Prevalence, awareness, treatment and control of hypertension in population older than 15 years of age in Beijing, 2013-2014 / 中华流行病学杂志

Objective: To investigate the rates on prevalence, awareness, treatment and control of hypertension in population older than 15 years of age in Beijing, 2013-2014. Methods: A cross-sectional survey was conducted in Beijing between 2013-2014. Stratified multistage random sampling method was used to select representative sample of 13 057 Chinese individuals aged over 15 years, from the general population. Blood pressure was measured for three readings at sitting position after resting for at least five minutes with an average reading recorded. A standardized structured questionnaire was developed to collect history of hypertension and antihypertensive treatment. Results: A total of 4 663 community residents aged over 15 years were hypertensive among the 13 057 individuals, with the standardized prevalence rate as 32.7%, in Beijing area. The age-standardized prevalence rates of hypertension appeared 34.6% in men and 30.8% in women. The age-and sexstandardized prevalence of hypertension rates were 33.3% in urban and 24.6% in rural areas. The prevalence of hypertension increased with age and appeared higher in men than in women, in urban than in rural residents. Among the hypertensive patients, rates of awareness, treatment and control were 66.8%, 64.6% and 31.6%, respectively. Conclusion: High prevalence of hypertension with low rates on awareness and treatment and control, appeared in the general population of Beijing. Related strategies should be developed regarding prevention, control and management of hypertension, to reduce the burden of this disease.

Prevalence of alcohol drinking in males aged 20-79 years in China, 2012 / 中华流行病学杂志

Objective: To understand the prevalence of alcohol drinking in 20-79 years old males with different educational backgrounds and smoking behaviors in different areas of China. Methods: A multi-stage cluster random sampling survey was conducted in 150 surveillance sites in 2010-2012 Chinese nutrition and health surveillance in China. At least 1 000 subjects were selected in each surveillance site. Alcohol drinking prevalence and pattern information were collected by using personal health and food frequency questionnaire in face to face interviews. Results: A total of 60 791 males aged 20-79 years were surveyed. The prevalence of alcohol drinking was 57.8% (58.3% in rural area, 57.3% in urban area). The mean daily alcohol intake level was 32.7 g (33.3 g in rural area, 32.1 g in urban area). The rate of almost drinking every day and daily alcohol intake level were highest among males aged 50-59 years. Mean daily alcohol intake level, rate of almost drinking every day and excessive drinking decreased with the increase of education level. Non-smokers had higher rate of never drinking and lower prevalence of drinking and excessive drinking, lower mean daily alcohol intake level, and lower rate of almost drinking every day compared with current and past smokers. Conclusions: Alcohol drinking was common in males aged 20-79 years in China, and, the difference was not obvious between rural residents and urban residents. The differences in daily intake level of different alcohol drinks among males with different characteristics had certain significance. Significant difference in excessive drinking was found among different age groups, those with different education levels and those with different smoking history.

Effect of health literacy and exercise-focused interventions on glycemic control in patients with type 2 diabetes in China / 中华流行病学杂志

Objective: To evaluate the effect of health literacy and exercise-focused interventions on glycemic control in patients with type 2 diabetes (T2DM) in China. Methods: In this cluster randomized controlled trial, a total of 799 T2DM patients with most recent hemoglobin A1c (HbA1c) ≥ 7.5% (or fasting plasma glucose level ≥10 mmol/L) were recruited from 8 communities in Minhang and Changning districts of Shanghai, and randomized into a health literacy intervention group, an exercise intervention group, a comprehensive intervention group and a control group. After baseline survey and examination, a one-year intervention and 3 times (at 3(rd), 6(th), and 12(th) month) follow-up surveys were conducted. Results: The follow-up rates for all the subjects were 99.4%, 98.4% and 95.2%, respectively, at 3(rd), 6(th) and 12(th) month. Patients in intervention groups were more likely to achieve a goal HbA1c level (HbA1c <7.0%) than those in control group, with the highest glycemic control rate (25.3%) observed in comprehensive intervention group at 3(rd) month and then in exercise intervention group (25.3% and 34.6%) respectively, at 6(th) month and 12(th) month. The average levels of HbA1c in three intervention groups were lower at each follow-up time point than those at baseline survey. However, the decreases in HbA1c were obvious only at 6(th) month (P<0.001), with ls-mean (95%CI) of -0.48% (-0.71%, -0.25%), -0.33% (-0.55%, -0.11%) and -0.70% (-0.92%, -0.48%), respectively, in comprehensive, health literacy and exercise intervention groups, but it increased slightly by 0.03% (-0.19%, 0.25%) in control group. Compared with control group, the interventions were significantly associated with the decrease of HbA1c level, with the most improvement observed in comprehensive group (β=-0.47, 95% CI: -0.73, -0.20) at 3(rd) month, and in exercise intervention group at 6(th) month (β=-0.73, 95%CI: -0.98, -0.47) and at 12(th) month (β=-0.75, 95%CI: -1.05, -0.45) of follow-up. Stratified analyses showed that patients with lower health literacy level could benefit from any intervention, while those with higher numeracy skill benefited more from exercise intervention. Conclusion: Both health literacy and exercise-focused interventions may decrease HbA1c level in patients with T2DM, which would be helpful in reducing the risks of complications and deaths in diabetes patients.

Relationship between meat consumption and metabolic syndrome in adults in China / 中华流行病学杂志

Objective: To explore the relationship between meat consumption and metabolic syndrome (MS) in Chinese adults aged ≥18 years. Methods: The data were obtained from 2010- 2012 National Nutrition and Health Survey. A total of 34 923 subjects who completed the dietary survey, the physical examination and had the testing results of blood sugar and blood lipid levels were enrolled in this study. MS was defined according to the diagnostic criteria of China Diabetes Society 2013. The prevalence ratios of MS and each form of MS and related 95%CI were calculated after post stratification weight according to the population data (2009) released by the national bureau of statistics. Results: The average meat intake among subjects was 94.8 g/d. People who had meat consumption between 100 g/d and 199 g/d had the lowest prevalence of MS, abdominal obesity and hyperglycemia. As the meat consumption increased, the prevalence of MS in men increased. Men who had meat consumption of ≥300 g/d had a higher risk of MS than those who had low level of meat consumption, with prevalence ratio equaled to 1.46 (95%CI: 1.14~1.87). Similar trend was not observed in women. Conclusion: Moderate intake of meat is associated with reduced risk of MS in Chinese adults.

Prevalence of alcohol drinking and influencing factors in female adults in China, 2010-2012 / 中华流行病学杂志

Objective: To understand the prevalence of alcohol drinking and influencing factors in female adults in China. Methods: At the 150 survey sites where 2010-2012 Chinese nutrition and health surveillance was conducted, a face to face questionnaire survey was conducted in female adults selected through multi-stage stratified cluster random sampling. Sample weights was assigned to each participant based on the study design by using national population census data in 2009. The complex sampling and unconditional multivariate logistics regression analysis was conducted to identify the influencing factors for the prevalence of alcohol drinking in the female adults. Results: A total of 75 518 participants were included in this study. The prevalence of drinking in female adults was 13.9% (95%CI: 11.7-16.2) in urban area and 13.3% (95%CI: 9.4-17.2) in rural area. The prevalence of frequent drinking was 13.9% (95%CI: 9.9-17.9) in women in urban area and 14.2% (95%CI: 10.8-17.6) in women in rural area. The prevalence of excessive drinking was 11.1% (95%CI: 7.5-14.8) in women in urban area and 12.8% (95%CI: 9.1-16.4) in women in rural area. The prevalence of wine drinking in women in urban area was significantly higher than in women in rural and had positive correlation with income and education levels. The social and economic factors influencing drinking behavior of the female adults included occupation, drinking behaviors of family members and smoking behavior. Those who were engaged in agriculture, production and transportation (OR=0.72, 95%CI: 0.56-0.94, P=0.016), housework (OR=0.59, 95%CI: 0.44-0.78, P<0.001) and other work (OR=0.61, 95%CI: 0.43-0.85, P=0.004) had lower drinking prevalence. Whereas those whose family members had drinking behavior (OR=2.66, 95%CI: 2.17-3.26, P<0.001) and those who were current smokers (OR=4.32, 95%CI: 2.95-6.34, P<0.01) had higher drinking prevalence. Conclusions: The prevalence of drinking, frequent alcohol drinking and excessive drinking were relatively low in female adults in China. Occupation, drinking behaviors of family members and smoking behavior were the main factors influencing the prevalence drinking behavior in female adults in China.