Objective To investigate the prevalence of hypertension in Keshan disease endemic areas in China,in order to provide evidence for making the policy in hypertension prevention and control for the most disadvantaged people in China.Methods Using non probability sampling method,50 counties with the highest prevalence rate of Keshan disease were selected in the 13 provinces (municipalities and autonomous regions) investigated in the 2012 national monitoring of Keshan disease,and in each county 2 villages were selected as the survey sites.Survey respondents aged over 18 years old were selected as the survey subjects.The prevalence of hypertension in residents was investigated through questionnaire investigation and clinical physical examination.The diagnostic criterion for hypertension was based on the 2010 Chinese Guidelines for the Management of Hypertension.Results A total of 45 165 adults aged 18 years and older were surveyed and 12 329 patients with hypertension in total were found,and the prevalence rate of hypertension was 27.3％.Among which the prevalence of men and women was 27.4％ (5 163/18 868) and 27.3％ (7 166/26 297),respectively.The prevalence rates of hypertension increased with age (x2 =4 132.3,P ＜ 0.05).Among different categories of hypertension,the proportion of grade one hypertension was the largest [33.4％ (4 116/12 329)],and differences between different proportions were significant (x2 =1 586.0,P ＜ 0.05).Conclusions The prevalence of hypertension in Keshan disease endemic areas is significantly higher than the national average level.The prevention and control of hypertension in vulnerable groups in the rural areas and Keshan disease areas should be emphasized.

Objective To survey the prevalence of hypertension in population of Keshan disease endemic areas, in order to provide a scientific basis for prevention and control of hypertension in rural areas of our country.Methods One hundred and twenty villages were selected as the survey places based on case-finding from 15 provinces including Gansu, Hebei, Henan, Heilongjiang, Jilin, Liaoning, Shaanxi, Shandong, Shanxi, Hubei, Yunnan,Sichuan, Guizhou, Chongqing and Mongolia in 2009.The subjects were permanent residents in the survey places.Basic situation of all subjects was collected through the questionnaire survey and blood pressure was measured by a clinician.Diagnostic criterion for hypertension was based on the Chinese Guidelines for the Management of Hypertension.Results Totally 33 558 subjects aged 18 and over were surveyed, including 8 699 hypertension patients.The positive rate of hypertension was 25.9％ (8 699/33 558), among that 26.3％ (3 532/13 408) were males,and 25.6％ (5 167/20 150) were females.The positive rate of hypertension increased with age (x2 =3 348.325, P ＜0.05).In the classification of hypertension, the proportion of stage 1, 2 and 3 hypertension and isolated systolic hypertension was 31.8％ (2 770/8 699), 26.1％ (2 273/8 699), 17.2％ (1 492/8 699) and 24.9％ (2 164/8 699),respectively.Conclusions The positive rates of hypertension in Keshan disease endemic areas are higher than those of the national average (18.8％).Hypertension is a serious public health problem in Keshan disease endemic areas.The strategy of hypertension prevention and control should be formulated for remote rural areas.

Objective To investigate the relevance ratio of abnormal electrocardiogram (ECG) and describe the abnormal ECG index among the residents in Keshan disease (KD) area.To assess the KD illness severity and provide comparable quantitative indicators,provide the scientific basis for elimination of KD.Methods Non probability sampling method was used,and monitoring stations with the highest incidence of KD at the county level were selected in 2012.Clinical examination and 12 lead ECG was carried out.According to The KD Diagnosis Standard (WS/T 210-2011),eight common changes in ECG of KD were scored.According to age and sex group,check the abnormal rate of ECG detection of Keshan disease,while analysed the changes of abnormal ECG index score in latent KD patients and chronic KD patients.Abnormal ECG index to determine:If there was one change,the score was 1 and the abnormal ECG index was 1.And so on,the highest score was 8.Results Totally 61 831 residents were surveyed and 9 634 were found with abnormal ECG,and the relevance ratio of abnormal ECG was 15.58％;totally 3 862 residents had eight ECG changes of KD and the relevance ratio was 6.25％;totally 508 residents were diagnosed with KD and the relevance ratio was 0.82％.The relevance ratio of abnormal ECG among all age groups was statistically different (x2 =3 065.64,P ＜ 0.05).The relevance ratio of abnormal ECG in women was higher than that of men [3.91％ (2 419/61 831) vs 2.33％ (1 443/61 831),x2 =86.30,P＜ 0.05].Abnormal ECG index score was (1.06 ± 0.25) which was not statistically different between gender [men:(1.07 ± 0.27) vs women:(1.06 ± 0.24),t =1.41,P ＞ 0.05].The abnormal ECG index score in latent KD patients was lower than that of chronic KD patients [(1.09 ± 0.30) vs (1.60 ± 0.69),t =-4.87,P ＜ 0.05].In eight ECG changes,the most check out items were T wave and/or ST segment changes (2 816).Conclusions The relevance ratio of abnormal ECG in KD area is at a higher level.The abnormal ECG index can be used to assess the KD illness severity and provide comparable quantitative indicators,in order to provide a new train of thought for the evaluation of KD elimination.

Objective:To master the new cases and the condition of Keshan disease (KD) in key endemic areas and provide scientific basis for updating control strategies.Methods:In 2017, sentinel surveillance was carried out in some counties with substandard KD or serious historical KD. Two to three villages with more KD patients and the total population of 1 000 were chosen to investigate. All of the inhabitants were checked by physical examination and electrocardiography. Suspected KD patients were examined by echocardiography. KD was identified according to "Diagnosis of Keshan Disease" (WS/T 210-2011). The confirmed cases were followed up.Results:A total of 70 008 people were examined in 86 counties of 14 provinces. The ratio of male to female was 1.0 ∶ 1.2 (31 720/38 288). The total number of KD patients identified was 308, including 68 chronic KD and 240 latent KD. The detection rates were 44/10 000, 10/10 000 and 34/10 000, respectively. Totally 198 cases of chronic KD and 115 cases of latent KD were followed up, and the follow-up mortality was 8.1% (16/198) and 7.0% (8/115), respectively. In this year, 29 cases of latent KD and 5 cases of chronic KD were newly diagnosed.Conclusion:There are still a number of KD patients including new cases in endemic areas with high prevalence nowadays or in the past indicating the prevention and control of KD should be maintained.