HYPERTENSION PREVALENCE AND RELATED FACTORS IN ELDERLY PEOPLE IN KHANH HOA PROVINCE, VIETNAM Truong Tan Minh, Le Tan Phung...
1. Introduction <ul><li>Vietnam now has approximately 7 million Elderly People, accounting for 10% of population. The agin...
<ul><li>Studies in Vietnam as well as over the world showed that hypertension is increasingly concerned health problems. A...
<ul><li>On hypertension prevalence among Elderly People in Hai Duong Province – Vietnam based on a sample of 3,117 Elderly...
<ul><li>Khanh Hoa is a South-Central Province of Vietnam comprised of 8 district units with approximately population of 1....
2. Subjects and Method <ul><li>Study population was Elderly People (60+ years of age) who lived in Khanh Hoa province at t...
2. Subjects and Method (cont) <ul><li>Sample size was determined by the following formula: </li></ul><ul><li>In which: </l...
3. Results and discussion <ul><li>3.1. Baseline data </li></ul><ul><li>There were total of 2,170 Elderly People seleted fo...
Table 1: Baseline Characteristics of the Sample of Elderly People Items Frequency (n=2,170) Percent % <ul><li>Gender: </li...
3.2. Anthropometric characteristics of Elderly People. <ul><li>3.2.1. Weight </li></ul><ul><li>Mean weight of the sample w...
3.2. Anthropometric characteristics of Elderly People (cont) <ul><li>3.2.2. Height </li></ul><ul><li>Mean height of the sa...
3.2. Anthropometric characteristics of Elderly People (cont) <ul><li>3.2.3. Body Mass Indeces (BMI) </li></ul><ul><li>Mean...
3.2. Anthropometric characteristics of Elderly People (cont) <ul><li>According to WHO classification of BMI (with 4 catego...
Table 5: BMI classification of Elderly People by gender Category Male Female Total Test Underweight 239 (28.2%) 409 (31.0%...
3.3. Hypertension prevalence <ul><li>3.3.1. Mean systolic and diastolic blood pressures. </li></ul><ul><li>Mean blood pres...
Table 6: Mean blood pressures by Gender Gender Total Mean BP SD Test Systolic blood pressure (mmHg) Male 849 138 20.6 t 21...
3.3. Hypertension prevalence (cont) <ul><li>3.3.2. Hypertension prevalence. </li></ul><ul><li>Based on Definitions and Cla...
3.3. Hypertension prevalence (cont) <ul><li>Comparing hypertension prevalence among Kinh People and Raglai People who is t...
Table 7: Hypertension by Gender and Ethnicity Gender Total Hypertension Percent Test Gender Male 849 443 52.2 χ 2  =9.46 p...
3.4. Association between blood pressure and anthropometric indeces <ul><li>Scatter plots created by Stata software showed ...
Figure 1: Association between systolic blood pressure and age
Figure 2: Association between systolic blood pressure and BMI
3.4. Association between blood pressure and anthropometric indeces (cont) <ul><li>Analyzing those associations by gender s...
Figure 3: Association between systolic blood pressure and age by Gender
Figure 4: Association between systolic blood pressure and BMI by Gender
3.4. Association between blood pressure and anthropometric indeces (cont) <ul><li>Using multiple logistic regression, the ...
4. Conclusion <ul><li>4.1. The hypertension prevalence among Elderly People of Khanh Hoa Province is 48.1% (95% CI: 46.0% ...
<ul><li>1. The Communist Party of Vietnam (CPV) Online Newspaper.  International workshop on Care for Elderly People   on ...
<ul><li>3. Nguyễn Đăng Phải.  Survey on hypertension and building a model of caring for Elderly People based on Community....
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6. le tan phung

  1. 1. HYPERTENSION PREVALENCE AND RELATED FACTORS IN ELDERLY PEOPLE IN KHANH HOA PROVINCE, VIETNAM Truong Tan Minh, Le Tan Phung et al Khanh Hoa Provincial Health Service
  2. 2. 1. Introduction <ul><li>Vietnam now has approximately 7 million Elderly People, accounting for 10% of population. The aging problem has been increasingly concerned in Vietnam in terms of socio-economic status. In an International workshop on Care for Elderly People held in Hanoi in 2009, experts showed that health care cost for Elderly People was 7 times higher than other adult cost [1]. Common diseases and health problems in Elderly People are hypertension, cardiovascular diseases, endocrinologic disorders, depression, arthritis etc. These affect significantly life quality of Elderly People. </li></ul>
  3. 3. <ul><li>Studies in Vietnam as well as over the world showed that hypertension is increasingly concerned health problems. A multi-center study in Bangladesh and India conducted by WHO gave a prevalence of hypertension among Elderly at 65% [2]. The prevalence was higher in urban area and showed no significant difference by gender. </li></ul>1. Introduction (cont)
  4. 4. <ul><li>On hypertension prevalence among Elderly People in Hai Duong Province – Vietnam based on a sample of 3,117 Elderly People selected in community, Nguyen Dang Phai’s study [3] showed the hypertension prevalence was 28.2% with higher among Male (30.3% vs 26.7%). Another survey conducted by the National Institute of Health Strategy and Policy in 7 provinces of Vietnam [4] showed the hypertension prevalence of 28.4%. </li></ul>1. Introduction (cont)
  5. 5. <ul><li>Khanh Hoa is a South-Central Province of Vietnam comprised of 8 district units with approximately population of 1.2 million. This survey aims at examining hypertension prevalence as well as related factors in Elderly People who is living in Khanh Hoa. </li></ul>1. Introduction (cont)
  6. 6. 2. Subjects and Method <ul><li>Study population was Elderly People (60+ years of age) who lived in Khanh Hoa province at the time of study (from Nov to Dec 2008). A cross-sectional design was used with cluster sampling based on 30 communes selected conveniently from 137 communes in the province. </li></ul>
  7. 7. 2. Subjects and Method (cont) <ul><li>Sample size was determined by the following formula: </li></ul><ul><li>In which: </li></ul><ul><li>n = sample size </li></ul><ul><li>p = hypertension prevalence, take p = 50%. </li></ul><ul><li>d = desired precision, select d = 3%. </li></ul><ul><li>Calculated n = 1,067. Adjusted with design effect (DE=2) and 5% missing subjects, we have the final sample size was 2,240 Elderly Peole. Data collected were age, gender, ethnicity, systolic and diastolic blood pressures, height and weight. </li></ul><ul><li>Data were entered by EpiData Software version 3.1, analyzed by Stata version 10.0. </li></ul>
  8. 8. 3. Results and discussion <ul><li>3.1. Baseline data </li></ul><ul><li>There were total of 2,170 Elderly People seleted for the sample because of some missing and some under 60 years old. Over 60% of the sample was female, reflecting a larger proportion of female among Elderly population. More than 80% of them was at the age of under 80. The age group between 80 and 89 had only a proportion of 17%. Raglai Ethnic minority People accounted for 3% of Elderly population (Table 1). </li></ul>
  9. 9. Table 1: Baseline Characteristics of the Sample of Elderly People Items Frequency (n=2,170) Percent % <ul><li>Gender: </li></ul><ul><ul><li>Male </li></ul></ul><ul><ul><li>Female </li></ul></ul>849 1,321 39.1 60.9 <ul><li>Age groups: </li></ul><ul><ul><li>From 60-69 years old </li></ul></ul><ul><ul><li>From 70-79 years old </li></ul></ul><ul><ul><li>From 80-89 years old </li></ul></ul><ul><ul><li>From 90-99 years old </li></ul></ul><ul><ul><li>>=100 years old </li></ul></ul>885 866 367 50 2 40.8 39.9 16.9 2.3 0.1 <ul><li>Ethnicity: </li></ul><ul><ul><li>Kinh </li></ul></ul><ul><ul><li>Raglai </li></ul></ul><ul><ul><li>T’rin </li></ul></ul><ul><ul><li>Others </li></ul></ul>2,095 64 1 10 96.5 2.9 0.1 0.5
  10. 10. 3.2. Anthropometric characteristics of Elderly People. <ul><li>3.2.1. Weight </li></ul><ul><li>Mean weight of the sample was 49 kg ± 8.7 kg. Mean weight of male was significantly higher than female (Table 2). </li></ul><ul><li>Table 2: Mean weight of Elderly People by gender </li></ul>Gender Mean weight SD Test Male (n = 849) 52.4 kg 8.5 kg t 2168 = 15.025 p = 0.000… Female (n = 1,321) 46.9 kg 8.2 kg Total (n = 2,170) 49.0 kg 8.7 kg
  11. 11. 3.2. Anthropometric characteristics of Elderly People (cont) <ul><li>3.2.2. Height </li></ul><ul><li>Mean height of the sample was 155cm ± 7.3cm with the statistically higher mean among male Elderly (160 cm vs 152 cm). </li></ul><ul><li>Table 3: Mean height of Elderly People by gender </li></ul>Gender Mean height SD Test Male (n = 849) 160 cm 6.4 cm t 2168 = 28.622 p = 0.000… Female (n = 1,321) 152 cm 6.1 cm Total (n = 2,170) 155 cm 7.3 cm
  12. 12. 3.2. Anthropometric characteristics of Elderly People (cont) <ul><li>3.2.3. Body Mass Indeces (BMI) </li></ul><ul><li>Mean BMI of the sample was 20.26 kg/m 2 . There was no significant difference in mean BMI between men and women (Table 4). </li></ul><ul><li>Table 4: Mean BMI of Elderly People by gender </li></ul>Gender Mean BMI SD Test Male (n = 849) 20.40 3.01 t 2168 = 1.683 p = 0.0926 Female (n = 1.321) 20.17 3.14 Total (n = 2.170) 20.26 3.09
  13. 13. 3.2. Anthropometric characteristics of Elderly People (cont) <ul><li>According to WHO classification of BMI (with 4 categories: underweight, normal, overweight, and obesity), this survey showed a percentage of 30% underweight, whereas normal BMI was 64%. The very small proportions of overweight (5.6%) and obesity (0.3%) reflects that overweight and obesity are not a health problem among Elderly People in Khanh Hoa province (Table 5). </li></ul>
  14. 14. Table 5: BMI classification of Elderly People by gender Category Male Female Total Test Underweight 239 (28.2%) 409 (31.0%) 648 (29.9%) χ 2 = 2.7525 p = 0.431 Normal 562 (66.2%) 832 (63.0%) 1,394 (64.2%) Overweight 45 (5.3%) 77 (5.8%) 122 (5.6%) Obesity 3 (0.3%) 3 (0.2%) 6 (0.3%) Total 849 1,321 2,170
  15. 15. 3.3. Hypertension prevalence <ul><li>3.3.1. Mean systolic and diastolic blood pressures. </li></ul><ul><li>Mean blood pressures, both systolic and diastolic, were significantly different between men and women with higher mean blood pressures in men (p<0.001). </li></ul>
  16. 16. Table 6: Mean blood pressures by Gender Gender Total Mean BP SD Test Systolic blood pressure (mmHg) Male 849 138 20.6 t 2166 = 3.313 p = 0.0009 Female 1,319 135 20.9 Total 2,168 136 20.8 Diastolic blood pressure (mmHg) Male 849 82 9.9 t 2166 = 3.989 p = 0.0001 Female 1,319 80 10.7 Total 2,168 81 10.4
  17. 17. 3.3. Hypertension prevalence (cont) <ul><li>3.3.2. Hypertension prevalence. </li></ul><ul><li>Based on Definitions and Classification of Blood Pressure Levels by WHO/ISH [5], the prevalence of hypertension among Elderly People in Khanh Hoa province was 48.1%, significantly higher than Nguyen Dang Phai’s and Dam Viet Cuong’s surveys. Hypertension among men was statistically higher than women: 52.2% vs 45.4% (Table 7). </li></ul>
  18. 18. 3.3. Hypertension prevalence (cont) <ul><li>Comparing hypertension prevalence among Kinh People and Raglai People who is the main ethnicity minority group living in Khanh Hoa Province (most of them are in Khanh Son and Khanh Vinh district), the survey showed a higher hypertension prevalence among Kinh People, probably related to urbunization and sedentary lifestyle in Kinh Pepole. </li></ul>
  19. 19. Table 7: Hypertension by Gender and Ethnicity Gender Total Hypertension Percent Test Gender Male 849 443 52.2 χ 2 =9.46 p = 0.002 Female 1,321 600 45.4 Total 2,170 1,043 48.1 Ethnicity Kinh 2,095 1,016 48.5 χ 2 =8.8 p = 0.003 Raglai 64 19 29.7
  20. 20. 3.4. Association between blood pressure and anthropometric indeces <ul><li>Scatter plots created by Stata software showed positive association between systolic blood pressure and BMI, age. Systolic blood pressure has increasing tendency proportional to BMI and age. Figure 1 and Figure 2 showed those associations. </li></ul>
  21. 21. Figure 1: Association between systolic blood pressure and age
  22. 22. Figure 2: Association between systolic blood pressure and BMI
  23. 23. 3.4. Association between blood pressure and anthropometric indeces (cont) <ul><li>Analyzing those associations by gender showed a stronger association in female than male in terms of systolic blood pressure and BMI as shown in Figure 4 and a stronger association in male than female in terms of systolic blood pressure and age as shown in Figure 3. </li></ul>
  24. 24. Figure 3: Association between systolic blood pressure and age by Gender
  25. 25. Figure 4: Association between systolic blood pressure and BMI by Gender
  26. 26. 3.4. Association between blood pressure and anthropometric indeces (cont) <ul><li>Using multiple logistic regression, the model is showed below. However, this model is weak (R 2 = 0,0329) </li></ul><ul><li>log(sysBP) = 4,5391 + 0,0034*age – 0,0017 * gender * age + 0,0051*log(BMI)*gender </li></ul><ul><li>in which sysBP is systolic blood pressure, gender = 1 if gender is female and = 0 if gender is male. </li></ul>
  27. 27. 4. Conclusion <ul><li>4.1. The hypertension prevalence among Elderly People of Khanh Hoa Province is 48.1% (95% CI: 46.0% - 50.2%). </li></ul><ul><li>4.2. Hypertension is higher in Male Elderly than Female (52.2% vs 45.4%), higher in Kinh People than Raglai People (48.5% vs 29.7%). Both differences are statistically significant. </li></ul><ul><li>4.3. There are positive associations between systolic blood pressure and age, BMI. Gender plays as an interaction role in multiple logistic regression model. </li></ul>
  28. 28. <ul><li>1. The Communist Party of Vietnam (CPV) Online Newspaper. International workshop on Care for Elderly People on the web at http://www.cpv.org.vn/cpv/Modules/News/NewsDetail.aspx?co_id=30085&cn_id=372058 , dated 20/11/2009. </li></ul><ul><li>2. WHO - Hypertension Study Group. Prevalence, Awareness, treatment and Control of Hypertension among the Elderly in Bangladesh and India: A multicentre study. Bulletin of the WHO , Vol 79 No 6, 2001. </li></ul>
  29. 29. <ul><li>3. Nguyễn Đăng Phải. Survey on hypertension and building a model of caring for Elderly People based on Community. Report to the provincial committee of Hai Duong, on the web http://www.haiduongdost.gov.vn dated 30/11/2009. </li></ul><ul><li>4. Dam Viet Cuong et al. Examine Caring for Elderly People in Vietnam – summary report of the year 2006 on the web at http://www.hspi.org.vn/ 30/11/2009. </li></ul><ul><li>5. WHO/ISH writing group. 2003 World Health organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. “Journal of Hypertension” Vol 21, No 11. 2003. </li></ul>

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