title: Associations of metabolic disorder factors with the risk of uncontrolled hypertension: a follow-up cohort in rural China.
abstract: We evaluated how metabolic disorders affected antihypertension therapy. 2,912 rural Chinese patients with hypertension who provided blood samples, demographic and clinical data at baseline and after 1 year of antihypertension therapy were evaluated. At baseline, 1,515 patients (52.0%) were already receiving drug therapy and 11.4% of them had controlled blood pressure (BP). After 1 year, all 2,912 patients were receiving antihypertension therapy that was administered by community physicians, and 59.42% of them had controlled BP. Central obesity and abnormal triglyceride, high-density lipoprotein cholesterol, and glucose were associated with 15-70% higher risks of uncontrolled hypertension. Metabolic syndrome using the JIS criteria was associated with poor BP control (odds ratio: 1.71 and 1.54 for the baseline and follow-up datasets, respectively). The risk of uncontrolled hypertension increased with the number of metabolic disorders (p for trend <0.01). The presence of ≥3 metabolic disorder factors was associated with higher risks of poor BP control. The associations of metabolic factors and uncontrolled hypertension were stronger for the standard and modified ATP III criteria, compared to the IDF and JIS criteria. Metabolic factors were associated with less effective antihypertension therapy, and all definitions of metabolic syndrome helped identify patients with elevated risks of uncontrolled hypertension.
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, P.R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, P.R. China.
authors.forename: Tianqi
authors.initials: T
authors.lastname: Hua
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, P.R. China.
authors.forename: Huan
authors.initials: H
authors.lastname: Shen
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, P.R. China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Chronic Disease and Prevention, Center for Disease Control and Prevention of Haian, Nantong, Jiangsu, 226600, P.R. China.
authors.forename: Xiao-Jian
authors.initials: XJ
authors.lastname: Wang
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, P.R. China. gaoyuexia1103@163.com.
authors.forename: Yue-Xia
authors.initials: YX
authors.lastname: Gao
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, P.R. China.
authors.forename: Qinyun
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, 226019, P.R. China.
authors.forename: Chuanli
authors.initials: C
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use; D015415:Biomarkers; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology*; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers