Knowledge, awareness, behavior (KAB) and control of hypertension among urban elderly in Western China

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Abstract

Objective

To explore knowledge, awareness, behaviors (KAB) and control of hypertension among urban elderly population (≥ 60 years) in Xi'ning and Chengdu cities.

Methods

A 2-stage sampling method recruited 4141 participants sampled from 20 communities. Data collection included blood pressure measurements, using a mercury sphygmomanometer, and information about KAB and other factors through face-to-face structured questionnaire.

Results

The overall prevalence of hypertension (SBP  140 and/or DBP  90, and/or current treatment for hypertension) reached to 48.5%; 75.3% of hypertensive participants were aware about their disease; 32.1% in all hypertensive patients had controlled BP (BP < 140/90) and 48.2% of those treated had controlled BP. A higher proportion of hypertensive participants showed adequate knowledge on complications in comparison to knowledge about HTN risk factors. Participants with controlled BP were more knowledgeable about threshold, risk factors, and complications as a result of hypertension, had increased awareness, and took medications and BP measurements on regular basis with more inclination to follow or initiate treatment. In the logistic regression model, men (odd ratio [OR]: 1.31), good knowledge of hypertension risk factors (OR: 1.19), awareness of being hypertensive (OR: 2 * 109), and regular medication (OR: 1.48) were associated with controlled BP.

Conclusion

The control rate of hypertension was much higher in our study compared to the 2002 nation wide study and other studies performed in some developing countries. Health care providers ought to strengthen their measures by delivering appropriate knowledge to elderly patients about hypertension risk factors, raising more awareness among people about their hypertension status, and encourage more compliance towards treatment.

Introduction

The prevalence of hypertension (HTN) in China is witnessing an ascending trend since 1992. From 1992 to 1994 the prevalence rate was at 22.7%, and in 1998 the prevalence rate reached to 24.0% [1]. In 2001, it was reported that the prevalence of HTN among adults (aging 35 to 74 years) has increased to 27.4% (48.8% among people older than 65 years, a much higher prevalence) [2].

Several studies have had analyzed many factors involved in controlling HTN [3], [4], [5], [6], among them the elderly people, considered as one of the most important predisposing factor leading to uncontrolled HTN [3], [5]. It is shown that patients' knowledge, awareness, and behavior/practice (KAB/KAP) are critical in controlling HTN [4], [6], [7].

To get the periodic information about HTN, we carried out the 2006 survey. In this survey we examined the KAB situation and other influential factors responsible for the control of HTN among urban elderly population in Xi'ning and Chengdu city, Western China, sponsored by the UHPP project (China/UK Urban Health and Poverty Project).

Section snippets

Study subjects

Chengdu and Xi'ning are two large cities located in Western China. In Chengdu, there are about 10 million residents, 9 districts and 10 counties, among which 5 districts are in the city center; Xi'ning covers 5 urban districts and 3 counties inhabiting about 1.7 million residents. The cross-sectional study with a 2-stage sampling method contained elderly participants (≥ 60 years old) chosen from an urban population. Firstly, 2 communities in each urban district were sampled — a community (Jie

Prevalence and control of HTN

A total of 2009 cases of HTN were diagnosed in this survey, and the prevalence of HTN reached to 48.5% among total participants, 48.4% were men and 48.6% women, and increased with advancing age (see Fig. 2).

Blood pressure was controlled in 32.1% of all hypertensive participants and in 48.2% of all those received treatment (including medical treatment and/or lifestyle change). The control rate of hypertension in men reached to 33.5%, while the control rate of hypertension in women attained 31.3%

Discussion

This study provides an up-to-date information on factors contributing to the control of HTN among elderly urban residents located in Western China. The definition of HTN and BP control in our study were similar to those shown in Dongfeng Gu's study [2], and BP measurements were similar to those in other studies [2], [7]. However, in this research paper, the change in lifestyle was considered as one category of treatment, and lifestyle interventions also had influence in controlling BP and

Conclusion

Our study has several important findings for the control of HTN in China. Firstly, it emphasized on the importance of early screening of HTN. BP measurements should be taught at the CHCs; each person suspicious of being hypertensive will be able to measure and become aware of ones own BP situation. Secondly, it suggests that health care delivery systems, especially CHCs and the health education department at the Centers of Disease Control and Prevention (CDC) should strengthen education, by

Authors' contributions

Xinping Zhang initiated and designed the study. She was in charge of the questionnaire's construction, sampling method design, field survey implementation and paper revision. Minmin Zhu participated in the design of the study. He also performed the statistical analysis and wrote the original draft. Hassan H. Dib did the final paper revision and restructuring, and editing and proof reading of the manuscript. Jian Hu participated in the questionnaire construction and assembly of data. Shengchun

Acknowledgements

This study was funded by the UHPP project (China/UK Urban Health and Poverty Project).

Many thanks to the assistance received from the department of health administration of Xi'ning, Qinghai province, and Wuhou district, Chengdu, Sichuan province, in the process of data collection. We wish to particularly acknowledge the contributions of the community health service centers of the two cities, and their staffs.

We also thank Ping Li, Naigeng Zhu, Liying Wang, Wenbin Liu, Chuan-mei You, Ruihua Fen,

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