Cai L, Dong J, Cui W L, You D Y, Golden A R
Cheng Gong New City, School of Public Health, Kunming Medical University, Kunming, China.
J Hum Hypertens. 2017 Jun;31(6):388-394. doi: 10.1038/jhh.2016.87. Epub 2017 Jan 5.
This study investigates socioeconomic differences in prevalence, awareness, control and self-management of hypertension in rural China. A cross-sectional survey was conducted among four ethnic minority groups in Yunnan Province: Na Xi, Li Shu, Dai and Jing Po. Approximately 5532 consenting individuals aged ⩾35 years (48.4% of whom were male) were selected to participate in the study using a stratified, multistage sampling technique. Information about participants' demographic characteristics and hypertension awareness, treatment, control and self-management practices was obtained using a standard questionnaire. The age-standardised prevalence of hypertension in the study population was 33.6%. In hypertensive subjects, the overall levels of awareness, treatment and control of hypertension were 42.1%, 28.5% and 6.7%, respectively. Approximately 58.7% of hypertensive patients regularly self-monitored blood pressure (BP), 64.7% adhered to their physician-prescribed anti-hypertensive drugs, and 88.0% took at least one measure to control BP. Hypertensive patients of Jing Po ethnicity had the lowest rates of awareness, treatment, control and self-management of hypertension among the four ethnic minority groups studied. Individuals with lower levels of education were more likely to be hypertensive. Further, individuals with lower levels of education had a lower probability of awareness of their hypertensive status and of treatment with antihypertensive medication. Access to medical services was positively associated with awareness of suffering from hypertension, being treated with antihypertensive medication, and compliance with antihypertensive drug treatment. This study suggests that effective strategies to enhance awareness, treatment and management of hypertension should focus on individuals with low levels of education and poor access to medical services.
本研究调查了中国农村地区高血压患病率、知晓率、控制率及自我管理方面的社会经济差异。在云南省的四个少数民族群体（纳西族、傈僳族、傣族和景颇族）中开展了一项横断面调查。采用分层多阶段抽样技术，选取了约5532名年龄≥35岁的同意参与研究的个体（其中48.4%为男性）。通过标准问卷获取了参与者的人口统计学特征以及高血压知晓、治疗、控制和自我管理情况的信息。研究人群中高血压的年龄标准化患病率为33.6%。在高血压患者中，高血压的总体知晓率、治疗率和控制率分别为42.1%、28.5%和6.7%。约58.7%的高血压患者定期自我监测血压，64.7%的患者坚持服用医生开具的降压药，88.0%的患者至少采取了一项措施来控制血压。在所研究的四个少数民族群体中，景颇族高血压患者的知晓率、治疗率、控制率和自我管理率最低。受教育程度较低的个体患高血压的可能性更高。此外，受教育程度较低的个体知晓自己高血压状态以及接受降压药物治疗的可能性也较低。获得医疗服务与高血压患病知晓、接受降压药物治疗以及降压药物治疗依从性呈正相关。本研究表明，提高高血压知晓、治疗和管理的有效策略应聚焦于受教育程度低且获得医疗服务机会少的个体。
