Lan Shao, Zugui Zhang, Linfeng Zhang, Guang Hao, Ying Dong, Jiali Wang, Runlin Gao, Congyi Zheng, Xin Wang, Manlu Zhu, Ye Tian, William S Weintraub, Zengwu Wang, Zuo Chen
Background
-Although the prevalence of hypertension (HTN) continues to increase in developing countries including China, recent data are lacking. A national wide survey was conducted from October 2012 to December 2015 to assess the prevalence of HTN in China.
Methods
-A stratified multistage random sampling method was used to obtain a nationally representative sample of 451,755 residents aged ≥18 years from 31 provinces in mainland China from October 2012 to December 2015. Blood pressure (BP) was measured after resting for 5 minutes by trained staff, using a validated oscillometric BP monitor. HTN was defined as systolic BP (SBP) ≥140 mmHg and/or /diastolic BP (DBP) ≥90 mmHg and/or use of antihypertensive medication within two weeks. Pre-HTN was defined as SBP 120-139 mmHg and DBP 80-89 mmHg without antihypertensive medication. HTN control was defined as SBP <140 mmHg and DBP<90 mm Hg. In addition, the prevalence of HTN (SBP≥130 or DBP≥80 mmHg) and control rate (SBP<130 and DBP<80 mmHg) of HTN were also estimated according to the 2017 American College of Cardiology (ACC) /American Heart Association (AHA) High Blood Pressure Guideline.
Results
-Overall, 23.2% (estimated 244.5 million) of the Chinese adult population aged ≥18 years had HTN, and another 41.3% (estimated 435.3 million) had pre-HTN according to the Chinese guideline. There were no significant differences of HTN prevalence between urban and rural residents (23.4% vs. 23.1%,P=0.819). Among individuals with HTN, 46.9% were aware of their condition, 40.7% were taking prescribed antihypertensive medications, and 15.3% had controlled HTN. Calcium channel blockers were the most commonly used antihypertensive medication (46.5%) as monotherapy; and 31.7% of treated hypertensive patients used two or more medications. The prevalence of HTN based on the 2017 ACC/AHA guideline was twice as high as that based on 2010 Chinese guideline (46.4%), while the control rate fell to 3.0%.
Conclusions
-In China, there is a high prevalence of HTN and pre-HTN; awareness, treatment and control of HTN were low. Management of medical therapy for HTN needs to improve.
