developing countries, as in the developed world. Blood pressure-induced cardiovascular risk rises continuously across the whole blood pressure range. Countries vary widely in capacity for management of hypertension, but worldwide the majority of diagnosed hypertensives are inadequately controlled. This statement addresses the ascertainment of overall cardiovascular risk to establish thresholds for initiation and goals of treatment, appropriate treatment strategies for non-drug and drug therapies, and cost-effectiveness of treatment. Since publication of the WHO/ISH Guidelines for the Management of Hypertension in 1999, more evidence has become available to support a systolic blood pressure threshold of 140 mmHg for even 'low-risk' patients. In high-risk patients there is evidence for lower thresholds. Lifestyle modification is recommended for all individuals. There is evidence that specific agents have benefits for patients with particular compelling indications, and that monotherapy is inadequate for the majority of patients. For patients without a compelling indication for a particular drug class, on the basis of comparative trial data, availability, and cost, a low dose of diuretic should be considered for initiation of therapy. In most places a thiazide diuretic is the cheapest option and thus most cost effective, but for compelling indications where other classes provide additional benefits, even if more expensive, they may be more cost effective. In high-risk patients who attain large benefits from treatment, expensive drugs may be cost effective, but in low-risk patients treatment may not be cost-effective unless the drugs are cheap.
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              Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002.

              The present article aims to provide accurate estimates of the prevalence, awareness, treatment, and control of hypertension in adults in China. Data were obtained from sphygmomanometer measurements and an administered questionnaire from 141 892 Chinese adults >/=18 years of age who participated in the 2002 China National Nutrition and Health Survey. In 2002, approximately 153 million Chinese adults were hypertensive. The prevalence was higher among men than women (20% versus 17%; P<0.001) and was higher in successive age groups. Overall, the prevalence of hypertension was higher in urban compared with rural areas in men (23% versus 18%; P<0.01) and women (18% versus 16%; P<0.001). Of the 24% affected individuals who were aware of their condition, 78% were treated and 19% were adequately controlled. Despite evidence to suggest improved levels of treatment in individuals with hypertension over the past decade, compared with estimates from 1991, the ratio of controlled to treated hypertension has remained largely unchanged at 1:4. One in 6 Chinese adults is hypertensive, but only one quarter are aware of their condition. Despite increased rates of blood pressure-lowering treatment, few have their hypertension effectively controlled. National hypertension programs must focus on improving awareness in the wider community, as well as treatment and control, to prevent many tens of thousands of cardiovascular-related deaths.
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                Author and article information

                Contributors
                lxchenkmu@163.com
                zongykmu@163.com
                weitaokmu@163.com
                shengxunkmu@163.com
                shenweikmu@163.com
                lijunkmu@163.com
                yangxiaokmu@163.com
                zhonghuakmu@163.com
                zhangyangkmu@163.com
                1119abcd@163.com
                chenkmu@163.com
                zhoculist@163.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                15 April 2015
                15 April 2015
                2015
                : 15
                : 383
                Affiliations
                [ ]The First Affiliated Hospital of Kunming, Medical University, Kunming, China
                [ ]The First Affiliated Hospital of Nanjing, Medical University, Nanjing, China
                [ ]Kunming Medical University, Kunming, China
                [ ]The Second People’s Hospital of Yunnan Province, Kunming, China
                Article
                1687
                10.1186/s12889-015-1687-4
                4404212
                25886600
                2e06aa0c-cbcf-49f2-a2e7-787169b89b70
                © Chen et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 November 2014
                : 26 March 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Public health
                hypertension,prevalence,awareness,medication,control,risk factors,yi ethnic group
                Public health
                hypertension, prevalence, awareness, medication, control, risk factors, yi ethnic group

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