[Study on the risk factors of hypertension among rural residents in mid-west areas of Shandong province, using the classification tree analysis methodology].

OBJECTIVE: To explore the risk factors of hypertension and risk population for adults aged > or = 25 in the mid-western rural areas of Shandong province and to provide evidence for development of intervention measure. METHODS: Subjects aged > or = 25 were selected by multi-stage stratified random sampling method. All participants were interviewed with a standard questionnaire and physically examined on height, weight, waist circumference, blood pressure and fasting plasma glucose (FPG). Classification tree analysis was employed to determine the risk factors of hypertension and high risk populations related to it. RESULTS: The major risk factors of hypertension would include age, abdominal obesity, overweight or obesity, family history and high blood sugar. The major populations at high risk would include populations as: a) being elderly, b) at middle-age but with: high blood sugar or with abdominal obesity/overweight, or with family history, c) people at middle-age but with family history and abdominal obesity. Through classification tree analysis, sensitivity, specificity and overall correct rates were 71.87%, 66.38% and 68.79%, respectively on 'learning sample' while 70.70%, 65.84% and 67.97% respectively on 'testing sample'. CONCLUSION: Efforts on both weight and blood sugar reduction were common prevention measures for general population. Different kinds of prevention and control measures should be taken according to different risk factors existed in the targeted high-risk population of hypertension. Community-based prevention and control for hypertension measures should be integrated when targeting the population at high risk.

[Estimation on the mortality and disease burden attributed to selected risk factors in Shandong province].

OBJECTIVE: To determine the major health related risk factors and provide evidence for policy-making, using health burden analysis on selected factors among general population from Shandong province. METHODS: Based on data derived from the Third Death of Cause Sampling Survey in Shandong, years of life lost (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) were calculated according to the GBD methodology. Deaths and DALYs attributed to the selected risk factors were than estimated together with the PAF data from GBD 2001 study. The indirect method was employed to estimate the YLDs. RESULTS: 51.09% of the total deaths and 31.83% of the total DALYs from the Shandong population were resulted from the 19 selected risk factors. High blood pressure, smoking, low fruit and vegetable intake, alcohol consumption, indoor smoke from solid fuels, high cholesterol, urban air pollution, physical inactivity, overweight and obesity and unsafe injections in health care settings were identified as the top 10 risk factors for mortality which together caused 50.21% of the total deaths. Alcohol use, smoking, high blood pressure, low fruit and vegetable intake, indoor smoke from solid fuels, overweight and obesity, high cholesterol, physical inactivity, urban air pollution and iron-deficiency anemia were proved as the top 10 risk factors related to disease burden and were responsible for 29.04% of the total DALYs. CONCLUSION: Alcohol use, smoking and high blood pressure were determined as the major risk factors which influencing the health of residents in Shandong. The mortality and burden of disease could be reduced significantly if these major factors were effectively under control.

[Estimation of disability weights on malignant neoplasms in Shandong province].

OBJECTIVE: To determine stage-specific and average disability weights (DWs) of malignant neoplasm and provide support and evidence for study on burden of cancer and policy development in Shandong province. METHODS: Health status of each cancer patient identified during the cancer prevalence survey in Shandong, 2007 was investigated. In line with the GBD methodology in estimating DWs, the disability extent of every case was classified and evaluated according to the Six-class Disability Classification version and then the stage-specific weights and average DWs with their 95% confidence intervals were calculated, using SAS software. RESULTS: A total of 11 757 cancer cases were investigated and evaluated. DWs of specific stage of therapy, remission, metastasis and terminal of all cancers were 0.310, 0.218, 0.450 and 0.653 respectively. The average DW of all cancers was 0.317 (95%CI: 0.312 - 0.321). Weights of different stage and different cancer varied significantly, while no significant differences were found between males and females. DWs were found higher (> 0.4) for liver cancer, bone cancer, lymphoma and pancreas cancer. Lower DWs (< 0.3) were found for breast cancer, cervix uteri, corpus uteri, ovarian cancer, larynx cancer, mouth and oropharynx cancer. CONCLUSION: Stage-specific and average DWs for various cancers were estimated based on a large sample size survey. The average DWs of 0.317 for all cancers indicated that 1/3 healthy year lost for each survived life year of them. The difference of DWs between different cancer and stage provide scientific evidence for cancer prevention strategy development.