Research on hypertension in hohhot of mongolian:analysis of 9675 cases survey da

Hong-Mei Yu Jian-Qiang Wu*

1Hong-Mei Yu, Basic Medical Department, Inner Mongolia Medical University, Hohhot, 010100, China.

Abstract Objective: Through investigating the daily habits of hypertensive and non-hypertensive Mongolian in Hohhot to explore the effect of daily habits on hypertension and further provide basis for future policy making.Methods: Two community health service centers were identified in each of the four districts of Hohhot City using a stratified cluster random sampling method and a multi-stage stratified sampling method.Results: By January 2019, a total of 9,800 people was investigated, and 9675 people with complete data. The effective rate of the questionnaire was 98.7%. The standardized prevalence of hypertension was 21.8% in Mongolia. The prevalence rate of hypertension in Mongolia was statistically significant among the different genders, ages, presence or absence of obesity, different diet types, whether smoking or drinking, or having tea, and aerobic exercise. (P ＜ 0.05 for all). Multivariate unconditional logistic regression analysis showed that males were risk factors for hypertension; female, non-obese, non-hobby meat, no smoking, hobby tea, no alcohol and aerobic exercise were protective factors. Obesity, hobbies, meat, smoking, drinking are important risk factors for hypertension in Mongolian population in Hohhot.Conclusion: It is preliminarily clarified that the risk factors related to hypertension are mainly related to their own health-related behaviors and genetic factors, suggesting the necessity of healthy physical examination, maintaining blood pressure stability, controlling body mass, and moderate exercise.

Key words: Mongolian, Daily habits, Hypertension, Cardiovascular

Introduction

I nner Mongolia region is located in highland, with an average altitude of about 1000 meters. The landform is dominated by the Inner Mongolia Plateau. Its weather belongs to a typical temperate continental monsoon climate with characteristics of less and uneven precipitation and drastic changes in cold and heat. The cold weather is long,which lasts for 5 months to half a year [1-7]. Affected by environmental factors, the eating habits here are characterized by high salt, high fat, low consumption of fruits and vegetables, more red meat, and heavy drinking. For the long and chilly cold season, the time on outdoor activities was also reduced. These factors, such as high salt, high fat, low fruit and vegetables consumption, high alcohol consumption, smoking, etc. increased the risk of obese, arteriosclerosis, hypertension, diabetes and hyperlipidemia.The epidemiological study has showed that the prevalence rate of hypertension, diabetes, hyperlipidemia, coronary heart disease and atrial fibrillation among Mongolian population in Hohhot is higher than that in other parts of the country [8]. Therefore, it is necessary to investigate the daily habits of hypertensive and non-hypertensive Mongolian in Hohhot to explore the effect of daily habits on hypertension and further provide basis for future policy making. In this research, by comparing the daily habits of hypertensive and non-hypertensive Mongolian in Hohhot,we evaluated the effects of dietary habit, smoking, drinking, exercise on the hypertension.

1 Research objects and methods

1.1 The populations and survey content

Two community health service centers were identified in each of the four districts of Hohhot City using a stratified cluster random sampling method and a multi-stage stratified sampling method. People in every 10 years old were divided into a group. 2-3 residential communities are randomly selected in the service area of each community health service center. Permanent residents (with a residence time of more than 6 months) over the age of 20 are coded and randomly sampled. The household survey was conducted by the professional survey team consisting of community doctors and medical students from Inner Mongolia Medical University.

Diagnostic criteria for essential hypertension: according to the Guidelines for the Prevention and Treatment of Hypertension in China, those with systolic blood pressure≥ 140mmHg and/or diastolic blood pressure ≥ 90mmHg;those who have taken antihypertensive drugs within two weeks, even the pressure ＜ 140/90mmHg should be diagnosed with hypertension.

Survey contents: 1. General information: name, gender,age (years), height (cm), weight (kg), body mass index(kg/m2), ethnicity, occupation, education level and family economic income (annual average). 2. The medication and control of blood pressure: complications, comorbidities,disease course, blood glucose level. 3. Daily habits: daily exercise, dietary preferences, meat, eggs, milk, grains,vegetables, fruits, oils and high-quality protein intake and salt intake and other conditions, the proportion of main and non-staple food, daily diet control and regularity of meals. 4. Command of health knowledge: the relationship between cardiovascular disease and diet structure, the healthy life habits, and so on. Meat: daily consumption is more than 500g. Vegetarian: daily consumption is more than 500g. Exercise: do efficient aerobic exercises daily which would consume more than 300 calories. Drinking:daily consumption is more than 50g. Drinking tea: daily consumption is more than 50g.

1.2 Quality control methods

The investigation team consists of a community doctor and a fourth-grade student at Inner Mongolia Medical University. Before the investigation, they have received professional training and passed the assessment. During the investigation, they should conform to unified quality control. The investigator shall conduct self-examination and mutual examination of the investigation forms timely.The supervisor conducted a comprehensive inspection of questionnaire weekly, and randomly selected 5% of the population to conduct a sample review to eliminate the invalid questionnaire. The consensus rate was over 90%.After reexamination, the characteristics, variables, and numbers of surveyed in the questionnaire are entered into the Epidata database. After logical examination, the data is analyzed.

1.3 Statistical analysis

Data analysis was performed using the SPSS 25 statistical software package. The rank-sum test was applied to compare dietary patterns of different populations, and the significance level was set to 0.05.

1.4 Results

Prevalence of hypertension in Mongolian population in Hohhot City: by January 2019, a total of 9,800 people was investigated, and 9675 people with complete data.The effective rate of the questionnaire was 98.7%. 4932 males (50.9%) and 4743 females (49.1%) with the average 42.7 people with rank-sum tes were in the study.There were 2292 among 20-29 years (23.7%), 2184 among 30～39 years, 1680 among 40-49 years old, 1188 among 50-59 years old, 1032 among 60-69 years old, 891 among 70-79 years old, 408 ≥ 08ng 70-79 years old, 4743 fem 22.6%), 1680 cases (19.1%), 1188 cases (13.1%),1032 cases (11.6%), 891 cases (4.6%), 408 cases (1.5%).Among the 9600 cases, 2426 cases (21.0%) has obesity,4926 cases (71.0%) prefer meat diet, 5496 cases (65.6%)have smoking history, 3699 cases (24.5%) like drinking,1422 cases (10.7%) do not prefer drinking tea, 5698 cases(64.5 %) without effective aerobic exercise regularly; A total of 2464 cases (25.5%) in the 9600 cases has hypertension. According to the age structure of the Mongolian population in Hohhot from the sixth national census, the standardized prevalence of hypertension was 21.8%. The prevalence rate of hypertension in Mongolia is statistically significant among the different genders, ages, presence or absence of obesity, different diet types, whether smoking or drinking, or having tea, and aerobic exercise. (P ＜ 0.01 or P＜ 0.05 for all). (Table 1)

Table 1: Comparison of Cardiovascular Diseases in Different Characteristics of Mongolian Residents in Hohhot

30- 2184 556 25.4 40- 1680 482 28.7 50- 1188 656 55.2 60- 1032 325 31.5 70- 891 43 4.8-80 408 39 9.5 Obesity No 2426 509 0.21 29.35 0.000 Yes 7249 4363 60.2 Diet type Meat 4926 3500 71.0 23.56 0.000 Vegetarian 4749 663 13.9 Smoking No 4179 962 23.0 22.35 0.000 Yes 5496 3605 65.6 Drinking No 5976 602 10.0 21.76 0.000 Yes 3699 905 24.5 Drinking tea No 1422 153 10.7 25.63 0.000 Yes 8253 253 3.1 Aerobic exercise No 5698 3675 64.5 0.000 Yes 3977 563 14.2

1.5 Analysis of risk factors for hypertension in Mongolian population in Hohhot City

Multivariate unconditional logistic regression analysis was performed with hypertension as the dependent variable, gender, obesity, diet type, smoking, drinking, tea drinking, and aerobic exercise as independent variables,age as the covariate (to weaken the influence of age). The results showed that males were risk factors for hypertension; female, non-obese, non-hobby meat, no smoking,hobby tea, no alcohol and aerobic exercise were protective factors. Obesity, hobbies, meat, smoking, drinking are important risk factors for hypertension in Mongolian population in Hohhot. (Figure 1, Table 2)

Aerobic exercise

Table 2: Multivariate logistic analysis of hypertension in Mongolian population in Hohhot

2 Conclusion and recommendation

To investigate the causes of hypertension in Mongolian population in Hohhot and improve the prevention and treatment of hypertension, the relationship between Mongolian daily habits and hypertension were researched. The results of this survey showed that the prevalence rate of hypertension of Mongolian in Hohhot was 25.5%, which was higher than the 15.08% of the national hypertension in 2012 [9], suggesting that Mongolian hypertension in Hohhot is more prevalent. This may be related to the rapid economic growth in Hohhot, which leads to high work tension, changes in dietary structure, and the neglect of the prevention and treatment of hypertension.

The analysis of risk factors for hypertension in Mongolian population in Hohhot shows that obesity, meat, smoking, drinking, etc. are important risk factors for hypertension in Mongolian, and the risk is 4.4, 8.7, 5.7, 1.4 and 2.4 times, respectively. The results showed that it is necessary to raise people's awareness of the disease through publicity and education.

Hypertension is preventable and treatable. It is prelimi narily clarified that the risk factors related to hypertension are mainly related to their own health-related behaviors and genetic factors, suggesting the necessity of healthy physical examination, maintaining blood pressure stability,controlling body mass, and moderate exercise. A healthy lifestyle is of great significance to improving people's qual-ity of life. Prevention and treatment of hypertension should continuously improve the community medical system, regularly follow up and intervene in patients with hypertension, and guide their regular medication. It is imperative to strengthen the publicity and education of prevention and control of hypertension in Inner Mongolia. This urgently requires us to speed up the prevention and intervention of hypertension, carry out education on knowledge of hypertension prevention, carry out lifestyle interventions, and attach importance to primary prevention.