Li Yichong

Prevalence of Drink-driving Among Adults in China: A Nationally Representative Survey in 2010

ABSTRACT Objective: We examined the prevalence of and characteristics associated with drink-driving in China. We compared this studys drink-driving findings with those from the United States to explore how effective traffic safety interventions from Western cultures might be adapted for use in China. Methods: Data from the 2010 China Chronic Disease and Risk Factor Survey were analyzed to describe the prevalence and characteristics associated with drink-driving in China. Results: Overall, 1.5% of Chinese adults reported drink-driving in the past 30 days—3% of males and 0.1% of females. However, among males who had driven a vehicle in the past 30 days and consumed at least one alcoholic beverage in the past 30 days, 19% reported drink-driving during the 30-day period. Excessive drinking, binge drinking, nonuse of seat belts, and having been injured in a road traffic crash in the past year were most strongly associated with drink-driving among males. Conclusions: Drink-driving is prevalent among male drivers in China. Although large differences exist between China and the United States in the proportion of adults who drive, the proportion who consume alcohol, and some of the personal characteristics of those who drink and drive, similarities between the 2 countries are present in patterns of risk behaviors among drink-driving. To reduce injuries and deaths from drink-driving, effective interventions from Western cultures need to be tailored for adoption in China.

GW24-e0583 Cardiovascular Disease Risk Factors among Chinese Hypertensive Population: Findings from a Nationally Representative Survey

Objectives We sought to examine prevalence and clustering of seven selected cardiovascular disease risk factors (CDRFs) by blood pressure level among Chinese hypertensive population. Methods Data from the 2010 China Chronic Disease and Risk Factor Surveillance, a nationally representative survey assessing chronic diseases and related risk factors, were used. A total of 36,971 respondents with hypertensive condition (SBP ≥ 140 mm Hg, DBP ≥ 90 mmHg, or self-reported hypertension) were included in the study. We examined prevalence for seven CDRFs and their clustering (mean number of CDRFs) by blood pressure (BP) levels, such as current smoking, excessive drinking (daily consumption of alcohol ≥ 25 g for men, 15 g for women), insufficient intake of fruit and vegetables (≤ 400 g of fruit and vegetables per day), physical inactivity (≤ 150 minutes of moderate-intensity activity per week or equivalent), overweight or obesity (BMI ≥25), raised blood glucose (fasting plasma glucose value ≥ 7.0 mmol/L or on medication for raised blood glucose), and raised total cholesterol (total cholesterol ≥ 5.0 mmol/L). According to 2007 WHO/ISH definitions and classification of BP levels, the BP of each respondent was classified into six levels: optimal, normal, high-normal, stage 1 hypertension, stage 2 hypertension, and stage 3 hypertension. Ordinal logistic regression was used to access independent effect of the BP levels on clustering of CDRFs, with adjustment of demographic and social-economic covariates. SAS carried out all computation and accounted for the complex sampling design of the survey. Results Of seven CDRFs, five were most prominent among respondents with stage 3 hypertension: 56.1% (95% CI: 52.1% - 60.2%) for insufficient intake of fruit and vegetables, 27.7% (24.4% - 31.0%) for physical inactivity, 54.9% (51.3% - 58.6%) for overweight or obesity, 17.9% (16.0% - 19.9%) for raised blood glucose, and 29.2% (26.8% - 31.5%)for raised total cholesterol. Individuals with stage 1 hypertension had the highest prevalence of current smoking (29.7%, 95% CI: 28.4% - 31.0%) and excessive drinking (17.1%, 95% CI: 15.7% - 18.5%). Clustering of CDRFs increased almost with BP levels. The mean number of CDRFs was 1.74 (95% CI: 1.54 – 1.93) for respondents with optimal BP, 2.00 (1.91 – 2.09) for normal BP, 2.10 (2.01, 2.19) for high-normal BP, 2.04 (1.98 – 2.10) for stage 1 hypertension, 2.16 (2.09 – 2.23) for stage 2 hypertension, and 2.26 (2.18 – 2.35) for stage 3 hypertension. Multiple Ordinal logistic regression showed that, compared with optimal BP, individuals with stage 3 hypertension had 2.39 times the cumulative odds (95%CI: 1.73 – 3.32) of having more number of CDRFs, stage 2 hypertension had 1.97 times (1.43 – 2.73), stage 1 hypertension had 1.63 times (1.20 – 2.22), high-normal BP had 1.61 times (1.20 – 2.17), and normal BP had 1.40 times (1.00 – 1.97). Conclusions The worse Chinese hypertensive population had their BP controlled, the more CDRFs appeared to be carried by them, regardless of demographic and social-economic status. This implies that, compared to those with good BP management, hypertensive individuals with poor BP control are not only more likely to be exposed to sequela attributable to hypertension, but also many other chronic diseases. Therefore, public health programs to enhance BP management skill among those with poor BP control should also take into consideration reducing CDRFs among them.

SHANDONG RESIDENTS READINESS FOR SODIUM REDUCTION: A CROSS-SECTIONAL SURVEY TO ASSESS KNOWLEDGE, ATTITUDE AND PRACTICES (KAP) RELATED TO SALT AND HEALTH

Objectives Assessment of knowledge, attitude and practice (KAP) is a crucial element. By performing a cross-sectional survey, we aimed to investigate KAP regarding dietary sodium intake in Shandong residents aged 18-year-old and above, and provide baseline data to develop public education campaigns to reduce dietary sodium intake. Methods A close-ended questionnaire was applied to assess KAP. With a response rate of 98.4%, a representative sample of 15350 residents were interviewed between June and July 2011. Difference in proportions of understanding the link between salt and hypertension, intention to reduce salt, and being currently take action to reduce salt were compared using the χ2 test. Predicators for intention and take action to reduce salt were determined by multivariate logistic regression with adjustment for potential confounders. Results Dietary sodium intake KAP of urban residents was generally better than rural counterparts. Although residents lacked knowledge on recommended limit of sodium, good knowledge and a favourable attitude towards low sodium diet was seen. Residents seemed ready for sodium reduction: Vast majority of residents (85.3% for urban; 86.7% for rural) reported intention to reduce salt; About four fifth of residents reported agreeing with the low sodium diet and food labelling. However, urban residents seemed more likely to be ready for sodium reduction than rural counterparts: Majority of urban residents (60.4%) reported understanding the relationship of sodium intake and hypertension, while 48.2% of the rural counterparts did so; 46.2% of urban residents reported currently taking actions to reduce salt, while 34.9% of rural counterparts did so. Comparing to residents with low education level, those with high education level were more likely to intend to reduce salt (OR=3.33, 95% CI 2.31 to 4.81, p for trend <0.001 for urban; OR=2.80, 95% CI 1.87 to 4.20, p for trend <0.001 for rural), and take action to reduce salt (OR=1.44, 95% CI 1.16 to 1.78, p for trend <0.001 for urban; OR=1.31, 95% CI 1.12 to 1.52, p for trend=0.001 for rural), after adjusting for potential confounders. Similarly, increased likelihood was observed among household income, intention and take action to reduce salt. Misperception seemed prevalent among residents: Vast majority of residents (82.1% for urban; 76.1% for rural) reported that food will lose its taste; many residents (28.4% for urban; 31.8% for rural) reported low sodium intake reduces strength. There was significantly independent association among favourable attitude toward low-sodium diet, intention and take action to reduce salt, while those who perceive low sodium reducing strength, were less likely to intend to reduce salt (OR=0.85, 95% CI 0.77 to 0.95 for urban; OR=0.78, 95% CI 0.69 to 0.89 for rural) and to take action to reduce salt (OR=0.91, 95% CI 0.79 to 1.04 for urban; OR=0.89, 95% CI 0.81 to 0.98 for rural). TV/radio was the most frequently reported source of information on salt and health (60.5% for urban; 54.9% for rural), doctors stood next in the line (29.4% for urban; 23.1% for rural). Conclusions The majority of Shandong residents recognise the health consequences of high-sodium diet and are interested in reducing their sodium intake. Expanded educational efforts are needed to broaden awareness of the health impact of a high-sodium diet, and address misperception of low sodium diet. Salt media campaign should be considered to achieve desirable salt consumption. The findings of this study suggest that socio-economic status (education and income) should be considered during the development of strategies for effective public education campaign.