Medical College, Tibet University, Lhasa, 850002, China.
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
BMC Public Health. 2021 Jan 6;21(1):33. doi: 10.1186/s12889-020-09858-0.
Tibet is an autonomous region in China located around an average altitude of 4500 m above sea level. Since 2012 the local government of Tibet has been providing free physical examinations, including screening for hypertension. However, the coverage and effectiveness of this free program have not been uncovered. This study aims to assess the coverage and effectiveness of hypertension screening and management program in 3 altitude levels of Tibet, and also the determinants of the success of the screening program.
A stratified cluster survey was conducted among 1636 residents aged 18 years or over in three different altitude areas in Tibet. We adjusted for age and sex based on national census data and used weighted logistic regression models to find factors associated with hypertension screening.
The coverage of the hypertension screening program evaluated by participation rate in the previous screening was 94.9%, while 24.7% (95% CI: 22.1-27.3%) of them were diagnosed with hypertension. Females and alcohol drinkers were more likely to be screened. Among those diagnosed with hypertension, 28.7% had it under control. High altitude areas had a high proportion of controlled hypertension. The overall rate of controlled hypertension in high, moderate and low altitude areas was 35.1% (95% CI: 24.8-45.3%), 32.7% (95% CI: 22.2-43.2%) and 23.7% (95% CI: 14.7-32.6%), respectively. Younger aged persons were more likely to have better control of their hypertension.
The coverage of hypertension screening in Tibet was high, especially in the low altitude areas. However, the effectiveness of hypertension control was low, indicating a need to implement the treatment adherence routines into the current screening interventions.
西藏是中国的一个自治区，位于平均海拔 4500 米以上的地区。自 2012 年以来，西藏地方政府一直在提供免费体检，包括高血压筛查。然而，该免费计划的覆盖范围和效果尚未得到揭示。本研究旨在评估西藏三个海拔高度地区的高血压筛查和管理计划的覆盖范围和效果，以及筛查计划成功的决定因素。
在西藏三个不同海拔高度的地区，对 1636 名年龄在 18 岁及以上的居民进行了分层聚类调查。我们根据国家人口普查数据调整了年龄和性别，并使用加权逻辑回归模型来寻找与高血压筛查相关的因素。
通过前一次筛查的参与率评估的高血压筛查计划的覆盖率为 94.9%，而其中 24.7%（95%CI：22.1-27.3%）被诊断为高血压。女性和饮酒者更有可能接受筛查。在被诊断为高血压的人群中，28.7%的人血压得到了控制。高海拔地区高血压控制率较高。高、中、低海拔地区高血压控制的总体率分别为 35.1%（95%CI：24.8-45.3%）、32.7%（95%CI：22.2-43.2%）和 23.7%（95%CI：14.7-32.6%）。年龄较小的人更有可能更好地控制高血压。
西藏的高血压筛查覆盖率很高，尤其是在低海拔地区。然而，高血压控制的效果很低，这表明需要将治疗依从性常规纳入当前的筛查干预措施中。
