Disparities in Hypertension Prevalence, Awareness, Treatment and Control between Bouyei and Han: Results from a Bi-Ethnic Health Survey in Developing Regions from South China

Hypertension is highly prevalent in low-income population. This study aims to investigate ethnic disparities in hypertension and identify modifiable factors related to its occurrence and control in developing regions in South China. Blood pressure was measured in the Bouyei and Han populations during a community-based health survey in Guizhou, 2012. A multistage stratified sampling method was adopted to recruit Bouyei and Han aged from 20 to 80 years. Taking mixed effects into consideration, multilevel logistic models with random intercept were used for data analysis. The prevalence rates of hypertension were 35.3% for the Bouyei and 33.7% for the Han. Among the hypertensive participants, 30.1% of the Bouyei and 40.2% of the Han were aware of their hypertensive conditions, 19.7% of the Bouyei and 31.1% of the Han were receiving treatment, and only 3.6% of the Bouyei and 9.9% of the Han had their blood pressure under control. Age-sex standardized rates of awareness, treatment, and control were consistently lower in the Bouyei than the Han. Such ethnic disparities were more evident in the elderly population. Avoidance of excessive alcohol consumption and better education were favorable lifestyle for reduction in risk of hypertension. Moderate physical activity improved control of hypertension in Bouyei patients under treatment. Conclusively, hypertension awareness, treatment, and control were substantially lower in Bouyei than Han, particularly in the elderly population. Such ethnic disparities indicate that elderly Bouyei population should be targeted for tailored interventions in the future.

[1]  Bing Zhang,et al.  The dynamics of hypertension prevalence, awareness, treatment, control and associated factors in Chinese adults: results from CHNS 1991–2011 , 2015, Journal of hypertension.

[2]  Xin Qian,et al.  Identification of Major Risk Sources for Surface Water Pollution by Risk Indexes (RI) in the Multi-Provincial Boundary Region of the Taihu Basin, China , 2015, International journal of environmental research and public health.

[3]  Luxia Zhang,et al.  Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. , 2014, American journal of hypertension.

[4]  Wenzhi Wang,et al.  Hypertension Detection, Management, Control and Associated Factors Among Residents Accessing Community Health Services In Beijing , 2014, Scientific Reports.

[5]  Jackson T. Wright,et al.  2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). , 2014, JAMA.

[6]  Martin McKee,et al.  Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. , 2013, JAMA.

[7]  S. Basu,et al.  Social Epidemiology of Hypertension in Middle-Income Countries: Determinants of Prevalence, Diagnosis, Treatment, and Control in the WHO SAGE Study , 2013, Hypertension.

[8]  R. Hu,et al.  Factors Associated with Prevalence, Awareness, Treatment and Control of Hypertension among Adults in Southern China: A Community-Based, Cross-Sectional Survey , 2013, PloS one.

[9]  Liping Liu,et al.  Stroke and stroke care in China: huge burden, significant workload, and a national priority. , 2011, Stroke.

[10]  G. Dong,et al.  Factors associated with prevalence, awareness, treatment and control of hypertension in urban adults from 33 communities in China: the CHPSNE Study , 2011, Hypertension Research.

[11]  M. Kanbay,et al.  Uric Acid and Hypertension: Cause or Effect? , 2010, Current rheumatology reports.

[12]  F. Hu,et al.  Plasma uric acid and hypertension in a Chinese community: prospective study and metaanalysis. , 2009, Clinical Chemistry.

[13]  Daniel W. Jones,et al.  Racial and ethnic differences in blood pressure: biology and sociology. , 2006, Circulation.

[14]  S. Rabe-Hesketh,et al.  Multilevel modelling of complex survey data , 2006 .

[15]  C. Yao,et al.  [Survey on the prevalence of hypertension in different ethnic groups in China in 2002]. , 2006, Wei sheng yan jiu = Journal of hygiene research.

[16]  K. Iseki,et al.  Hyperuricemia as a predictor of hypertension in a screened cohort in Okinawa, Japan. , 2004, Hypertension research : official journal of the Japanese Society of Hypertension.

[17]  Hirofumi Tanaka,et al.  How much exercise is required to reduce blood pressure in essential hypertensives: a dose-response study. , 2003, American journal of hypertension.

[18]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[19]  R. Asmar,et al.  Validation of the Omron HEM-907 device for blood pressure measurement , 2002, Blood pressure monitoring.

[20]  J. Hughes,et al.  Elevated Uric Acid Increases Blood Pressure in the Rat by a Novel Crystal-Independent Mechanism , 2001, Hypertension.

[21]  E. Krieger,et al.  Low-intensity exercise training decreases cardiac output and hypertension in spontaneously hypertensive rats. , 1997, American journal of physiology. Heart and circulatory physiology.

[22]  K. Arakawa Antihypertensive mechanism of exercise. , 1993, Journal of hypertension.

[23]  Y. Lacourciére,et al.  Aftereffects of exercise on regional and systemic hemodynamics in hypertension. , 1992, Hypertension.

[24]  E. Braunwald,et al.  Resolved and unresolved issues in the prevention and treatment of coronary artery disease: a workshop consensus statement. , 1991, American heart journal.

[25]  L. Kuller,et al.  SERUM CHOLESTEROL, BLOOD PRESSURE, AND MORTALITY: IMPLICATIONS FROM A COHORT OF 361 662 MEN , 1986, The Lancet.

[26]  Li Lin Analysis of hypertension of urban and rural areas of Guizhou Province , 2014 .

[27]  Yuan Hu Current Status of Evaluation of Health Education for Hypertensive Patients in Community in China , 2013 .

[28]  Tihomir Asparouhov,et al.  Multilevel Modeling of Complex Survey Data , 2006 .

[29]  D. Beevers,et al.  Hypertension MANAGEMENT OF HYPERTENSION IN ETHNIC MINORITIES , 2005 .

[30]  M. Pflanz,et al.  Social Epidemiology , 2005 .