title: Major inducing factors of hypertensive complications and the interventions required to reduce their prevalence: an epidemiological study of hypertension in a rural population in China.
abstract: BACKGROUND
  The complications of hypertension cause severe health problems in rural areas in China. We (i) screened the major factors inducing hypertensive complications and provided intervention measures; and (ii) verified the efficacy of the New Rural Cooperative Medical Scheme (NRCMS; a medical insurance scheme for rural residents) for hypertension management.
  
  
  METHODS
  A survey was conducted in the villages of Yunnan (an underdeveloped province in southwest China). The NRCMS was initiated there in 2005. Data were collected through questionnaires, physical examination, electrocardiography, as well as blood and urine tests. To detect factors inducing hypertension complications, a generalized estimating equations model was developed. Multivariable logistic regression was used to analyze influencing factors for hypertension control.
  
  
  RESULTS
  Poor management of hypertension was observed in women. Being female, old, poorly educated, a smoker, ignorant of the dangerousness of hypertension, and having uncontrolled hypertension made patients more prone to hypertension complications. Combination therapy with ≥ 2 drugs helped control hypertension, but most rural patients disliked multidrug therapy because they considered it to be expensive and inconvenient. The NRCMS contributed little to reduce the prevalence of complications and improve control of hypertension.
  
  
  CONCLUSIONS
  The present study suggested that the NRCMS needs to be reformed to concentrate on early intervention in hypertension and to concentrate on women. To increase hypertension control in rural areas in China, compound products containing effective and inexpensive drugs (and not multidrug therapy) are needed.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China. minniech2003@21cn.com
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Meng
authors.forename: Yongli
authors.initials: Y
authors.lastname: Yang
authors.forename: Yancai
authors.initials: Y
authors.lastname: Liu
authors.forename: Caiqin
authors.initials: C
authors.lastname: Dong
authors.forename: Jianming
authors.initials: J
authors.lastname: Xiao
authors.forename: Ling
authors.initials: L
authors.lastname: Zhao
authors.forename: Fang
authors.initials: F
authors.lastname: Li
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D016021:Epidemiologic Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012424:Rural Population