Abstract
BackgroundA Reference Framework for Hypertension Care was recently developed by Hong Kong government to emphasise the importance of primary care for subjects with high blood pressure (BP). The Dietary Approaches to Stop Hypertension (DASH) interventional regime was recommended for patients aged 40–70 years with grade 1 hypertension (having systolic BP of 140-159 mmHg and/or diastolic BP of 90-99 mmHg). This study explored factors associated with grade 1 hypertension among subjects screened in primary care settings.MethodsThe study sample consisted of community dwellers (N = 10,693) enrolled in a primary care programme in which participants overall had similar characteristics when compared to the Hong Kong population census. Invitation phone calls were given by trained researchers to a randomly selected subjects (N = 2,673, [50% of total subjects aged 40–70 years]) between January and June 2013. BP and body mass index (BMI) were measured by trained clinical professionals according to a standard protocol. Interviewer-administered survey questionnaires were used to collect self-report information on socio-demographics, family history, and lifestyle characteristics. Multiple logistic regression analysis was performed to explore factors associated with grade 1 hypertension. Adjusted odds ratios (aORs) were estimated with 95% confidence intervals (CI).ResultsA total of 679 out of 2,673 subjects agreed to participate in the screening and completed the baseline assessment (100% completion rate), among which, 320 subjects (47.1%, [320/679]) were grade 1 hypertensive. Unhealthy diet (aOR = 2.19, 95%CI 1.04-4.62), irregular meals (aOR = 1.47, 95%CI 1.11-1.95), BMI >27.5 kg/m2 (aOR = 1.87, 95%CI 1.53-2.27), duration of cigarette smoking (aOR = 1.83 per year), increased daily cigarette consumption (aOR = 1.59 per pack [20 cigarettes per pack]), duration of alcohol drinking (aOR = 1.65 per year), and higher frequency of weekly binge drinking (aOR = 1.87 per occasion) were independently associated with grade 1 hypertension. The increase in the number of risk factors combined significantly correlated with higher predicted probability of grade 1 hypertension.ConclusionsDietary-intake factors were significantly associated with grade 1 hypertension, echoing the recommendation in the Reference Framework on incorporating dietary-related intervention based on the DASH approach for hypertension care in primary care settings. The association between aggregate risk factors and grade 1 hypertension should also be taken into consideration in long-term preventive strategy.
Highlights
A Reference Framework for Hypertension Care was recently developed by Hong Kong government to emphasise the importance of primary care for subjects with high blood pressure (BP)
Of the total of 2,673 randomly selected subjects aged 40–70 years who received invitation phone calls, 679 subjects agreed to participate in the screening, and 320 subjects were identified as having grade 1 hypertension (Figure 1)
In the multiple logistic regression analysis, the independent associations of unhealthy diet regime, irregular daily meals, body mass index (BMI) >27.5 kg/m2, duration of cigarette smoking, increased daily cigarette consumption, duration of alcohol drinking, higher frequency of weekly binge drinking, and the presence of parental history of hypertension with grade 1 hypertension remained statistically significant after adjusting for the potential effects of other independent factors (Table 3)
Summary
A Reference Framework for Hypertension Care was recently developed by Hong Kong government to emphasise the importance of primary care for subjects with high blood pressure (BP). This study explored factors associated with grade 1 hypertension among subjects screened in primary care settings. More than one-fourth of the adult population worldwide have systolic BP (SBP)/diastolic BP (DBP) persistently over 140/90 mmHg [1], and the prevalence of hypertension is predicted to increase by 42% in 2025 [2]. In Hong Kong where the Chinese population are predominant, a recent territory-wide population-based health survey suggested that hypertension was the second most prevalent chronic condition [3]. Many patients might not be fully aware of the presence of hypertension until being screened with on-site physical measurement, as shown in a previous study that 15.1% of diagnosed hypertensive patients in Hong Kong were newly identified by field measurement [4]. Hypertension increases health care utilisation in primary care where hypertension serves as a major reason for doctor consultation [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
