Abstract
BackgroundThe prevalence of hypertension in adults is increasing each year and has become a main public health issue worldwide. We must consider the impact of both individual factors and interactions among these factors on hypertension in adults. This study was designed to elucidate the clinical and metabolic characteristics of the prevalence of hypertension in adults and to explore the risk factors and interactions among these factors in adults with hypertension.MethodsWe used overall random sampling to conduct a cross-sectional survey of 6660 individuals undergoing a health check from July to November 2012, the subjects were aged 20 to 89 years, including 3480 men and 3180 women. The survey content included a questionnaire, anthropometry, laboratory measurements, and liver Doppler ultrasonography. The clinical and metabolic characteristics were compared between the cases (adult hypertensive patients) and the controls (normotensives). The classification tree model and the non-conditional logistic regression were used to analyze the interactions of risk factors for hypertension in adults.ResultsIn total, 1623 adult hypertensive patients (940 men and 683 women) were detected. The results showed that adult hypertensive patients were older and had higher levels of systolic blood pressure, diastolic blood pressure, body mass index, fasting plasma glucose, uric acid, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and prevalence of non-alcoholic fatty liver disease (P < 0.001). The classification tree model comprising 5 layers, 39 nodes, and 20 terminal nodes showed that two variables, age and BMI, were closely related to hypertension in adults. The area under the receiver operating characteristic curve for classification tree model was 81.6 % (95 % CI: 80.6 % ~ 82.5 %). Both univariate and multivariate logistic regression analyses revealed that advanced age and high BMI had a significant positive interaction in terms of hypertension in adults. After controlling for confounding factors, the percentage of attributed interaction was 47.62 %.ConclusionsThis study showed that age, BMI, UA, TG, and TC were closely associated with the risk of hypertension in adults, and the positive interaction effect between advanced age and high BMI was an important risk factor for the prevalence of hypertension in adults.
Highlights
The prevalence of hypertension in adults is increasing each year and has become a main public health issue worldwide
Our study revealed the crude and population-standardized morbidity of hypertension in Guilin adults was 24.4 and 20.5 % respectively, which was lower than most of the northeastern cities of China [20], compared with morbidities in other cities of the same southwestern areas (Guangzhou: 11.8 %; Nandan county of Guangxi: 16.45 %) [21, 22], the prevalence of hypertension in adults was higher in Guilin
Hypertensive patients were older and had higher levels of body mass index (BMI), fasting plasma glucose (FPG), uric acid (UA), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and nonalcoholic fatty liver disease (NAFLD) morbidity, whereas they had a significantly lower level of HDLC, indicating that adults with hypertension might suffer from metabolic disorders such as overweight, dyslipidemia, hyperuricemia, hyperglycemia, NAFLD, et al Table 2 Cut-off criterion, sensitivity, specificity, area under the curve (AUC) and Youden index of receiver operating characteristic (ROC) curve for Classification and Regression Tree (CRT) model
Summary
The prevalence of hypertension in adults is increasing each year and has become a main public health issue worldwide. With the rapid social and economic development and the change in people’s diets, the prevalence of hypertension has been increasing each year, especially in the adult population. In 2000, approximately 972 million people had hypertension worldwide, and the prevalence of hypertension in adults was approximately 26.4 % (men: 26.6 %, women: 26.1 %). By 2025, the prevalence of hypertension in adults is expected to rise to 29.2 % (men: 29.0 %, women: 29.5 %) [2]. The prevalence of hypertension in adults varies across different regions [3] and is affected by genetic background and environmental factors. Hypertension is becoming one of the world’s most costly health conditions and poses an especially large burden of disease in some developing countries [6]
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