[Analysis of therapeutic effects of rural patients with hypertension by combination administration of low dosage of hydrochlorothiazide and nitrendipine].

OBJECTIVE: To evaluate the therapeutic effects of combination administration of hydrochlorothiazide and nitrendipine at low dosage in the treatment of rural hypertension patients. METHODS: By the method of cluster random sampling, 5292 primary hypertension patients from Fuxin, Liaoning Province were divided into health education group (control group) and drug intervention group in June 2006. The drug intervention group were treated with hydrochlorothiazide, nitrendipine and captopril by stepwise approach and we observe the antihypertensive effect of drug and the effect on the onset of stroke. RESULTS: The average follow-up time was 15 months. At last, 308 patients were lost to follow-up (the lost follow-up rate was 5.8 percent). The 4984 in cohort, including 2530 of intervention group and 2454 of control group, had examination of all indicators. Through health education and drug intervention, the average blood pressure in drug intervention group decreased by 16.1/9.4 mm Hg (1 mm Hg = 0.133 kPa) while the average blood pressure in control group decreased by 6.7/3.5 mm Hg. The control rate of blood pressure in drug intervention group was higher than control group (33.1% vs. 15.1%, P < 0.001). Through drug intervention, the morbidity risk of nonfatal stroke in drug intervention group decreased by 57.3% compared to control group, the total morbidity risk of stroke decreased by 59.4%. The results had significant statistical difference. And, the morbidity of severe hypopotassaemia (K(+) < 3.0 mmol/L) and diabetes mellitus had no significant statistical difference between two groups. CONCLUSIONS: The low-cost antihypertensive program based on thiazide had good antihypertensive effect, high safety and good cost-effect ratio. The program could be used in rural areas of China.

[Correlation between body mass index, waist circumference and blood pressure in rural residents from west part of Liaoning Province].

OBJECTIVE: This study observed the association between body mass index (BMI), waist circumference (WC) and blood pressure level in rural residents from west Liaoning province. METHODS: This epidemiological study using stratified cluster random sampling was conducted from 2004 to 2006 in Fuxin County, Liaoning Province, 43,692 rural residents (21,680 males) aged 35-74 years old [(49. 8 +/-10.2) years] were surveyed. Database was established with the help of Epidata 3.1 software. RESULTS: In total 43,692 persons were surveyed, including 21,680 male (49.6%) and 22,012 female (50.4%). The average BMI and WC was (23.31 +/- 3.08) kg/m2 and (80.87 +/- 9.0) cm, respectively. No matter male or female, SBP started from 20 kg/m2, increased with the increase of BMI; DBP increased gradually with the increase of BMI; the prevalence of hypertension were significant differences among different BMI groups (P < 0.001). Multiple logistic regression show that in male, using the group with BMI, <18 kg/m2 as control, 28-30 kg/m2 group OR and 95% CI was 6.285 (4.612-8.566); in female, when BMI >22 kg/ m2 OR increased with the increasing of BMI. In male and female, both SBP and DBP, also the prevalence rate of hypertension increased gradually with the increase of WC (P < 0.001). No matter in male or female, when BMI <24 kg/m2, and WC male <85 cm, female WC <80 cm, the average blood pressure levels and prevalence of hypertension are the lowest; after adjusting for age and other risk factors, the prevalence rate of overweight and obesity for male with hypertension OR are 1.704 (1.592-1.825) and 3.710 (3.148 -4.371) , respectively, for female is 1.527 (1.428-1.632) and 3.014 (2.668-3.405), respectively. When the WC is higher than the standard, male and female hypertension risk OR and 95% CI are 1.231 (1.153-1.314) and 1.353 (1.269-1.442), respectively. CONCLUSION: Both BMI and WC are risk factors of hypertension.