Research ArticleThe burden and correlates of hypertension among Chinese rural population in Han, Uygur, and Kazak: a cross-sectional study
Introduction
In the past decades, the contribution of different risk factors to disease burden has changed considerably, with a shift away from risks for communicable diseases toward those for noncommunicable diseases.1, 2 Cardiovascular and other noncommunicable diseases are currently responsible for two-thirds of global mortality, and cardiovascular disease is also the leading cause of death in China.3 Hypertension is one of the most common chronic noncommunicable diseases, and it is also a readily treatable risk factor for the most common causes (ischemic heart disease, stroke, and Alzheimer's disease) of morbidity and mortality.4, 5, 6 It was reported that 54% of stroke and 47% of ischemic heart disease were attributable to high blood pressure (BP).7, 8 Worldwide, 8.1 million premature deaths were attributable to hypertension each year.9 It has been estimated that hypertension accounted for 20% of the deaths recorded in China in 2005.10 According to the result of four national, large-scale surveys focused on hypertension (1958–1959, 1979–1980, 1991, and 2002), the prevalence of hypertension among participants aged >15 years has increased in China (5.1%, 7.7%, 13.6%, and 17.6%, respectively).11 Although the prevalence of hypertension increased evidently in the past decades, the overall awareness, treatment, and control of hypertension remain low.
Hypertension is rapidly becoming a major public health burden in China, but data on its prevalence, awareness, treatment, and control of hypertension are paltry, especially for rural communities and the minority group. More than half of the Chinese live in rural regions. Previous studies have reported that the prevalence of hypertension in rural areas in 1991, 2002, and 2007 were 20.4%, 24.5%, and 30.6%, respectively.12, 13, 14, 15 Recently, several studies have noted the striking differences in the prevalence, awareness, treatment, and control of hypertension across ethnic groups in different regions of the world.16, 17, 18 Some researchers showed that income inequality, lack of health education, genetic background, and poor health service system may be the reasons of the ethnic differences.16, 17, 18 However, in China, these ethnic differences have been scarcely reported. Xinjiang is a multiethnic co-populated area in China. The national census showed that there lives 47 ethnicities in Xinjiang, and 13 of them are confirmed to be native ethnicities, such as the Uygur, and Kazak. In the present study, we aimed to assess the prevalence, awareness, treatment, and control rate of hypertension as well as the associated risk factors among rural population in three different ethnic groups (Han, Uygur, and Kazakh) in Xinjiang, China.
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Ethics Statement
This study was approved by the Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University and was conducted according to the standards of the Declaration of Helsinki. Written informed consent was obtained from the participants.
Study Population
All the participants were selected from the Cardiovascular Risk Survey study which is a multiethnic, community-based, cross-sectional study designed to investigate the prevalence, incidence, and risk factors for cardiovascular diseases. The survey
Results
A total of 8640 eligible subjects were selected. One hundred ninety-four subjects were excluded because they refused to take part in and 151 subjects were excluded for incomplete data. Finally, 8295 participants (1179 Hans, 4266 Uygurs, and 2850 Kazaks) with complete data were enrolled in the present study. Table 1 shows the characteristics of the study population by ethnic group. Han had significantly higher level of age but lower level of BMI and WC. The proportion of Han individuals with a
Discussion
In this representative sample of the rural adult population in Xinjiang, China, we assessed the prevalence, awareness, treatment, control, and associated risk factors of hypertension in three different ethnic groups (Han, Uygur, and Kazak). Our results indicated that hypertension is highly prevalent among rural area in Xinjiang China, especially in Kazak group. We observed the improvement in awareness, treatment, and control rates of hypertension, but there still exist gaps compared with
Conclusion
Hypertension was found to be highly prevalent among rural adults in Xinjiang, China. Although there was an increase in hypertension awareness, treatment, and control rates, gaps still persisted. Hypertension awareness, treatment, and control rates were still lower than that of urban area. Effective measures such as population-wide and high-risk strategies and hypertension prevention programs should be implemented to promote the prevention and control of hypertension.
Acknowledgments
The authors acknowledge the volunteers who agreed to participate in the study. The authors acknowledge all the staff from First Affiliated Hospital of Xinjiang Medical University who participated in the surveys.
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This work was supported by Innovation team development plan sponsored by the National Department of Education in China (IRT13094) and the National Natural Science Foundation of China Youth Science Fund Project (81700315).
Conflict of interest: None.
Supplemental Material can be found at www.ashjournal.com.
- 1
These authors contributed equally to this work.