Self-reported hypertension in Northern China: a cross-sectional study of a risk prediction model and age trends

Abstract

BackgroundHypertension is a major risk factor for the global burden of disease, particularly in countries that are not economically developed. This study aimed to evaluate risk factors associated with self-reported hypertension among residents of Inner Mongolia using a cross-sectional study and to explore trends in the rate of self-reported hypertension.MethodsMulti-stage stratified cluster sampling was used to survey 13,554 participants aged more than 15 years residing in Inner Mongolia for the 2013 Fifth Health Service Survey. Hypertension was self-reported based on a past diagnosis of hypertension and current use of antihypertensive medication. Adjusted odds risks (ORs) of self-reported hypertension were derived for each independent risk factor including basic socio-demographic and clinical factors using multivariable logistic regression. An optimized risk score model was used to assess the risk and determine the predictive power of risk factors on self-reported hypertension among Inner Mongolia residents.ResultsDuring study period, self-reported hypertension prevalence was 19.0% (2571/13,554). In multivariable analyses, both female and minority groups were estimated to be associated with increased risk of self-reported hypertension, adjusted ORs (95% CI) were 1.22 (1.08, 1.37) and 1.66 (1.29, 2.13) for other minority compared with Han, increased risk of self-reported hypertension prevalence was associated with age, marital status, drinking, BMI, and comorbidity. In the analyses calculated risk score by regression coefficients, old age (≥71) had a score of 12, which was highest among all examined factors. The predicted probability of self-reported hypertension was positively associated with risk score. Of 13,421 participants with complete data, 284 had a risk score greater than 20, which corresponded to a high estimated probability of self-reported hypertension (≥67%).ConclusionsSelf-reported hypertension was largely related to multiple clinical and socio-demographic factors. An optimized risk score model can effectively predict self-reported hypertension. Understanding these factors and assessing the risk score model can help to identify the high-risk groups, especially in areas with multi-ethnic populations.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3279-3) contains supplementary material, which is available to authorized users.

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“…First, the finding that FIS was significantly associated with self-reported hypertension rather than a hypertension diagnosis or elevated measured blood pressure is an important finding. As others have noted, the reliability of self-reported hypertension can vary widely along patient demographic lines, with particularly high false positives found among people of low socioeconomic status [66,67]. Furthermore, the accuracy of self-reported health depends greatly on patients' level of healthcare access and health literacy [68].…”

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“…Several studies have found that the overweight and obesity are the risk of hypertension. [17,18] Furthermore, hypertensive patients who normalized their body mass index can largely improve BP level and a number of metabolic and hormonal parameters. [19,20] Our study suggested that a major risk factor for hypertension among residents of Xinjiang is BMI ≥ 28.0, associated the highest addition to the risk score (23 points) of all of the risk factors examined, similar to several epidemiological research conducted in other countries.…”

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