Multilevel Analysis of the Determinants of Pre-Hypertension and Hypertension in Rural Southwest China

Robson, Mark G.; Cai, Le; Dong, Jun; Yi-chun, LU; Zhankun, Shu; Ke-ying, Zhao

doi:10.1177/003335491112600316

Cited by 15 publications

(9 citation statements)

References 33 publications

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“…From 2001 to 2010, the prevalence of pre-hypertension decreased, whereas the prevalence of hypertension increased with increasing age, which is consistent with other studies [ 13 , 15 33 , 34 ]. Males had a higher prevalence of pre-hypertension but a lower prevalence of hypertension, particularly in 2010, demonstrating a trend similar to that reported for the subgroup aged 65–74 by Gu et al [ 28 ].…”

Section: Discussionsupporting

confidence: 91%

Trends in Prevalence, Awareness, Treatment and Control of Hypertension during 2001-2010 in an Urban Elderly Population of China

Jiang

et al. 2015

PLoS ONE

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ObjectiveAs the most important risk factors of cardiovascular disease, pre-hypertension and hypertension are important public health challenges. Few studies have focused on the trends of pre-hypertension and hypertension specifically for the aging population in China. Given the anticipated growth of the elderly population in China, there is an urgent need to document the conditions of pre-hypertension and hypertension in this aging population.MethodsWe conducted two cross-sectional surveys of Chinese adults aged ≥60 years in 2001 and 2010. A total of 2,272 (943 males, 1,329 females) and 2,074 (839 males, 1,235 females) participants were included in the two surveys, respectively.ResultsThe age- and sex-standardized prevalence of hypertension significantly increased from 60.1% to 65.2% from the 2001 to the 2010 survey. Among the participants with hypertension, the awareness, treatment and control of hypertension all significantly increased from 69.8% to 74.5%, 50.3% to 63.7%, and 15.3% to 30.3%, respectively, from 2001 to 2010. A logistic regression showed that a higher education level, a higher BMI, a family history of hypertension and doctor-diagnosed cardiovascular disease were significantly associated with hypertension awareness and treatment.ConclusionHypertension prevalence increased rapidly between the years surveyed. Although the awareness, treatment and control of hypertension improved significantly, the values of these variables remained low. More attention should be given to the elderly because the population is aging worldwide, and urgent action, optimal treatment approaches and proper public health strategies must be taken to prevent and manage hypertension.

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Section: Discussionsupporting

confidence: 91%

Trends in Prevalence, Awareness, Treatment and Control of Hypertension during 2001-2010 in an Urban Elderly Population of China

Jiang

et al. 2015

PLoS ONE

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“…Among the individual level non-modifiable factors, age, sex and marital status are found to be significantly associated with hypertension. Similar to the previous studies, older participants, males, widowed, divorced and separated, Christians and Muslims, scheduled tribes, low educated and wealthier respondents are more likely to be hypertensive[ 24 – 26 ].…”

Section: Discussionsupporting

confidence: 75%

“…socio-economic characteristics, health and lifestyle practices). On the contrary, at the community level a higher value of VPC (13% to 14%) shows a higher rate of variation in the prevalence of hypertension and can be attributed to the effects of background factors [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of hypertension in Maharashtra, India: A multilevel analysis

Bhise

Patra

2018

PLoS ONE

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Background and aimIn the last few decades, the prevalence of hypertension has been drastically increased in India. The present study estimates the current prevalence of hypertension and its correlates in the state of Maharashtra. The variation in the prevalence of hypertension associated with individual-level characteristics is explained at the community and district level.MethodsData is used from the recent round of District Level Household & Facility Survey (DLHS-4), 2012–13. The DLHS-4 has used the nationally representative sample, collected through multistage stratified sampling procedure. A similar sampling frame, used in NSSO-2007-08, has been followed. The chi-square test is used to show the significance level of the association between the estimated prevalence of hypertension and its correlates. Multilevel regression analysis is carried out to investigate the effects of individual and community level factors on the prevalence of hypertension.ResultsThe overall prevalence of hypertension is 25% in Maharashtra, and a huge variation in the prevalence of hypertension is found across the districts. Dhule, Gadchiroli (with a low HDI rank), Mumbai and Satara (with higher HDI rank) are the districts with the higher (above 30%) prevalence of high blood pressure. The prevalence also significantly varies according to different correlates. The prevalence of high blood pressure is higher among elderly population (40%), among males (28%), in the urban areas (27%) and in the richest wealth quintile (28%). The prevalence is also higher among cigarette smokers (31%), alcohol consumers (30%) and people with obesity (38%) as compared to their counterparts. The results of the multilevel analysis show that the older and obese persons are at four-time higher risk of hypertension. Again, age, sex, marital status, place of residence, wealth status, unhealthy habits (i.e. smoking and alcohol consumption) and BMI are significantly associated with hypertension. The results of VPC statistics show that 14% of hypertension prevalence could be attributed to differences at the community level.ConclusionThe prevalence of hypertension largely varies in the districts of Maharashtra irrespective of their level of socio-economic development (i.e. HDI rank). The variation in the rate of prevalence of hypertension is higher in the community (PSU) level as compared to the variation in the prevalence rate at the district level. Hypertension is attributable to the modifiable factors like risky lifestyle practices.

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“…In China, the prevalence of chronic diseases has risen rapidly in the last decade. This increase has been followed by a worldwide trend in the consideration of the growing burden of non-communicable diseases as a serious public health concern [ 5 ]. As recent studies have shown, the burden of chronic diseases can increase considerably as the population ages [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

What Contributes to the Activeness of Ethnic Minority Patients with Chronic Illnesses Seeking Allied Health Services? A Cross-Sectional Study in Rural Western China

Tang

Dong

et al. 2015

IJERPH

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Actively seeking health services lies at the core of effective models of chronic disease self-management and contributes to promoting the utilization of allied health services (AHS). However, the use of AHS by ethnic minority Chinese, especially the elderly living in rural areas, has not received much attention. This study, therefore, aims to explore the association between personal characteristics and the activeness of ethnic minority patients with chronic diseases in rural areas of western China seeking AHS. A cross-sectional study was conducted to collect data on the socio-demographic and economic characteristics, health knowledge level and health communication channels of the sampled patients. A logistic regression model was used to examine the association of these predictors with the activeness of the surveyed patients in seeking AHS. A total of 1078 ethnic minorities over 45 years old who had chronic conditions were randomly selected from three western provinces in China and were interviewed in 2014. It is found that the New Cooperative Medical Scheme (NCMS) is the most salient predictor affecting the activeness of Chinese ethnic minorities in seeking AHS. The probability is 8.51 times greater for those insured with NCMS to actively seek AHS than those without (95% Confidence Interval (CI) 4.76–15.21; p < 0.001). Moreover, participants between 60 and 70 years old and those who have five to six household members are more likely to seek AHS compared with other social groups (Odds Ratio (OR) = 1.64, 95% CI 1.28–2.97, p = 0.007; OR = 1.95, 95% CI 1.15–2.36, p = 0.002). However, the activeness of patients seeking AHS is lower for those who have better household economic conditions. Besides socio-demographic predictors, the Chinese ethnic minorities’ activeness in seeking AHS is clearly associated with the communication channels used for receiving health information, which include direct communication with doctors (OR = 5.18, 95% CI 3.58–7.50, p < 0.001) and dissemination of elementary public health knowledge posted on bulletin boards (OR = 2.30, 95% CI 1.61–3.27, p < 0.001) and traditional mass media (OR = 1.74, 95% CI 1.22–2.48, p = 0.002). First, the government should further improve the coverage of NCMS to households suffering from chronic diseases and satisfy the requirements of social groups at different income levels and various ages in their health care to improve their activeness in AHS utilization. Second, doctors’ advice, bulletin boards and traditional media are common health communication channels for those seeking AHS and thus should be continuously employed in rural western China. Third, specified healthcare services should be designed to meet the needs of different patient segmentations.

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Multilevel Analysis of the Determinants of Pre-Hypertension and Hypertension in Rural Southwest China

Cited by 15 publications

References 33 publications

Trends in Prevalence, Awareness, Treatment and Control of Hypertension during 2001-2010 in an Urban Elderly Population of China

Trends in Prevalence, Awareness, Treatment and Control of Hypertension during 2001-2010 in an Urban Elderly Population of China

Prevalence and correlates of hypertension in Maharashtra, India: A multilevel analysis

What Contributes to the Activeness of Ethnic Minority Patients with Chronic Illnesses Seeking Allied Health Services? A Cross-Sectional Study in Rural Western China

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