Wei Qiu

Background. Reliable epidemiologic data on the present burden of hypertension are needed in developing region-specific strategies since previous studies have suggested that China is lagging in risk factor management. Objective. The study aimed at exploring the prevalence of hypertension and its associated factors among adult residents in Ganzhou, China. Methodology. A multistage, stratified, and cluster random sampling method was used to conduct the cross-sectional survey. The study selected four county-level districts in Ganzhou City, China, as the investigation area. Permanent residents aged 18 years who have settled in the area for 6months or more were selected. A total of 7430 residents were involved in the study. Univariate and multivariate logistic regression analysis was carried out to identify predictors of hypertension. Results. The prevalence of hypertension in Ganzhou was 28.5, and the age-standardized prevalence of hypertension was 22.4. Univariate logistic regression analysis revealed that multiple variables have a statistically significant effect on the prevalence of hypertension. The elderly (odds ratio [95 CI]: 2.791 [2.5943.004]), men (1.805 [1.5832.058]), lower educated (0.848 [0.8050.893]), a family history of hypertension (4.575 [3.9005.368]), higher body mass index (1.344 [1.2151.488]), central obesity (1.532 [1.3041.799]), and less vegetable intake (1.150 [1.0231.294]) were the major risk factors for hypertension. Conclusion. Hypertension is a major public health problem in Ganzhou and requires much effort to reduce its prevalence. An effective multifaceted implementation strategy is highly desirable to combat the emerging burden of hypertension.

Background: Comorbidity is a common problem among elderly people, significantly damaging individuals’ health and healthcare systems. However, observational studies may be susceptible to residual confounding factors and bias. The present study aimed to assess the causal effect of common chronic disease comorbidity using the Mendelian randomization (MR) approach. Methods: Data for the present study were obtained from a community survey conducted between 2018 and 2020 in four counties in Ganzhou City, southern China. A cross-sectional survey was conducted using a multi-stage stratified random sampling method. A total of 1756 valid questionnaires were collected to analyze common chronic disease comorbidities. Genetic variants associated with hypertension, diabetes, stroke, and hyperlipidemia-related factors were selected as instrumental variables for univariate and multivariate MR analyses. Results: The self-reported prevalence of chronic disease in the older adult population in Southern China was 68.1%, with hypertension (46.1%), diabetes (10.5%), and hyperlipidemia (8.5%) being the three most common conditions. The prevalence of chronic disease comorbidity was 20.7% among the 12 chronic diseases studied. Hypertension was identified as a predictor of diabetes (OR [95% CI]: 1.114 [1.049, 1.184], p < 0.001), and diabetes mellitus was equally identified as a risk factor for hypertension (OR [95% CI]: 1.118 [1.069, 1.187], p < 0.001). Furthermore, high triglyceride levels were identified as a risk factor for hypertension (OR [95% CI]: 1.262 [1.129, 1.411], p < 0.001). In contrast to intracranial hemorrhages, hypertension had a significant impact on ischemic stroke (OR [95% CI]: 1.299 [1.161, 1.454], p < 0.001). Conclusion: The causal association between multiple cardiovascular and metabolism-related diseases is mediated by hypertension, with a bidirectional cause-and-effect relationship between hypertension and diabetes. Hypertension is a risk factor for ischemic stroke, and the hyperlipidemia-related factor triglycerides (TG) influence hypertension. Therefore, prioritizing hypertension prevention and control in the elderly is critical for effective chronic disease management.

Background: The COVID-19 crisis poses considerable threats to public health, and exploring the key configuration conditions of the public behavior response is very important for emergency risk management. Objective: This study attempts to reveal differences in the conditional configuration and mechanism of public behavior based on the proposed framework, further make up for the deficiencies of existing research in explaining such issues as “How to promote the public’s protective behavior or reduce the public’s excessive behavior?” and finally provide new evidence and ideas for the government to improve the emergency management system. Methods: A total of 735 valid cases were obtained using an online survey and revealed the conditional configuration and mechanism of public behavior differences through a fuzzy set qualitative comparative analysis based on the proposed public behavioral framework. Results: The results show that critical factors including risk communication, trust, risk perception, and negative emotions alone did not constitute a necessary condition for public protective or excessive behavior. The different configurations of influencing factors reveal the complexity of public behavioral risk management, and taking adequate measures to increase public trust and reduce negative public emotions constitute the core path of risk management to enhance positive public behavior. Conclusions: The configurations of various influencing factors reveal the complexity of public behavioral risk management. For behavioral risk management, governments should focus on adapting to multiple conditions according to their situations and, under the “overall perspective,” formulate policies based on local conditions and further form a differentiated risk management path. Practically speaking, for the government, taking adequate measures to increase public trust and reduce negative public emotions is the core path of risk management to enhance positive public behavior.