Open Access Research article

Major inducing factors of hypertensive complications and the interventions required to reduce their prevalence: an epidemiological study of hypertension in a rural population in China

Min Zhang1*, Yong Meng2, Yongli Yang1, Yancai Liu3, Caiqin Dong3, Jianming Xiao1, Ling Zhao1 and Fang Li4

Author Affiliations

1 Department of Cardiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China

2 Department of Cardiology, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, P.R. China

3 First Hospital of Binchuan County, Yunnan 671600, P.R. China

4 Emergency Department, Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650101, P.R. China

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BMC Public Health 2011, 11:301  doi:10.1186/1471-2458-11-301

Published: 11 May 2011

Abstract

Background

The complications of hypertension cause severe health problems in rural areas in China. We (i) screened the major factors inducing hypertensive complications and provided intervention measures; and (ii) verified the efficacy of the New Rural Cooperative Medical Scheme (NRCMS; a medical insurance scheme for rural residents) for hypertension management.

Methods

A survey was conducted in the villages of Yunnan (an underdeveloped province in southwest China). The NRCMS was initiated there in 2005. Data were collected through questionnaires, physical examination, electrocardiography, as well as blood and urine tests. To detect factors inducing hypertension complications, a generalized estimating equations model was developed. Multivariable logistic regression was used to analyze influencing factors for hypertension control.

Results

Poor management of hypertension was observed in women. Being female, old, poorly educated, a smoker, ignorant of the dangerousness of hypertension, and having uncontrolled hypertension made patients more prone to hypertension complications. Combination therapy with ≥2 drugs helped control hypertension, but most rural patients disliked multidrug therapy because they considered it to be expensive and inconvenient. The NRCMS contributed little to reduce the prevalence of complications and improve control of hypertension.

Conclusions

The present study suggested that the NRCMS needs to be reformed to concentrate on early intervention in hypertension and to concentrate on women. To increase hypertension control in rural areas in China, compound products containing effective and inexpensive drugs (and not multidrug therapy) are needed.

Keywords:
hypertension; complications; Chinese rural areas; the New Rural Cooperative Medical Scheme