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    Association of Blood Pressure Level with the Risk of Chronic Kidney Disease among the Elderly in Longevity Areas of China
    ZHANG Yunsheng, ZHANG Peng, JIN Yujing, GAO Ying
    Chinese General Practice    2023, 26 (28): 3502-3506.   DOI: 10.12114/j.issn.1007-9572.2022.0876
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    Background

    Chronic kidney disease (CKD) is a serious risk to the health and longevity of the elderly, and hypertension is closely related to CKD. However, the studies on the correlation of blood pressure levels with the development and progression of CKD in older adults have shown inconsistent results.

    Objective

    To explore the association between blood pressure levels and the risk of CKD among the elderly in longevity areas of China.

    Methods

    From October 2021 to May 2022, a total of 989 older adults who underwent physical examination with biomedical indicators collected in 2012 were selected as subjects based on the subcohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) -Healthy Aging and Biomarkers Cohort Study (HABCS) . Age, gender, height, weight, blood pressure, blood lipid, blood glucose, routine blood and urine indicators were collected at baseline, and follow-up monitoring was conducted in 2014. Cox proportional hazards regression model was used to analyze the association between the blood pressure levels and the risk of CKD.

    Results

    A total of 989 subjects were included in the study, with a median age of 79 (70, 88) years. The cumulative follow-up were 2 046 person-years, with an average follow-up time of (2.07±0.50) years. There were 183 new cases of CKD, the cumulative incidence of CKD was 18.5%〔95%CI (16.1%, 21.1%) 〕, and the incidence density was 89.4/1 000 person-years. During the follow-up, 9.8% (10/102) , 14.0% (47/335) and 22.8% (126/552) of the older adults in the normal blood pressure, high normal blood pressure and hypertension groups developed CKD, respectively, and the difference was statistically significant among the three groups (χ2=16.40, P<0.001) . The results of Cox regression showed that after adjusting for age, sex, BMI, waist circumference, calf circumference, fasting blood glucose, glycosylated serum protein, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, uric acid, superoxide dismutase, vitamind3, white blood cell count, red blood cell count, platelet count, blood urea nitrogen and history of diabetes, the older adults in the hypertension group had a higher risk of CKD〔HR (95%CI) =2.28 (1.13, 4.60) 〕 than those in the normal blood pressure group; the risk of CKD was 1.83 times〔95%CI (1.02, 3.29) 〕 higher in the older adults with baseline SBP≥140 mmHg (1 mmHg=0.133 kPa) than those with baseline SBP<120 mmHg, and the risk of CKD was 1.55 times〔95%CI (1.02, 2.35) 〕 higher in the older adults with baseline DBP≥90 mmHg than those with baseline DBP<80 mmHg (P<0.05) .

    Conclusion

    Hypertension is an independent risk factor for CKD in the elderly. It is particularly important to increase screening and prevention of CKD in older adults with predominantly elevated systolic blood pressure.

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    Relationship between Sleep Duration and All-cause Mortality in Middle-aged and Older Adults
    XU Zhe, ZHANG Jinxia, ZHANG Xiuhong, XIE Kaihong
    Chinese General Practice    2023, 26 (28): 3507-3512.   DOI: 10.12114/j.issn.1007-9572.2023.0199
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    Background

    The scale and follow-up time of studies related to the association between sleep duration and all-cause mortality in middle-aged and older adults vary widely, and the results of studies such as correlations and recommended sleep duration remain controversial.

    Objective

    To explore the association between sleep duration and the risk of all-cause mortality in middle-aged and older adults.

    Methods

    From January to December 2022, the longitudinal study cohort was created based on the case ID numbers of coding manual combined with baseline and follow-up data of the China Health and Retirement Longitudinal Study (CHARLS) and Chinese Longitudinal Healthy Longevity Study (CLHLS) databases from January to December in 2022, which ultimately included 43 922 respondents. Social demographics, health status and health-related behaviors, sleep duration and death related information were extracted from CHARLS and CLHLS databases, recoding and variable transformations were performed according to the measurement and evaluation criteria of relevant indicators. The Kaplan-Meier method of Log-Rank test was used to plot survival curves, and the Cox proportional hazard regression model was used to explore the relationship between sleep duration and mortality risk in the middle-aged and older adults, followed by unrestricted cubic spline to observe the effect of the continuous-type variable of sleep duration on mortality risk.

    Results

    Among 43 922 middle-aged and older adults with a median follow-up of 6 years and an average sleep duration of 7.32 h, 9 369 cases (21.33%) had sleep duration of≤5 h, 7 779 cases (17.71%) had sleep duration of >5-6 h, 295 cases (0.67%) had sleep duration of >6-7 h, 15 611 cases (35.54%) had sleep duration of >7-8 h, 2 567 cases (5.84%) had sleep duration of >8-9 h, 5 011 cases (11.41%) had sleep duration of >9-10 h and 3 290 cases had sleep duration >10 h (7.49%) . Kaplan-Meier survival analysis showed that middle-aged and older adults with moderate sleep duration (>6-7 h) had the highest probability of survival, and those with extra-long sleep duration (>10 h) had the lowest probability of survival. Cox regression model results showed that compared with middle-aged and older adults with sleep duration >10 h, middle-aged and elderly adults with sleep duration of ≤5 h〔HR (95%CI) =1.19 (1.09, 1.29) , P<0.05〕, >7-8 h〔HR (95%CI) =1.16 (1.08, 1.25) , P<0.05〕, >8-9 h〔HR (95%CI) =1.32 (1.19, 1.46) , P<0.05〕, and >9-10 h〔HR (95%CI) =1.12 (1.04, 1.22) , P<0.05〕 had increased risk of death. Restricted cubic spline showed an S-shaped non-linear association between sleep duration and risk of all-cause death (P=0.023) , with no significant association of sleep duration of 4.62-7.97 h with the risk of death, significant association of sleep duration <4.62 h and >7.97-10.00 h with all-cause mortality risk.

    Conclusion

    Middle-aged and older adults with moderate sleep duration had the highest probability of survival, so the recommended sleep duration for middle-aged and older adults is 5-7 h.

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    Association between Self-rated Health and Frailty among Community-dwelling Older Adults: the Moderating Role of Apathy
    TAO Lu, LI Sha, DING Yaping, ZONG Qianxing, GAO Shiying, NIE Zuoting, CHEN Long, WU Yan, YANG Rumei
    Chinese General Practice    2023, 26 (28): 3513-3519.   DOI: 10.12114/j.issn.1007-9572.2022.0841
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    Background

    Previous studies have shown that self-rated health would be used as a simple assessment indicator for frailty, and individuals with poor self-rated health status are at higher risk of frailty. However, the association between self-rated health and frailty may be different and the effectiveness of self-rated health in frailty assessment may vary in apathetic older adults.

    Objective

    To explore the moderating role of apathy in the association between self-rated health and frailty among community-dwelling older adults, so as to provide theoretical guidance for the application of the self-rated health in the assessment of frailty in apathetic older adults.

    Methods

    From November 2021 to March 2022, a total of 384 community-dwelling older adults were selected as respondents by convenience sampling method, including 179 cases in Nanjing Dongshan Community and 205 cases in Lianyungang Qinghu Community. Questionnaire surveys were conducted using the General Information Questionnaire, Fried Frailty Phenotyp (FFP) , Geriatric Depression Scale (GDS-3) , and the self-reported health (SRH) . Generalized linear model was used to analyze the association between self-rated health and frailty of community-dwelling older adults. The model 1 of the SPSS macro program process compiled by Hayes was used to analyze the moderating role of apathy on the association between the self-rated health and frailty, with simple slope analyze performed and simple slope graphs plotted.

    Results

    The median FFP and SRH item scores of 384 community-dwelling older adults were 1.00 (2.00) and 4.00 (1.00) , respectively, with the detection rate of apathy of 55.5% (213/384) . The results of the generalized linear model showed that the relationship between the self-rated health and frailty of community-dwelling older adults was significant (b=0.310, P<0.001) . The results of the moderating effect test showed that apathy played a moderating role in the relationship between self-rated health status and frailty in community-dwelling older adults (b=0.355, t=3.074, P=0.002) , and the results of simple slope analysis showed that the simple slope of the non-apathy group and apathy group was 0.100 (t=1.209, P=0.228) and 0.455 (t=5.206, P<0.001) respectively.

    Conclusion

    There is an association between self-rated health and frailty in community-dwelling older adults, and the application of the self-rated health can help community health workers assess frailty in older adults. Apathy plays a moderating role in the relationship between self-rated health and frailty. Compared with the non-apathetic older adults, the association between self-rated health and frailty is significant in apathetic older adults. Strengthening the self-rated health assessment of older adults is beneficial to the identification of their frailty.

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    Prevalence of Dyslipidemia and Its Influencing Factors among Elderly Community Residents
    HUANG Qixian, WEN Yanting, HUANG Jun, LI Weibin, XU Yongneng, LIN Xiayi, WANG Haoxiang, WENG Fan, YANG Lianping
    Chinese General Practice    2023, 26 (28): 3520-3525.   DOI: 10.12114/j.issn.1007-9572.2022.0808
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    Background

    Dyslipidemia is the most important and causal independent risk factor for atherosclerotic cardiovascular disease (ASCVD) . The prevalence of dyslipidemia in elderly residents in Guangdong Province is high, and it is urgent to analyze the specific prevalence of dyslipidemia and its influencing factors among the elderly, and to carry out targeted preventive and control measures for dyslipidemia.

    Objective

    To investigate the epidemiological status of dyslipidemia and its risk factors among elderly residents included in the national basic public health service in Yuexiu District, Guangzhou.

    Methods

    A total of 41 469 elderly residents aged 65 years and above with complete important variables were selected as subjects from the information system of community health service center in Yuexiu District, Guangzhou City in 2020, the 2020 health checkup data was used to describe the epidemiological characteristics of the included patients such as basic information, BMI and blood lipid levels. Restricted cubic spline (RCS) fitting Logistic regression model was used to analyze the relationship between age, BMI and the prevalence of dyslipidemia.

    Results

    The prevalence of dyslipidemia in 41 469 elderly residents was 53.65% (22 247/41 469) , with a standardized prevalence of 53.89%. The prevalence of hypercholesterolemia (HTC) , hypertriglyceridemia (HTG) , mixed hyperlipidemia and low high-density lipoprotein cholesterol was 21.43%, 16.50%, 14.51% and 3.80%, with the standardized prevalence of 21.57%, 16.53%, 14.61%, 3.78%, respectively. Multivariate Logistic regression analysis showed that gender, age, education level, exercise status, and BMI were all influencing factors for dyslipidemia in elderly residents, among which female, low age group, and high BMI were risk factors for dyslipidemia in elderly residents (P<0.05) . The results of RCS fitting showed a non-linear relationship between age, BMI and the prevalence of dyslipidemia in elderly residents. The overall prevalence of dyslipidemia in elderly residents showed a decreasing trend with the increase of age. The risk of dyslipidemia showed on increasing and then decreasing trend with the increase of BMI, the OR increased significantly at low BMI, while decreased at high BMI.

    Conclusion

    The prevalence of dyslipidemia is relative high among elderly residents aged 65 years and above included in the national basic public health services in Yuexiu District, Guangzhou. The prevalence of dyslipidemia in the elderly group tends to decrease with the increase of age, and the risk of dyslipidemia prevalence tends to increase and then decrease with the increase of BMI, suggesting special features in the management of dyslipidemia among the elderly, the analysis of risk factors for dyslipidemia in the elderly should be focused on and early preventive and control measures should be carried out.

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    Association of Health Promotion Behaviors and Multimorbidity in the Elderly in Ningxia
    HE Yuzheng, YU Jiqing, ZHENG Jianzhong, TONG Yan
    Chinese General Practice    2023, 26 (28): 3526-3532.   DOI: 10.12114/j.issn.1007-9572.2023.0026
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    Background

    In the context of increasing population aging, maintaining the health of the elderly is the key to successful aging. Multimorbidity is an important factor threatening the health of the elderly, and its relationship with the health promotion behaviors of the elderly has been rarely reported.

    Objective

    To understand the multimorbidity patterns and distribution of health promotion behaviors among the elderly in Ningxia, analyze the relationship between multimorbidity patterns and health promotion behaviors in the elderly, so as to provide a reference for the development of management and intervention strategies for the health of elderly.

    Methods

    The population aged 65 years and above in Ningxia were selected as study subjects by using random cluster sampling method from January 2021 to July 2021, and surveyed by self-designed questionnaire〔including general information questionnaire, patient health questionnaire-9 (PHQ-9) , mini-mental state examination (MMSE) , health promoting lifestyle profile-Chinese version (HPLP-C) 〕. Multimorbidity patterns of the elderly was analyzed by association rules of Apriori algorithm, the correlation between multimorbidity and health promotion behaviors of the elderly was analyzed by multivariable Logistic regression analysis.

    Results

    A total of 2 010 older adults aged 65 years and above were included, with the multimorbidity rate of 31.00% (623/2 010) . The most common binary multimorbidity pattern was coronary heart disease and hypertension〔25.36% (158/623) 〕, the most common ternary multimorbidity pattern was hypertension, coronary heart disease and stroke〔4.49% (28/623) 〕. The association rules revealed 16 patterns of multimorbidity, 15 of which were related to hypertension, 10 were related to coronary heart disease, and 7 were related to asthma. The multivariate Logistic regression analysis showed that compared with older adults with poor health promotion behaviors, those with general〔OR (95%CI) =0.364 (0.185, 0.714) 〕, good〔OR (95%CI) =0.488 (0.251, 0.948) 〕, excellent〔OR (95%CI) =0.426 (0.213, 0.853) 〕health promotion behaviors had a lower risk of multimorbidity (P<0.05) . HPLP-C physical activity〔OR (95%CI) =0.960 (0.925, 0.997) 〕and stress management〔OR (95%CI) =0.963 (0.938, 0.989) 〕dimension scores in older adults were negatively associated with the occurrence of multimorbidity; HPLP-C health responsibility〔OR (95%CI) =1.038 (1.013, 1.063) 〕dimension score was positively associated with the occurrence of multimorbidity.

    Conclusion

    The multimorbidity patterns of the elderly in Ningxia are complex, and there is an association between health promotion behaviors and occurrence of multimorbidity. The risk of multimorbidity can be reduced by interventions such as encouraging the elderly to practice health promotion behaviors and improve their lifestyles.

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    Analysis of Abnormal Detection Rates of Health Examination for the Older Adults in the National Essential Public Health Services
    LI Mengyu, LIAN Juan, LIAO Zirui, ZAN Ziqing, LIU Lu, YOU Lili, LIU Yuanli
    Chinese General Practice    2023, 26 (22): 2756-2762.   DOI: 10.12114/j.issn.1007-9572.2022.0831
    Abstract753)   HTML20)    PDF(pc) (1700KB)(625)       Save
    Background

    The contribution of geriatric health examination services of national essential public health services to the detection of abnormal health conditions in the elderly and the awareness of examination results of the elderly has been rarely reported in the current studies.

    Objective

    To investigate the abnormal detection of several common diseases including abnormal blood pressure, abnormal blood glucose, overweight and obesity, anemia, fatty liver disease, gallstones or cholecystitis in the health examination of the older adults aged 65 years and above.

    Methods

    The older adults aged 65 years and above who visited 20 primary care institutions in 5 cities of 3 provinces in eastern, central and western China were selected as study subjects (excluding those with unclear health examination results in this year) from November to December 2019 by using a multi-stage stratified sampling method, and divided into the general older adults (without hypertension or diabetes), older adults with hypertension, older adults with diabetes. A one-on-one questionnaire survey was conducted on all respondents (The questionnaire included the general demographic characteristics of the respondents and the abnormal detection in the health examination of the elderly) .

    Results

    Among 3 018 older adults, 2 033 (67.36%) reported abnormalities in the health examination. There were statistically significant differences in the abnormal detection rates of health examination for the older adults with different types of residence, population, and household registration (P<0.05). Among 3 018 older adults, 1 174 (38.90%) self-reported abnormal blood pressure detection, 747 (24.75%) self-reported abnormal blood glucose detection, 719 (23.82%) self-reported dyslipidemia detection, 445 (14.74%) self-reported fatty liver detection, 393 (13.02%) reported overweight and obesity detection, 238 (7.89%) reported gallstones or cholecystitis detection, and 60 (1.99%) reported anemia detection. Abnormal blood pressure was detected in 49.13% of the older adults diagnosed with hypertension during the annual health examination, with the blood pressure control rate of 50.87%. Abnormal blood glucose was detected in 60.48% of the older adults diagnosed with diabetes during health examination with the control rate of blood glucose of 39.52%. Multivariate Logistic regression analysis showed that the detection rate of abnormal blood pressure was 2.57 times〔95%CI (2.01, 3.29) 〕 higher in the older adults with diabetes than in the general older adults; the detection rate of dyslipidemia was 1.64 times〔95%CI (1.29, 2.08) 〕 and 1.42 times〔95%CI (1.10, 1.84) 〕 higher in the older adults with hypertension and diabetes than in the general older adults, respectively; the detection rate of overweight and obesity was 2.79 times〔95%CI (1.94, 4.00) 〕 and 2.64 times〔95%CI (1.80, 3.87) 〕 higher in the older adults with hypertension and diabetes than in the general older adults, respectively; the detection rate of fatty liver was 2.10 times〔95%CI (1.55, 2.85) 〕 higher in the the older adults with hypertension than the general older adults; while the detection rate of anemia was 0.25 times〔95%CI (0.13, 0.47) 〕 and 0.47 times〔95%CI (0.25, 0.86) 〕 higher in the older adults with hypertension and diabetes than in the general older adults; the detection rate of dyslipidemia, gallstones or cholecystitis was 0.76〔95%CI (0.64, 0.90) 〕and 1.32〔95%CI (1.01, 1.73) 〕 times higher in the rural older adults than the urban older adults, respectively (P<0.05) .

    Conclusion

    The physical examination program for the elderly in the national essential public health services plays an important role in early detection and wareness of health problems.

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    COVID-19 Vaccination Behavior and Its Influencing Factors among the Elderly in Four Regions of China
    WU Jian, YU Chengcheng, YANG Yinmei, XIA Qingyun, LI Quanman, FU Xiaoli
    Chinese General Practice    2023, 26 (22): 2763-2770.   DOI: 10.12114/j.issn.1007-9572.2023.0131
    Abstract429)   HTML13)    PDF(pc) (1807KB)(453)       Save
    Background

    The elderly are a priority population for COVID-19 vaccination. COVID-19 vaccination can effectively reduce the risk of developing severe and critically ill patients or even death in COVID-19 patients. However, the current vaccination rate of the elderly in China is relatively low, and the COVID-19 vaccination behavior among the elderly has been rarely reported in current studies.

    Objective

    To investigate COVID-19 vaccination behavior and its influencing factors among the elderly in China, and to provide a reference for improving the COVID-19 vaccination rate of the elderly.

    Methods

    A total of 1 323 older adults aged 60 years and above in Wujin District of Changzhou City, Zhongmu County of Zhengzhou City, Chengzhong District of Xining City and Linkou County of Mudanjiang City were selected as research subjects from August 3 to August 14 in 2022 by using a stratified random sampling method and investigated by self-designed questionnaires. Binary Logistic regression analysis was used to explore the influencing factors of the first dose of COVID-19 vaccination, full course of COVID-19 vaccination, and booster dose of COVID-19 vaccination.

    Results

    96.60% (1 278/1 323) of the elderly received the first dose of COVID-19 vaccine, 91.76% (1 214/1 323) completed the full course of COVID-19 vaccination, and 79.67% (1 054/1 323) received the booster dose of COVID-19 vaccine. The results of binary Logistic regression analysis showed that compared with the older adults aged 60-64 years, the older adults aged 75 years and above were less likely to receive the first dose of the COVID-19 vaccine〔OR (95%CI) =0.27 (0.11, 0.62), P<0.05〕; compared with the older adults with chronic disease, the older adults without chronic disease were more likely to receive the first dose of COVID-19 vaccine〔OR (95%CI) =2.07 (1.12, 3.84), P<0.05〕; the older adults with higher levels of perceived benefit were more likely to receive the first dose of COVID-19 vaccine〔OR (95%CI) =1.39 (1.07, 1.79), P<0.05〕. Compared with the older adults aged 60-64 years, who maintained regular physical exercise, those aged 75 years and above〔OR (95%CI) =0.34 (0.19, 0.59), P<0.05〕, who did not maintain regular physical exercise〔OR (95%CI) =0.64 (0.42, 0.96), P<0.05〕were less likely to complete the full course of vaccination; compared with the older adults with chronic diseases, the older adults without chronic diseases were more likely to complete the full course of the COVID-19 vaccination〔OR (95%CI) =1.59 (1.05, 2.40), P<0.05〕. Compared with older adults aged 60-64 years and from the central region, the older adults aged 75 years and above〔OR (95%CI) =0.55 (0.36, 0.86), P<0.05〕and from the eastern region〔OR (95%CI) =0.47 (0.34, 0.64), P<0.05〕were less likely to receive the booster dose of COVID-19 vaccine; compared with the older adults with chronic diseases, the older adults without chronic diseases were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.54 (1.15, 2.06), P<0.05〕; older adults with higher levels of perceived severity were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.06 (1.00, 1.11), P<0.05〕. Subgroup analysis showed that compared with the older adults with chronic diseases aged 60-64 years, from the central region, older adults with chronic diseases aged 75 years and above〔OR (95%CI) =0.35 (0.19, 0.65), P<0.05〕, from the eastern region〔OR (95%CI) =0.49 (0.29, 0.83), P<0.05〕were less likely to receive the booster dose of COVID-19 vaccine; older adults with chronic diseases who had higher levels of perceived severity were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.09 (1.01, 1.18), P<0.05〕. Compared with the older adults from the central region without chronic diseases, the older adults from the eastern region without chronic diseases were less likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =0.44 (0.29, 0.68), P<0.05〕.

    Conclusion

    More attention should be paid to the elderly who are senior and with chronic diseases in the process of COVID-19 vaccination. The vaccination rate of the elderly should be further increased by strengthening the publicity of COVID-19 vaccine knowledge.

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    Differences between the First and Another 3-day Blood Pressure Levels and Associated Factors in a Self-reported Non-hypertensive Population Aged 35-64 Years
    ZUO Xu, HUANG Zhaolan, LU Biao
    Chinese General Practice    2023, 26 (22): 2771-2777.   DOI: 10.12114/j.issn.1007-9572.2022.0347
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    Background

    Previous studies have compared the first and another 3-day blood pressure levels in populations with no history of self-reported hypertension, but there have been few studies conducted in COVID-19 vaccine recipients.

    Objective

    To understand the blood pressure levels among 35-64-year-old COVID-19 vaccine recipients during regular COVID-19 containment, and to assess the differences between the first and another 3-day blood pressure levels and the factors affecting the fluctuation of blood pressure levels in the recipients with suspected hypertension, providing a reference and guidance for blood pressure measurement before COVID-19 vaccination.

    Methods

    In September 2021, 2 814 residents aged 35-64 with no history of self-reported hypertension were randomly selected for screening for hypertension before receiving COVID-19 vaccination at Qingling Community Health Service Center, Hongshan District, Wuhan City, Hubei Province. Blood pressure was measured and recorded as the first blood pressure measurement value, then based on this, those who were found with suspected hypertension〔systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg (1 mmHg=0.133 kPa) 〕standardizedly measured their clinic blood pressure for another three times on different days without the use of any antihypertensive drugs. Based on the 3-day blood pressure measurement results, the proportions of those with blood pressure in the ideal range (systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg), in the high normal range (systolic blood pressure: 120-139 mmHg and/or diastolic blood pressure: 80-89 mmHg), and in the hypertensive range (systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg) were calculated, and the rate of hypertension diagnosis was compared between them by sex, age group, and the first blood pressure measurement level. The factors affecting the fluctuation of blood pressure levels (changes in blood pressure analyzed based on comparing the first blood pressure level and the 3-day blood pressure levels) in suspected hypertensive patients were analyzed using univariate and multivariate ordered Logistic regression.

    Results

    Of the 2 814 cases, 36.67% (1 032/2 814) were suspected hypertensive patients. Analysis of the 3-day blood pressure levels indicated that the proportions of suspected hypertensive patients with a blood pressure level in the ideal range, high normal range and hypertensive range were 8.82% (91/1 032), 14.34% (148/1 032), and 76.84% (793/1 032), respectively. Among the cases with confirmed hypertension, the prevalence of stages 1, 2, and 3 hypertension was 63.68% (505/793), 26.48% (210/793) and 9.84% (78/793), respectively. The hypertension diagnosis rate was higher in females〔80.68% (380/471) 〕than that in males〔73.62% (413/561) 〕, with statistical significance (χ2=7.173, P=0.007). The hypertension diagnosis rate increased with the increase in the first blood pressure level in suspected hypertensive patients (χ2 trend =23.443, P<0.001). The factors affecting the fluctuation of blood pressure levels in suspected hypertensive patients were gender, age, time period for first blood pressure measurement, psychological factors and environmental noise≥40 dB during first blood pressure measurement (P<0.05) .

    Conclusion

    There are significant differences between the first blood pressure measurement results and 3-day blood pressure measurement results among suspected hypertensive patients. To improve the reliability of blood pressure measurement results to ensure the successful implementation of COVID-19 vaccination, it is suggested for community medical workers to ensure the vaccine recipients are in good mental state, and pre-vaccination blood pressure measurement for them is performed in a quiet environment, and to pay more attention to verify the reliability of pre-vaccination blood pressure level in males, the 55-64 age group, or individuals receiving blood pressure measurement at community health centers between 11: 01 in the morning and 14: 00 in the afternoon.

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    Osteoporosis in Community-dwelling Elderly People: Prevalence and Associated Prevention and Control Strategies in General Practice
    MENG Fan, DONG Minjie, GUO Jin, XU Songtao, YAN Wei, GU Jun, CHEN Yirong, YANG Cheng, WANG Jun, XIA Lifang, CHEN Jun, FU Lingjie
    Chinese General Practice    2023, 26 (22): 2778-2784.   DOI: 10.12114/j.issn.1007-9572.2022.0171
    Abstract568)   HTML21)    PDF(pc) (1837KB)(495)       Save
    Background

    The continuous increase in numbers of people with osteoporosis, and individuals with low bone mass in the community, brings severe challenges to the prevention and treatment of osteoporosis in the community.

    Objective

    To investigate the basic conditions related to the prevention and control of osteoporosis in communities, including the basic process and cost of enrolling the target population, and the prevalence and risk factors of osteoporosis in the target population, so as to provide evidence for supporting a general practice team to develop precise osteoporosis prevention and control measures.

    Methods

    This study selected 322 cases (including outpatient patients and older physical examinees) from Waitan Community Health Service Center, Shanghai from May to August 2021. General information, bone density test results and risk factors of osteoporosis were collected by a questionnaire.

    Results

    The cost of enrolling the target population in the community was 57.344 yuan per person. Among the 322 cases, 27 (8.4%) had normal bone mass, 157 (48.8%) had low bone mass, and 138 (42.8%) had osteoporosis. The prevalence of bone density abnormalities (low bone mass and osteoporosis) reached 91.6%. There were statistically significant differences in gender ratio and BMI among normal bone mass, low bone mass and osteoporosis groups (P<0.05). The average bone mineral density (BMD) values of normal bone mass, low bone mass and osteoporosis groups were (-0.72±0.27) AU/mm3, (-1.88±0.38) AU/mm3, and (-3.17±0.53) AU/mm3, respectively. In terms of exercise habits, the prevalence of individuals doing little exercise in normal bone mass, low bone mass and osteoporosis groups was 37.0% (10/27), 49.7% (78/157) and 64.5% (89/138), respectively. In terms of exercise intensity, the prevalence of individuals exercising at moderate-intensity in normal bone mass, low bone mass and osteoporosis groups was 74.1% (20/27), 79.6% (125/157) and 80.4% (111/138), respectively. Three groups had no significant differences in the other osteoporosis risk factors, such as surgical treatment history, smoking history, allergy history and disease history. There was also no significant intergroup difference in dietary habits. Of all cases, 48.8% (157/322) never drank beer, liquor and red wine, 32.0% (103/322) drank coffee 4-6 times per week, and 31.4% (101/322) ate pickled vegetables, smoked foods, or sauces 4-6 times per week.

    Conclusion

    The community is a favorable setting for conducting prevention, treatment and clinically research programs regarding osteoporosis owing to short participant enrollment period and low cost. As the exercise and eating habits of the elderly in the community are unhealthy, the general practice team should accurately guide them to rapidly improve their dietary structure and develop a healthy exercise habit according to their own status, by which the onset and progression of osteoporosis can be proactively controlled.

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