Liqiang Zheng

Factors associated with hypertension awareness, treatment and control in rural Chinese

The factors associated with hypertension awareness, treatment and control were studied in 45 925 rural Chinese aged ≥ 35 years. Of all hypertensives (n=17355), 29.5% were aware of their condition, 20.2% were receiving treatment and only 0.9% had their blood pressure (BP) adequately controlled, and most hypertensives in rural China did not comprehend the fatalness of high BP. Results indicate that more attention is needed in improving the cognitional level of hypertensive fatalness and more effort is also needed in promoting hypertension awareness, treatment and control among all hypertensives in rural China.

Risk factors of peripheral arterial disease and relationship between low ankle brachial index and mortality from all-cause and cardiovascular disease in Chinese patients with hypertension

The aim of this study was to evaluate the risk factors of peripheral arterial disease (PAD) and the relationship between ankle brachial index (ABI) and mortality from all-cause and cardiovascular disease (CVD) in Chinese patients with hypertension. The ABI cohort Study was designed to investigate risk factors of PAD and the relationship between ABI and mortality from all-cause and CVD in Chinese patients. ABI was identified at baseline by measuring systolic pressure at bilateral brachial and tibial arteries. Mortality surveillance was completed from November 2005 to January 2006. Among 3047 participants with hypertension at baseline, 839 (27.5%) were in the low-ABI group. Older age, female gender, higher serum level of triglycerides, lower serum level of high-density lipoprotein, a history of diabetes and a history of smoking were associated with low ABI. During the 13-month follow-up, there were 252 deaths, of which 100 died of CVD. Low ABI was associated with mortality from all-cause and CVD, whose adjusted relative risk was 1.619 (95% confidence interval 1.190–2.203) and 2.454 (1.531–3.933), respectively, in Cox regression models. The survival rate was significantly lower in the low-ABI group than in the normal-ABI group. This study demonstrated that low ABI was independently associated with a high risk of all-cause and CVD mortality in Chinese patients with hypertension. ABI should be promoted as an ideal tool to predict mortality in diabetic patients.

Prevalence of Hypertension and Associated Factors among Older Rural Adults: Results from Liaoning Province, China

Objective: The objective of the study was to estimate the prevalence of hypertension and associated factors among older rural adults in Liaoning Province, China. Subjects and Methods: The study was conducted in 2004–2006, using a multistage, stratified clustering sampling scheme to select a representative sample. A total of 10,065 adults aged 60 years or older were examined. A survey of blood pressure and associated factors was carried out. All data analyses were conducted using SPSS 11.5 statistical software package. Results: Overall, the prevalence rates of hypertension are 57, 64.4 and 64.9% for the age groups 60–69, 70–79 and ≥80 years, respectively. The prevalence of hypertension was positively correlated with age, female gender, Mongolian ethnicity, overweight and obesity, smoking and drinking, whereas income level was a protective factor for hypertension. The rates of awareness, treatment and control among older rural adults were very low (overall 35.2, 28.7 and 1.0%, respectively). Conclusion: Hypertension was highly prevalent among older rural adults in Liaoning Province, and it was associated with many factors. The percentages of hypertensives who were aware, treated, and controlled were very low. These data underscore the urgent need to strengthen the public health education and blood pressure monitoring system to better manage hypertension among older adults in rural China.

Risk of progression to hypertension in a rural Chinese women population with prehypertension and normal blood pressure.

BACKGROUNDnTo determine the incidence of hypertension and its risk factors among rural Chinese women with prehypertension and normotension.nnnMETHODSnA population-based sample of 12,060 rural Chinese women aged > or = 35 years and free from hypertension at baseline were followed from 2004-2006 to 2008. Incident hypertension was defined as systolic blood pressure (SBP) > or = 140 mm Hg, diastolic blood pressure (DBP) > or = 90 mm Hg, or current use of antihypertensive medication.nnnRESULTSnOver a median follow-up of 28 months (range, 14-47 months), 23.4% of women developed hypertension. The age-adjusted incidence rate was higher in prehypertension than in normotension (11.2/100 person-years vs. 7.9/100 person-years, P < 0.05). Among women with prehypertension, independent predictors of incident hypertension were baseline age, Mongolian ethnicity, low physical activity, baseline body mass index (BMI), baseline salt intake and family history of hypertension. Among women with normal blood pressure (BP), independent predictors were baseline age, low physical activity, baseline BMI and baseline salt intake. The awareness, treatment, and control rates for newly developed hypertension were 33.2, 23.0, and 2.1%, respectively.nnnCONCLUSIONSnThese data indicate that the incidence of hypertension is high among rural Chinese women and it is associated with many risk factors, and the data also suggest that most newly developed hypertension cases are not treated. This high incidence of hypertension may be related to rapid social changes in our country and may apply to other areas of the developing world. These results call for urgent improvements in hypertension prevention, detection and treatment.

The accelerating epidemic of hypertension among rural Chinese women: results from Liaoning Province.

BACKGROUNDnThe objective of the study was to assess prevalence, awareness, treatment, and control of hypertension and its risk factors in rural women in Liaoning Province in northeast China.nnnMETHODSnWe conducted a cross-sectional analysis of 23,178 women of minimum age 35 years, living in rural Liaoning province in northeast China. We measured their blood pressure (BP) and investigated associated factors. Hypertension was defined as an average systolic BP > or =140 mm Hg, and/or an average diastolic BP > or =90 mm Hg, and/or self-report of current treatment for hypertension with antihypertensive medication.nnnRESULTSnThe overall prevalence of hypertension in this study was 38.6%. Among those with hypertension, 32.8% were aware that they had high BP, 27.4% were being treated with antihypertensive medications, and in 1.4% of the women the hypertension was controlled. Multivariate analysis revealed that higher age, Mongolian ethnicity, higher body mass index (BMI), higher waist circumference (WC), excessive salt intake, smoking, alcohol consumption, lipid disorder, diabetes, and family history of hypertension were associated with the prevalence of hypertension; a higher level of education (high school or beyond) and a higher income level were inversely related to hypertension prevalence.nnnCONCLUSIONSnOur results indicate that hypertension is highly prevalent in rural women in Liaoning province and it is associated with known risk factors. There are unacceptably low percentages of those with hypertension who are aware of their condition, are receiving treatment, and in whom hypertension is controlled. Our study suggests the urgent need for a public health program to improve the prevention, detection, and treatment of hypertension in rural Chinese women.

The prevalence and heterogeneity of prehypertension: a meta-analysis and meta-regression of published literature worldwide

Objective Prehypertension appears to be a precursor of hypertension and has been recognised as a major risk factor for cardiovascular disease (CVD). Recognition of prehypertension provides important opportunities for preventing hypertension and CVD. We aimed to investigate the world-wide prevalence and heterogeneity of prehypertension. Methods We performed a meta-analysis of cross-sectional studies worldwide that reported the prevalence of prehypertension. We searched for publications between January 1966 and November 2010, using PubMed, Ovid and the Cochrane Library, with the keyword ‘prehypertension’, supplemented by a manual search of references from recent reviews and relevant published original studies. Pooled prevalence of prehypertension was calculated using random-effects models. Heterogeneity was investigated by subgroup analysis and meta-regression. Twenty-two articles met our inclusion criteria, with a total sample of 242 322 individuals. Results The overall pooled prevalence of prehypertension was 38%. Significant heterogeneity across estimates of prevalence was observed (p = 0.000, I2 = 99.9%). The prevalence rose as the sample size increased, and was higher among men than women (41 vs 34%). The non-Asian population was more likely to be prehypertensive than Asian individuals (42 vs 36%). A high prevalence of 47% was observed among the black African population in the non-Asian subgroup. The inception year of the surveys was the only source of heterogeneity we found by meta-regressional analysis (p = 0.06). Conclusion These results indicate that the prevalence of prehypertension was relatively high, particularly among males. Although more attention has been paid to this segment of the population since 2003, additional practical and reasonable steps should be taken to prevent and treat prehypertension.

Prevalence of and Risk Factors for Isolated Systolic Hypertension in the Rural Adult Population of Liaoning Province, China

The prevalence of and associated risk factors for isolated systolic hypertension, as defined by the Joint National Committee (JNC)-6 classification, were investigated in the rural population of Liaoning Province, China. A total of 45 925 people aged 35 years or older were examined in a cross-sectional study. Overall, the prevalence of isolated systolic hypertension was 10.6% (males 10.1%; females 11.2%). The prevalence of isolated systolic hypertension was positively correlated with age, gender, smoking status, alcohol intake, body mass index, salt intake and Mongolian race. This study showed that isolated systolic hypertension was very common in rural Chinese people and that many risk factors are linked with isolated systolic hypertension.

Prevalence and association with diabetes and obesity of lipid phenotypes among the hypertensive Chinese rural adults

BACKGROUNDnBoth dyslipidemia and hypertension are important risk factors for cardiovascular disease. Studies have found that there is a higher risk of dyslipidemia among hypertensive patients. This study was designed to investigate the epidemiologic features of some forms of dyslipidemia in rural hypertensive adults in China.nnnMETHODSnA cross-sectional survey was conducted during 2004 to 2006 through a cluster multistage sampling of a resident group of 6412 hypertensive individuals (2805 men and 3607 women), aged >/= 35 years, in the countryside of Liaoning, China. The cutpoints of lipid phenotypes were based on the 1992 recommendations of the European Atherosclerosis Society.nnnRESULTSnThe most prevalent abnormality was isolated hypercholesterolemia (34.1% for men and 37.3% for women). Mixed dyslipidemias was the second most prevalent abnormality (14.3%). Isolated hypertriglyceridemia was observed in 5.6% of the sample. The prevalence of normotriglyceridemic hypoalphalipoproteinemia and severe dyslipidemia was 2.0% and 3.3%, respectively. Only a few samples had the abnormality of hypertriglyceridemia/hypoalphalipoproteinemia (.8% for men and .3% for women). The prevalence of isolated hypertriglyceridemia, mixed dyslipidemias, and severe dyslipidemia was higher in diabetic patients compared with nondiabetic patients, in either men or women. Compared with those of normal weight, obese men had a higher prevalence of mixed dyslipidemias and hypertriglyceridemia/hypoalphalipoproteinemia, whereas isolated hypertriglyceridemia was prevalent in both genders.nnnCONCLUSIONnThe prevalence of lipid phenotypes among these hypertensive patients was relatively high, even in rural China. Diabetes and obesity, the modifiable risk factors, increased the likelihood of having several forms of an atherogenic lipid profile.

Incidence and Predictors of Hypertension Among Rural Chinese Adults: Results From Liaoning Province

Objective To determine the incidence of hypertension and its risk factors among rural Chinese adults. Methods A population-based sample of 24u2008360 rural Chinese adults aged ≥35u2005years and free from hypertension at baseline were followed from 2004–2006 to 2008. Incident hypertension was defined as systolic pressure ≥140u2005mmu2002Hg, diastolic pressure ≥90u2005mmu2002Hg, or current use of antihypertensive medication. Results Over a mean of 28u2005months of follow-up, 29.6% of men and 23.4% of women developed hypertension. The age-adjusted incidence rate was higher in men (12.75 per 100 person-years) than in women (10.04 per 100 person-years). Among men, independent predictors of incident hypertension were baseline age [RR per 5u2005years: 1.11; 95% CI 1.10 to 1.13], Mongolian ethnicity (RR: 1.09; 95% CI 1.01 to 1.18), use of alcohol, (RR: 1.14; 95% CI 1.06 to 1.23), high income versus low income (RR: 1.11; 95% CI 1.00 to 1.22; RR: 1.11; 95% CI 1.03 to 1.20), prehypertension versus normotension (RR: 1.18; 95% CI 1.08 to 1.28), overweight and obesity (RR: 1.28; 95% CI 1.17 to 1.40), baseline salt intake (RR per one g/day: 1.00; 95% CI 1.00 to 1.01) and family history of hypertension (RR: 1.14; 95% CI 1.03 to 1.27). With the exception of use of alcohol, mean income, low physical activity was shown as risk factors in women; the results were similar for women. The awareness, treatment and control rates for newly developed hypertension were 29.9%, 19.5% and 1.5% respectively. Conclusions These data indicate that the incidence of hypertension is high among these rural Chinese adults and it is associated with many risk factors. And suggest that most newly developed hypertension cases are not treated. These increases in hypertension are probably related to rapid social changes in our country and may apply to other areas of the developing world. These results call for urgent improvements in hypertension prevention and control programs in rural China.

Handgrip Strength and Blood Pressure in Children and Adolescents: Evidence From NHANES 2011 to 2014

BACKGROUNDnPrevious studies have reported that handgrip strength, a measure of muscular fitness, is associated with cardiovascular risk factors. However, the association of handgrip strength with blood pressure (BP) in children has been inconsistent. We tested the association of handgrip strength with systolic and diastolic BP in children and adolescents from the National Health and Nutrition Examination Survey (NHANES) 2011-2014.nnnMETHODSnThe study included 3,929 participants aged 8-19 years who underwent a handgrip test. The sum of the maximum handgrip strength from both hands was used. General linear models were used to examine the associations between handgrip strength and the outcome variables.nnnRESULTSnAfter adjustment for age, race, sex, body mass index, and physical activities, handgrip strength was significantly and positively associated with systolic (P < 0.0001) and diastolic (P = 0.01) BP. There was an increasing trend in systolic BP as handgrip strength increased from the bottom quartile to the top quartile, with 2.1 mm Hg difference between the top and the bottom quartiles (P for trend <0.0001). Similar results were observed for diastolic BP.nnnCONCLUSIONSnMuscular fitness is positively associated with BP in children and adolescents. The implications and underlying mechanisms for these results need further examinations.