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Ethnic variation in hypertension prevalence of women in Taiwan

Journal of Human Hypertension volume 23, pages 160–167 (2009)Cite this article

Abstract

The prevalence and risk factors of hypertension vary in ethnic groups. This study aimed to estimate the hypertension prevalence and to compare risk factors associated with hypertension in women of four ethnic groups in Taiwan. The study subjects were participants in the Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia (TwSHHH) enrolled in 2002. In this analysis, only 2810 women who were at age of 20–80 years old and whose father and mother had same ethnic background (Minnan, Hakka, Aborigines or Mainland Chinese) were included. Results showed that there were significant ethnic differences in the prevalence of hypertension, obesity indices, fasting glucose, dyslipidaemia, hyperuricaemia, history of alcohol drinking and tobacco smoking and socioeconomic status. Aborigines had the highest prevalence of hypertension (28.6%) and diabetes mellitus (8.9%), whereas the Minnan group had the second highest prevalence of hypertension (19.2%) and diabetes mellitus (7.9%). Both age and central obesity were associated with an increased prevalence of hypertension except central obesity in Mainland Chinese in all four ethnic groups. Compared with the Mainland Chinese as the referent, the multivariate-adjusted odds ratio (OR) (95% CI) was 1.19 (0.63–2.26), 1.92 (1.15–3.21) and 2.03 (1.00–4.12) for Hakka, Minnan and Aborigines, respectively. Elevated body mass index (⩾27.0 vs <24.0 kg m−2) and central obesity were significantly associated with hypertension showing multivariate-adjusted OR (95% CI) of 1.68 (1.18–2.38) and 1.95 (1.48–2.57), respectively. In addition, dyslipidaemia, hyperuricaemia and diabetes associated with higher OR for hypertension in Minnan women. In conclusion, there were ethnic variations in hypertension prevalence and determinants in Taiwanese women.

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References

  1. Chiung WVT . Language attitudes toward written Taiwanese. J Multiling Multicult Devel 2001; 22: 502–523.

    Article  Google Scholar 

  2. Lin M, Chu CC, Chang SL, Lee HL, Loo JH, Akaza T et al. The origin of Minnan and Hakka, the so-called ‘Taiwanese’, inferred by HLA study. Tissue Antigens 2001; 57: 192–199.

    Article  Google Scholar 

  3. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R, Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–1913.

    Article  Google Scholar 

  4. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure: the JNC 7 Report. JAMA 2003; 289: 2560–2571.

    Article  CAS  Google Scholar 

  5. Hong Y, de Faire U, Heller DA, McClearn GE, Pedersen N . Genetic and environment influences on blood pressure in elderly twins. Hypertension 1994; 24: 663–670.

    Article  CAS  Google Scholar 

  6. Kuller L, Reisler D . An explanation for the distribution of stroke and atherosclerotic heart disease among populations and racial groups. Am J Epidemiol 1971; 93: 1–9.

    Article  CAS  Google Scholar 

  7. Su TC, Bai CH, Chang HY, You SL, Chien KL, Chen MF et al. Evidence for improved control of hypertension in Taiwan: 1993–2002. J Hypertens 2008; 26: 600–606.

    Article  CAS  Google Scholar 

  8. Wen CP, Levy DT, Cheng TY, Hsu CC, Tsai SP . Smoking behaviour in Taiwan, 2001. Tob Control 2005; 14 (Suppl 1): i51–i55.

    Article  Google Scholar 

  9. Perloff D, Grim C, Flack J, Frohlich ED, Hill M, McDonald M et al. Human blood pressure determination by sphygmomanometry. Circulation 1993; 88 (5 Part 1): 2460–2670.

    Article  CAS  Google Scholar 

  10. Chen CJ, Cohen BH, Diamond EL, Lin TM, Chen JS . Genetic variance and heritability of cardiovascular risk factors in Chinese adolescent twins. Acta Genet Med Gemellol 1984; 33: 363–373.

    Article  CAS  Google Scholar 

  11. Chien KL, Yang CY, Lee YT . Major gene effects in systolic and diastolic blood pressure in families receiving a health examination in Taiwan. J Hypertens 2003; 21: 73–79.

    Article  CAS  Google Scholar 

  12. Kiefe CI, Williams OD, Bild DE, Lewis CE, Hilner JE, Oberman A . Regional disparities in the incidence of elevated blood pressure among young adults: the CARDIA study. Circulation 1997; 96: 1082–1088.

    Article  CAS  Google Scholar 

  13. Kotchen TA, Kotchen JM . Regional variations of blood pressure: environment or genes? Circulation 1997; 96: 1071–1073.

    Article  CAS  Google Scholar 

  14. Shaw CK, Chen LL, Lee A, Lee TD . Distribution of HLA gene and haplotype frequencies in Taiwan: a comparative study among Minnan, Hakka, Aborigines and Mainland Chinese. Tissue Antigens 1999; 53: 51–64.

    Article  CAS  Google Scholar 

  15. Ho CS, Tsai AC . Prevalence of overweight and obesity and its associated factors in aboriginal Taiwanese: findings from the 2001 National Health Interview Survey in Taiwan. Asia Pac J Clin Nutr 2007; 16: 572–579.

    PubMed  Google Scholar 

  16. Chang HY, Pan WH, Yeh WT, Tsai KS . Hyperuricemia and gout in Taiwan: results from the Nutritional and Health Survey in Taiwan (1993–96). J Rheumatol 2001; 28: 1640–1646.

    CAS  PubMed  Google Scholar 

  17. Pan WH, Chang HY, Yeh WT, Hsiao SY, Hung YT . Prevalence, awareness, treatment and control of hypertension in Taiwan: results of Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996. J Hum Hypertens 2001; 15: 793–798.

    Article  CAS  Google Scholar 

  18. Reaven GM, Lithell H, Landsberg L . Hypertension and associated metabolic abnormalities: the role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996; 334: 374–381.

    Article  CAS  Google Scholar 

  19. Nagahama K, Inoue T, Iseki K, Touma T, Kinjo K, Ohya Y et al. Hyperuricemia as a predictor of hypertension in a screened cohort in Okinawa, Japan. Hypertens Res 2004; 27: 835–841.

    Article  Google Scholar 

  20. Sundström J, Sullivan L, D’Agostino RB, Levy D, Kannel WB, Vasan RS . Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension 2005; 45: 28–33.

    Article  Google Scholar 

  21. Chien KL, Hsu HC, Sung FC, Su TC, Chen MF, Lee YT . Hyperuricemia as a risk factor on cardiovascular events in Taiwan: the Chin-Shan Community Cardiovascular Cohort Study. Atherosclerosis 2005; 183: 147–155.

    Article  CAS  Google Scholar 

  22. Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease. Circulation 2006; 113: 898–918.

    Article  Google Scholar 

  23. Klein S, Burke LE, Bray GA, Blair S, Allison DB, Pi-Sunyer X et al. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation 2004; 110: 2952–2967.

    Article  Google Scholar 

  24. Chien KL, Hsu HC, Sung FC, Su TC, Chen MF, Lee YT . Incidence of hypertension and risk of cardiovascular events among ethnic Chinese: report from a community-based cohort study in Taiwan. J Hypertens 2007; 25: 1355–1361.

    Article  CAS  Google Scholar 

  25. O’Keefe JH, Bybee KA, Lavie CJ . Alcohol and cardiovascular health: the razor-sharp double-edged sword. J Am Coll Cardiol 2007; 50: 1009–1014.

    Article  Google Scholar 

  26. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM, American Heart Association. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 2006; 47: 296–308.

    Article  CAS  Google Scholar 

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Acknowledgements

This study was supported by a grant from the Bureau of Health Promotion, Department of Health, Executive Yuan, Taiwan, Republic of China (DOH-2002). This study is based on the data from Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia (TwSHHH), provided by the Bureau of Health Promotion, Department of Health, Republic of China (Taiwan). The descriptions or conclusions herein do not represent the viewpoint of the Bureau. Part of supports comes from the grant (NHRI-EX97-9721PC) of the National Health Research Institute, Department of Health, Executive Yuan, Taiwan, Republic of China.

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Authors and Affiliations

  1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

    T-C Su

  2. Department of Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan

    L-C Hwang

  3. Genomics Research Center, Academia Sinica, Taipei, Taiwan

    S-L You & C-J Chen

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  1. T-C Su
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  2. L-C Hwang
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  3. S-L You
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  4. C-J Chen
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Correspondence to C-J Chen.

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Su, TC., Hwang, LC., You, SL. et al. Ethnic variation in hypertension prevalence of women in Taiwan. J Hum Hypertens 23, 160–167 (2009). https://doi.org/10.1038/jhh.2008.120

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