Hyung Min Lee 1, Yu-Mi Kim 2, Cheol Heon Lee 3, Jin Ho Shin 4, Mi Kyung Kim 1,5, Bo Youl Choi 1,5

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1 Journal of Preventive Medicine and Public Health March 2011, Vol. 44,. 2, This article is available at doi: /jpmph pissn eissn Awareness, Treatment and Control of Hypertension and Related Factors in the Jurisdictional Areas of Primary Health Care Posts in a Rural Community of Korea Hyung Min Lee 1, Yu-Mi Kim 2, Cheol Heon Lee 3, Jin Ho Shin 4, Mi Kyung Kim 1,5, Bo Youl Choi 1,5 1 Department of Preventive Medicine, Hanyang University College of Medicine, Seoul; 2 Department of Preventive Medicine, Dong-A University College of Medicine, Pusan; 3 Neodin Medical Institute; 4 Department of Internal Medicine, Hanyang University College of Medicine; 5 Institute for Community Health, Hanyang University, Seoul, Korea Objectives: This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. Methods: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October to August Hypertension is defined as a condition characterized by a systolic BP 140 mmhg, a diastolic BP 90 mmhg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. Results: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. Conclusions: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program. Key words: Awareness, Control, Hypertension, Prevalence, Rural community, Treatment J Prev Med Public Health 2011;44(2):74-83 cc This is an Open Access article distributed under the terms of the Creative Commons Attribution n-commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Corresponding author :

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3 Table 1. Characteristics of study population (n=1986) (n=2682) (n=4598) p-value Demographic variables Age (y) Medical aid Psychologic factors Self rated health Subjective stress state Health behavioral factors Regular alcohol comsumption Regular physical activity Weight control attempts Dietary habit of salt intake Anthropometrics Body mass index (kg/m 2 ) Subjective body shape Comorbidity with other chronic disease Diabetes mellitus Hypercholesterolemia Others Blood pressure measurement (mmhg) Systolic pressure Diastolic pressure Classification by JNC7 rmal Pre-hypertension Stage 1 hypertension Stage 2 hypertension Mean SD Fair to good Poor Often Sometimes Never n-smoking Ex-smoking t salty Salty Mean SD Lean rmal Obese Mean SD Mean SD (3.9) 0236 (11.9) 0392 (19.7) 0518 (26.1) 0577 (29.1) 0185 (9.3) 1811 (94.5) 0105 (5.5) 1564 (82.3) 0337 (17.7) 0411 (21.3) 0803 (41.7) 0713 (37.0) 0740 (37.9) 0762 (39.0) 0453 (23.2) 1474 (56.9) 1115 (43.1) 1437 (72.4) 0549 (27.6) 0393 (20.4) 1534 (79.6) 0657 (33.4) 1311 (66.6) (42.6) 0493 (25.6) 0613 (31.8) 0488 (25.3) 0964 (50.0) 0475 (24.7) 1726 (85.9) 0280 (14.1) 1866 (95.9) 0079 (4.1) 1224 (69.0) 0551 (31.0) (25.4) 0924 (46.5) 0429 (21.6) 0128 (6.5) (4.2) 0318 (12.2) 0459 (17.6) 0674 (25.8) 0737 (28.2) 0313 (12.0) 2368 (92.8) 0183 (7.2) 1945 (77.1) 0557 (22.9) 0698 (27.5) 1092 (43.0) 0748 (29.5) 2433 (94.1) 0115 (4.4) 0038 (1.5) 0428 (21.9) 1530 (78.1) 2104 (80.5) 0508 (19.5) 0728 (28.68) 1810 (71.32) 0771 (29.7) 1824 (70.3) (35.2) 0645 (25.4) 1000 (39.4) 0436 (17.2) 1126 (44.4) 0976 (38.5) 2229 (85.3) 0383 (14.7) 2486 (96.9) 0080 (3.1) 1341 (57.6) 0987 (42.4) (28.5) 1175 (45.0) 0520 (19.9) 0172 (6.6) SD: standard deviation, JNC: Joint National Committee. Values are number (%) p-values estimated by chi square test for categorical variables, and by independent t test for continuous variables (4.1) 0554 (12.1) 0851 (18.5) 1192 (25.9) 1314 (28.6) 0498 (10.8) 4179 (93.5) 0288 (6.5) 3509 (79.3) 0914 (20.7) 1132 (24.8) 1934 (42.5) 1489 (32.7) 3173 (69.9) 0877 (19.3) 0491 (10.8) 1902 (41.8) 2645 (58.2) 3541 (77.0) 1057 (23.0) 1124 (25.1) 3349 (74.9) 1428 (31.3) 3135 (68.7) (38.6) 1172 (25.5) 1651 (35.9) 0947 (20.8) 2124 (46.7) 1474 (32.4) 3935 (85.6) 0663 (14.4) 4352 (96.5) 0159 (3.5) 2565 (62.5) 1538 (37.5) (27.2) 2099 (45.7) 0949 (20.6) 0300 (6.5)

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5 Table 2. Distribution of prevalence, awareness, treatment, and control of hypertension in this study and 2005 KHANES Prevalence Awareness Treatment in awareness Treatment in prevalence Control in treatment Control in prevalence Study population 2005 KNHANES Crude rate (%) Age-adjusted rate SE (%) p-value Rural area KNHANES: Korea National Health and Nutrition Examination Survey, SE: standard error, : not available. p-values estimated by Mantel-Haenszel chi square test for comparison between men and women

6 Table 3. Index of hypertension control and related factors in men Demographic variables Age (y) Medical aid Psychologic factors Self rated health Fair to good Poor Subjective stress state Often Sometimes Never Health behavioral factors n-smoking Ex-smoking Regular alcohol comsumption Prevalence 1.62 ( ) Regular physical activity 0.55 ( ) Dietary habit of salt intake t salty Salty Anthropometrics BMI (kg/m 2 ) < Comorbidity with other chronic disease Diabetes mellitus 2.05 ( ) Hypercholesterolemia 2.23 ( ) Others 0.76 ( ) Exposure to education for hypertension management PHC Clinics Awareness Treatment in awareness Treatment in prevalence Control in treatment Control in prevalence aor (95% CI) aor (95% CI) aor (95% CI) aor (95% CI) aor (95% CI) aor (95% CI) 1.20 ( ) 2.37 ( ) 2.83 ( ) 3.62 ( ) 1.04 ( ) 1.48 ( ) 1.47 ( ) 1.13 ( ) 0.98 ( ) 1.07 ( ) 1.16 ( ) 1.45 ( ) 2.48 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 2.78 ( ) 6.91 ( ) 5.62 ( ) 0.40 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 1.13 ( ) ( ) ( ) ( ) 2.59 ( ) 6.95 ( ) 5.75 ( ) 0.41 ( ) ( ) ( ) ( ) ( ) ( ) ( ) 2.09 ( ) ( ) ( ) ( ) 1.25 ( ) ( ) ( ) ( ) 1.90 ( ) 1.75 ( ) 2.17 ( ) 0.60 ( ) 1.10 ( ) 0.77 ( ) 0.70 ( ) 0.67 ( ) 1.75 ( ) 0.32 ( ) 1.70 ( ) 0.98 ( ) 0.74 ( ) 0.46 ( ) 0.80 ( ) 0.78 ( ) 0.78 ( ) 1.76 ( ) 1.14 ( ) 0.60 ( ) 1.07 ( ) 1.17 ( ) 1.40 ( ) 0.60 ( ) 1.01 ( ) 0.63 ( ) 0.69 ( ) 0.84 ( ) 2.04 ( ) 0.30 ( ) 1.78 ( ) 0.94 ( ) 0.81 ( ) 0.50 ( ) 0.78 ( ) 0.78 ( ) 0.80 ( ) 1.80 ( ) 1.17 ( ) aor: adjusted odds ratio estimated by multiple logistic regression analysis, BMI: body mass index, PHC: public health center. : aor can not be calculated by the multivariate logistic regression analysis, : Variable was not included in the multivariate logistic regression analytic model.

7 Table 4. Index of hypertension control and related factors in women Demographic variables Age (y) Medical aid Psychologic factors Self rated health Fair to good Poor Subjective stress state Often Sometimes Never Health behavioral factors n-smoking Ex-smoking Regular alcohol comsumption Prevalence ( )0 Regular physical activity ( )0 Dietary habit of salt intake t salty Salty Anthropometrics BMI (kg/m 2 ) Comorbidity with other chronic disease Awareness Treatment in awareness Treatment in prevalence Control in treatment Control in prevalence aor (95% CI) aor (95% CI) aor (95% CI) aor (95% CI) aor (95% CI) aor (95% CI) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 2.88 ( ) 5.41 ( ) 4.52 ( ) 1.97 ( ) 2.05 ( ) 0.91 ( ) 1.16 ( ) 0.87 ( ) 0.96 ( ) 0.91 ( ) 1.81 ( ) 0.80 ( ) 1.27 ( ) 1.45 ( ) Diabetes mellitus ( ) ( ) Hypercholesterolemia01.36 ( ) ( ) Others ( ) ( ) Exposure to education for hypertension management PHC Clinics ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 1.54 ( ) 1.14 ( ) 1.31 ( ) 1.54 ( ) 0.69 ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) 0.95 ( ) 0.85 ( ) 1.51 ( ) 1.17 ( ) 1.21 ( ) 1.12 ( ) 0.66 ( ) 1.49 ( ) 1.22 ( ) 1.69 ( ) 0.72 ( ) 0.97 ( ) 1.17 ( ) 0.83 ( ) 1.12 ( ) 0.89 ( ) 0.89 ( ) 2.82 ( ) 1.01 ( ) 1.41 ( ) 1.09 ( ) aor: adjusted odds ratio estimated by multiple logistic regression analysis, BMI: body mass index, PHC: public health center. : aor can not be calculated by the multivariate logistic regression analysis, : Variable was not included in the multivariate logistic regression analytic model.

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