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Published in: Environmental Health and Preventive Medicine 1/2017

Open Access 01-12-2017 | Research article

Prevalence and risk factors associated with hypertension and prehypertension in a working population at high altitude in China: a cross-sectional study

Authors: Yang Shen, Chun Chang, Jingru Zhang, Ying Jiang, Bingying Ni, Yanling Wang

Published in: Environmental Health and Preventive Medicine | Issue 1/2017

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Abstract

Background

Little information is available on the epidemiology of hypertension and prehypertension at high altitude in China, the aim of this study was to determine the prevalence of hypertension, prehypertension and their risk factors among Chinese working population at high altitude regions.

Methods

A cross-sectional survey was performed in an occupational sample of 4198 employees aged 20–59 years on Qinghai-Tibet Plateau between May to July 2013. Information from a self-administered questionnaire, physical examinations and laboratory measurements were obtained from each participant. Multivariable analysis was performed to determine the association of various risk factors with hypertension and prehypertension.

Results

The total crude prevalence of hypertension and prehypertension was 28.1 and 41.5%, respectively; the overall standardized prevalence of hypertension and prehypertension was 26.7 and 41.3%, respectively. Multivariate logistic regression showed that age, sex, ethnicity, job position, overweight or obesity, frequent drinking, family history of hypertension, diabetes and hyperuricemia were risk factors for hypertension, and age, sex, education, job position, overweight or obesity, current smoking and family history of hypertension were risk factors for prehypertension. Among the hypertensives, 36.5% were aware of their condition, 19.4% were being treated and 6.2% had their blood pressure (BP) controlled; among the treated hypertensives, 31.9% had their BP under control.

Conclusions

There is a high prevalence of hypertension and prehypertension in the working population at high altitude in China, but with very low awareness, treatment and control rates. Workplace-based BP screening and intervention programs that aim to modify risk factors such as high BMI, tobacco use, alcohol consumption and inappropriate use of antihypertensive medicine are urgently needed.
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Literature
1.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–72.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–72.CrossRefPubMed
2.
go back to reference Yang L, Yan J, Tang X, Xu X, Yu W, Wu H. Prevalence, awareness, treatment, control and risk factors associated with hypertension among adults in Southern China, 2013. PloS One. 2016;11:e0146181.CrossRefPubMedPubMedCentral Yang L, Yan J, Tang X, Xu X, Yu W, Wu H. Prevalence, awareness, treatment, control and risk factors associated with hypertension among adults in Southern China, 2013. PloS One. 2016;11:e0146181.CrossRefPubMedPubMedCentral
3.
go back to reference Wang J, Zhang L, Wang F, Liu L, Wang H, China National Survey of Chronic Kidney Disease Working G. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am J Hypertens. 2014;27:1355–61.CrossRefPubMedPubMedCentral Wang J, Zhang L, Wang F, Liu L, Wang H, China National Survey of Chronic Kidney Disease Working G. Prevalence, awareness, treatment, and control of hypertension in China: results from a national survey. Am J Hypertens. 2014;27:1355–61.CrossRefPubMedPubMedCentral
4.
go back to reference Yu D, Huang J, Hu D, Chen J, Cao J, Li J, et al. Prevalence and risk factors of prehypertension among Chinese adults. J Cardiovasc Pharmacol. 2008;52:363–8.CrossRefPubMed Yu D, Huang J, Hu D, Chen J, Cao J, Li J, et al. Prevalence and risk factors of prehypertension among Chinese adults. J Cardiovasc Pharmacol. 2008;52:363–8.CrossRefPubMed
5.
go back to reference Guo F, He D, Zhang W, Walton RG. Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999 to 2010. J Am Coll Cardiol. 2012;60:599–606.CrossRefPubMed Guo F, He D, Zhang W, Walton RG. Trends in prevalence, awareness, management, and control of hypertension among United States adults, 1999 to 2010. J Am Coll Cardiol. 2012;60:599–606.CrossRefPubMed
6.
go back to reference Xu T, Liu J, Zhu G, Liu J, Han S. Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey. BMC Public Health. 2016;16:775.CrossRefPubMedPubMedCentral Xu T, Liu J, Zhu G, Liu J, Han S. Prevalence of prehypertension and associated risk factors among Chinese adults from a large-scale multi-ethnic population survey. BMC Public Health. 2016;16:775.CrossRefPubMedPubMedCentral
7.
go back to reference Arestegui AH, Fuquay R, Sirota J, Swenson ER, Schoene RB, Jefferson JA, et al. High altitude renal syndrome (HARS). J Am Soc Nephrol. 2011;22:1963–8.CrossRefPubMed Arestegui AH, Fuquay R, Sirota J, Swenson ER, Schoene RB, Jefferson JA, et al. High altitude renal syndrome (HARS). J Am Soc Nephrol. 2011;22:1963–8.CrossRefPubMed
8.
go back to reference Brito J, Siques P, Leon-Velarde F, De La Cruz JJ, Lopez V, Herruzo R. Chronic intermittent hypoxia at high altitude exposure for over 12 years: assessment of hematological, cardiovascular, and renal effects. High Alt Med Biol. 2007;8:236–44.CrossRefPubMed Brito J, Siques P, Leon-Velarde F, De La Cruz JJ, Lopez V, Herruzo R. Chronic intermittent hypoxia at high altitude exposure for over 12 years: assessment of hematological, cardiovascular, and renal effects. High Alt Med Biol. 2007;8:236–44.CrossRefPubMed
9.
go back to reference Mingji C, Onakpoya IJ, Perera R, Ward AM, Heneghan CJ. Relationship between altitude and the prevalence of hypertension in Tibet: a systematic review. Heart. 2015;101:1054–60.CrossRefPubMedPubMedCentral Mingji C, Onakpoya IJ, Perera R, Ward AM, Heneghan CJ. Relationship between altitude and the prevalence of hypertension in Tibet: a systematic review. Heart. 2015;101:1054–60.CrossRefPubMedPubMedCentral
10.
go back to reference Sonkodi B, Sonkodi S, Steiner S, Helis E, Turton P, Zachar P, et al. High prevalence of prehypertension and hypertension in a working population in Hungary. Am J Hypertens. 2012;25:204–8.CrossRefPubMed Sonkodi B, Sonkodi S, Steiner S, Helis E, Turton P, Zachar P, et al. High prevalence of prehypertension and hypertension in a working population in Hungary. Am J Hypertens. 2012;25:204–8.CrossRefPubMed
11.
go back to reference Tracey ML, Fitzgerald S, Geaney F, Perry IJ, Greiner B. Socioeconomic inequalities of cardiovascular risk factors among manufacturing employees in the Republic of Ireland: a cross-sectional study. Prev Med Rep. 2015;2:699–703.CrossRefPubMedPubMedCentral Tracey ML, Fitzgerald S, Geaney F, Perry IJ, Greiner B. Socioeconomic inequalities of cardiovascular risk factors among manufacturing employees in the Republic of Ireland: a cross-sectional study. Prev Med Rep. 2015;2:699–703.CrossRefPubMedPubMedCentral
12.
go back to reference Ouyang X, Lou Q, Gu L, Mo Y, Nan JH, Kong AP, et al. Cardiovascular disease risk factors are highly prevalent in the office-working population of Nanjing in China. Int J Cardiol. 2012;155:212–6.CrossRefPubMed Ouyang X, Lou Q, Gu L, Mo Y, Nan JH, Kong AP, et al. Cardiovascular disease risk factors are highly prevalent in the office-working population of Nanjing in China. Int J Cardiol. 2012;155:212–6.CrossRefPubMed
13.
go back to reference Freak-Poli R, Wolfe R, Peeters A. Risk of cardiovascular disease and diabetes in a working population with sedentary occupations. J Occup Environ Med. 2010;52:1132–7.CrossRefPubMed Freak-Poli R, Wolfe R, Peeters A. Risk of cardiovascular disease and diabetes in a working population with sedentary occupations. J Occup Environ Med. 2010;52:1132–7.CrossRefPubMed
14.
go back to reference Cho K, Tian M, Lan Y, Zhao X, Yan LL. Validation of the Omron HEM-7201 upper arm blood pressure monitor, for self-measurement in a high-altitude environment, according to the European Society of Hypertension International Protocol revision 2010. J Hum Hypertens. 2013;27:487–91.CrossRefPubMedPubMedCentral Cho K, Tian M, Lan Y, Zhao X, Yan LL. Validation of the Omron HEM-7201 upper arm blood pressure monitor, for self-measurement in a high-altitude environment, according to the European Society of Hypertension International Protocol revision 2010. J Hum Hypertens. 2013;27:487–91.CrossRefPubMedPubMedCentral
15.
go back to reference Yongqing Z, Ming W, Jian S, Pengfei L, Xiaoqun P, Meihua D, et al. Prevalence, awareness, treatment and control of hypertension and sodium intake in Jiangsu Province, China: a baseline study in 2014. BMC Public Health. 2016;16:56.CrossRefPubMedPubMedCentral Yongqing Z, Ming W, Jian S, Pengfei L, Xiaoqun P, Meihua D, et al. Prevalence, awareness, treatment and control of hypertension and sodium intake in Jiangsu Province, China: a baseline study in 2014. BMC Public Health. 2016;16:56.CrossRefPubMedPubMedCentral
16.
go back to reference Hu DY, Ding RJ. Guidelines for management of adult dyslipidemia in China. Zhonghua Nei Ke Za Zhi. 2008;47:723–4.PubMed Hu DY, Ding RJ. Guidelines for management of adult dyslipidemia in China. Zhonghua Nei Ke Za Zhi. 2008;47:723–4.PubMed
17.
go back to reference Zhou BF. Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases--report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci. 2002;15:245–52.PubMed Zhou BF. Effect of body mass index on all-cause mortality and incidence of cardiovascular diseases--report for meta-analysis of prospective studies open optimal cut-off points of body mass index in Chinese adults. Biomed Environ Sci. 2002;15:245–52.PubMed
18.
go back to reference Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404–10.CrossRefPubMed Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404–10.CrossRefPubMed
20.
go back to reference Wei Q, Sun J, Huang J, Zhou HY, Ding YM, Tao YC, et al. Prevalence of hypertension and associated risk factors in Dehui City of Jilin Province in China. J Hum Hypertens. 2015;29:64–8.CrossRefPubMed Wei Q, Sun J, Huang J, Zhou HY, Ding YM, Tao YC, et al. Prevalence of hypertension and associated risk factors in Dehui City of Jilin Province in China. J Hum Hypertens. 2015;29:64–8.CrossRefPubMed
21.
go back to reference Li W, Gu H, Teo KK, Bo J, Wang Y, Yang J, et al. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens. 2016;34:39–46.CrossRefPubMed Li W, Gu H, Teo KK, Bo J, Wang Y, Yang J, et al. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens. 2016;34:39–46.CrossRefPubMed
22.
go back to reference Yang G, Ma Y, Wang S, Su Y, Rao W, Fu Y, et al. Prevalence and correlates of prehypertension and hypertension among adults in Northeastern China: a cross-sectional study. Int J Environ Res Public Health. 2016;13:82.CrossRef Yang G, Ma Y, Wang S, Su Y, Rao W, Fu Y, et al. Prevalence and correlates of prehypertension and hypertension among adults in Northeastern China: a cross-sectional study. Int J Environ Res Public Health. 2016;13:82.CrossRef
23.
go back to reference Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004;164:2126–34.CrossRefPubMed Wang Y, Wang QJ. The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines: new challenges of the old problem. Arch Intern Med. 2004;164:2126–34.CrossRefPubMed
24.
go back to reference Lin Y, Lai X, Chen G, Xu Y, Huang B, Chen Z, et al. Prevalence and risk factors associated with prehypertension and hypertension in the Chinese She population. Kidney Blood Press Res. 2012;35:305–13.CrossRefPubMed Lin Y, Lai X, Chen G, Xu Y, Huang B, Chen Z, et al. Prevalence and risk factors associated with prehypertension and hypertension in the Chinese She population. Kidney Blood Press Res. 2012;35:305–13.CrossRefPubMed
25.
go back to reference Meng XJ, Dong GH, Wang D, Liu MM, Liu YQ, Zhao Y, et al. Epidemiology of prehypertension and associated risk factors in urban adults from 33 communities in China. Circ J. 2012;76:900–6.CrossRefPubMed Meng XJ, Dong GH, Wang D, Liu MM, Liu YQ, Zhao Y, et al. Epidemiology of prehypertension and associated risk factors in urban adults from 33 communities in China. Circ J. 2012;76:900–6.CrossRefPubMed
26.
go back to reference Black ML, Wise CA, Wang W, Bittles AH. Combining genetics and population history in the study of ethnic diversity in the People’s Republic of China. Hum Biol. 2006;78:277–93.CrossRefPubMed Black ML, Wise CA, Wang W, Bittles AH. Combining genetics and population history in the study of ethnic diversity in the People’s Republic of China. Hum Biol. 2006;78:277–93.CrossRefPubMed
27.
go back to reference Wright-Nunes JA, Luther JM, Ikizler TA, Cavanaugh KL. Patient knowledge of blood pressure target is associated with improved blood pressure control in chronic kidney disease. Patient Educ Couns. 2012;88:184–8.CrossRefPubMedPubMedCentral Wright-Nunes JA, Luther JM, Ikizler TA, Cavanaugh KL. Patient knowledge of blood pressure target is associated with improved blood pressure control in chronic kidney disease. Patient Educ Couns. 2012;88:184–8.CrossRefPubMedPubMedCentral
28.
go back to reference Vrijkotte TG, van Doornen LJ, de Geus EJ. Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension. 2000;35:880–6.CrossRefPubMed Vrijkotte TG, van Doornen LJ, de Geus EJ. Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension. 2000;35:880–6.CrossRefPubMed
29.
go back to reference Grayson PC, Kim SY, LaValley M, Choi HK. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011;63:102–10.CrossRef Grayson PC, Kim SY, LaValley M, Choi HK. Hyperuricemia and incident hypertension: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2011;63:102–10.CrossRef
30.
go back to reference Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open. 2013;3:e003423.CrossRefPubMedPubMedCentral Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open. 2013;3:e003423.CrossRefPubMedPubMedCentral
31.
go back to reference Lewington S, Lacey B, Clarke R, Guo Y, Kong XL, Yang L, et al. The burden of hypertension and associated risk for cardiovascular mortality in China. JAMA Intern Med. 2016;176:524–32.CrossRefPubMed Lewington S, Lacey B, Clarke R, Guo Y, Kong XL, Yang L, et al. The burden of hypertension and associated risk for cardiovascular mortality in China. JAMA Intern Med. 2016;176:524–32.CrossRefPubMed
32.
go back to reference Parati G, Bilo G, Faini A, Bilo B, Revera M, Giuliano A, et al. Changes in 24 h ambulatory blood pressure and effects of angiotensin II receptor blockade during acute and prolonged high-altitude exposure: a randomized clinical trial. Eur Heart J. 2014;35:3113–22.CrossRefPubMed Parati G, Bilo G, Faini A, Bilo B, Revera M, Giuliano A, et al. Changes in 24 h ambulatory blood pressure and effects of angiotensin II receptor blockade during acute and prolonged high-altitude exposure: a randomized clinical trial. Eur Heart J. 2014;35:3113–22.CrossRefPubMed
33.
go back to reference Xu S, Jiayong Z, Li B, Zhu H, Chang H, Shi W, et al. Prevalence and clustering of cardiovascular disease risk factors among tibetan adults in china: a population-based study. PloS One. 2015;10:e0129966.CrossRefPubMedPubMedCentral Xu S, Jiayong Z, Li B, Zhu H, Chang H, Shi W, et al. Prevalence and clustering of cardiovascular disease risk factors among tibetan adults in china: a population-based study. PloS One. 2015;10:e0129966.CrossRefPubMedPubMedCentral
34.
go back to reference San T, Polat S, Cingi C, Eskiizmir G, Oghan F, Cakir B. Effects of high altitude on sleep and respiratory system and theirs adaptations. Sci World J. 2013;2013:241569.CrossRef San T, Polat S, Cingi C, Eskiizmir G, Oghan F, Cakir B. Effects of high altitude on sleep and respiratory system and theirs adaptations. Sci World J. 2013;2013:241569.CrossRef
Metadata
Title
Prevalence and risk factors associated with hypertension and prehypertension in a working population at high altitude in China: a cross-sectional study
Authors
Yang Shen
Chun Chang
Jingru Zhang
Ying Jiang
Bingying Ni
Yanling Wang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Environmental Health and Preventive Medicine / Issue 1/2017
Print ISSN: 1342-078X
Electronic ISSN: 1347-4715
DOI
https://doi.org/10.1186/s12199-017-0634-7

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