The urban-rural disparity in the prevalence of hypertension among middle-aged and older in China remains unclear. We used the data collected from the fourth wave (2018) of the China Health and Retirement Longitudinal Study (CHARLS) (n = 12,245) and analyzed using probit regression. Firstly, the prevalence of diagnosed, measured, total and undiagnosed hypertension is higher in urban areas than in rural areas (25.9% vs. 21.6%, 35.2% vs. 31.2%, 46.1% vs. 40.7%, and 20.2% vs. 19.1%, respectively). Past smokers and current smokers, compared with non-smokers, had a higher probability of total hypertension in rural areas (12.5% and 4.9%, respectively), and the difference was significant (p < 0.01). Compared with Sedentary exercisers, regular exercisers had a lower probability of total hypertension in rural areas than in urban areas (41.5% and 38.3%, respectively), and the difference was significant (p < 0.01). Our study shows that, Firstly, smoking is a significant risk factor for the urban-rural disparity of hypertension, which is significantly worse in rural areas. Secondly, though regular exercise helps prevent hypertension in both areas, urban residents need to exercise more.
The aims of this study are to estimate the mean change in the predicted probability and identify the most important predictors of diagnosed, measured, total, and undiagnosed hypertension among aged 45+ adults in China. We used data collected from the fourth wave (2015) of the China Health and Retirement Longitudinal Study (n = 12 236). First, we estimated the prevalence of diagnosed, measured, total, and undiagnosed hypertension. Second, we used probit models to identify the factors that were associated with hypertension, and we estimated average marginal effects of variables in probit models. Among Chinese people aged 45+, the prevalence of diagnosed, measured, total, and undiagnosed hypertension were 23.1%, 32.7%, 42.6%, and 19.5%, respectively. The probability of total hypertension is higher for overweight and obesity than normal body mass index (10.4% and 19.3%, respectively), higher for past smokers and current smokers than nonsmokers (5.9% and 3.8%, respectively), higher for urban population than rural population (4.0%), and lower for married individuals than unmarried/single (−7.1%). Our results suggest that continued strengthening for smoking prevention is needed to reduce smoking-related hypertension and greater focus on prevention of hypertension are necessary for overweight or obesity and in urban areas among middle-aged and older adults in China.
Body mass index (BMI) is typically used to define overweight and obesity. However, without waist circumference information, BMI may misclassify as overweight or obese. Therefore, we proposed a new index based on BMI. We developed a New Body Mass Index (NBMI) by adding waist circumference (WC) to BMI, which combined BMI and WC. That is, it also combined weight-for-height and waist-to-height ratios. The formula is: NBMI = BMI × WC (m) = WT (kg) / HT (m2) × WC (m) = WT (kg) / HT (m) × WC (m) / HT (m) = weight-for-height × waist-to-height. Firstly, individuals with the same height and weight have the same BMI, but their waist circumferences could vary considerably, and NBMI could distinguish body differences among people's waist sizes. Secondly, NBMI could better identify central obesity than BMI. Thirdly, NBMI could not only measure body mass but also classify health and obesity degrees according to a wide range of scores. Firstly, NBMI incorporating WC could better reflect the body difference in waist size than BMI. Secondly, NBMI is more convenient for identifying central obesity. Thirdly, NBMI could better classify different weight types by expanding the score range.
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