Gender and age-related risk features of arterial hypertension in the population with family stress in Russia/Siberia (WHO program "MONICA-psychosocial")

The purpose of research: to identify gender differences in stress at home influence on the risk of arterial hypertension (AH) in the general population 25-64 years in Russia / Siberia. Materials and methods. As part of the screening program III WHO «MONICA-psychosocial» surveyed a random representative sample of the population of both sexes aged 25-64 in Novosibirsk in 1994 (men: n = 657, 44,3 ± 0,4 years, the response - 82.1%; women : n = 689, 45.4 ± 0.4 years, the response - 72.5%). screened survey program included: registration of socio-demographic data, the definition of stress in the family. Scale "The knowledge and attitude towards their health" has been proposed to assess the level of stress in the family. The subjects were asked to answer independently scale according to the instructions. It was excluded all women and men diagnosed with cardio - vascular disease (ischemic heart disease, cerebrovascular disease, hypertension, myocardial infarction), diabetes mellitus, which occurred prior to or at the time of screening. The analysis included 384 women and 190 were men aged 25-64 in the initial years. Term prospective study of participants was 16 years. For 16-year period it was identified 229 cases of new-onset hypertension in women and 46 cases - men. Statistical analysis was performed using SPSS version 11.5 software package. To test the statistical significance of differences between groups were used: the criterion of "chi-squared» χ2 Pearson. To estimate the relative risk (RR) and its 95% CI (confidence interval) (minimum-maximum), taking into account the different time controls, used univariate and multivariate regression model of Cox proportional hazards (Cox-regression). The reliability in all kinds of analysis has been adopted at the level of significance p≤0,05. Results. In an open population of 25-64 high level of stress in the family it was higher among men (31.5%) than among women (20,9%) (χ2 = 29,638 df= 2 P = 0,001). The highest level of stress in the family was observed in men in the age group 55-64 years (39,3%) (χ2 = 19,744 df = 2 P = 0,001), and for women in the age group 45-54 years (22.9%) (χ2 = 7,659 df= 2 P = 0,022) in the univariate Cox regression analysis for a 16- year period, among those experiencing stressful situations in the family, the risk of hypertension was higher in men HR = 2.24 (95% CI 1, 67-7,42; p <0,01), than women HR = 1.39 (95% CI 1,08-1,78; p <0,01). In multivariate Cox regression analysis, with the inclusion in the model of social parameters and age, the risk of developing hypertension was also higher in men HR = 1.9 (95% CI 1,08-4,3; p <0,01), than women HR = 1.37 (95% CI 1,05-1,79; p <0,02). The greatest risk of developing hypertension was observed in divorced HR = 12.7 (95% CI: 3,1-52; p <0,0001) and widowed men HR = 10.6 (95% CI: 2,7-41; p <0, 0001), experiencing stress in the family. Conclusion: It was found that the stress in the family is more common in men than in women, as well as the risk of developing hypertension