Hypertension is the major cause of preventable disease burden in China. However, limited evidence is available on sex differences in the awareness, treatment, and control of hypertension. We assessed sex differences in the awareness, treatment, and control of hypertension in China. A systematic search of four English language and four Chinese-language databases was conducted to identify studies conducted from 2005 that reported sex-specific data on the awareness, treatment, and control of hypertension in China. Random effects meta-analysis weighted by the inverse of the variances were used to obtain pooled sex-specific rates and women-minus-men differences, and their 95% confidence intervals (CI). Overall, 57 studies comprising 2,155,829 individuals (55% women) were included. Awareness (53% in women vs. 47% in men), treatment among all (44% vs. 38%), treatment among aware (65% vs. 60%), control among all (17% vs. 14%), and control among treated (27% vs. 27%) were low for both sexes, but more favourable in women than men. The corresponding women-minus men difference was 7% (95% CI: 6; 8%) for awareness, 6% (5; 8%) for treatment among all, 6% (2; 9%) for treatment among aware, 3% (2; 3%) for control among all, and 0% (-2; 1%) for control among treated. Awareness, treatment, and control of hypertension in China is low in both sexes, but greater in women than men. Sex-specific interventions may be needed to efficiently combat the burden of hypertension.The Japanese Society of Hypertension Hypertension Research With nearly 20% of the world's population, China represents a large proportion of the global burden of hypertension; 17% of women and 22% of men in China had hypertension in 2015. 1,3 The management of hypertension in China is poor; 4,5 a recent report from a nationally representative survey indicated that approximately 60% of hypertensive individuals in China are not aware of their condition, about two-thirds are not treated, and less than 10% have proper control. 6 Several studies, from mostly Western populations, have reported that women have greater awareness of their hypertension and higher rates of treatment and control than men. [7][8][9][10][11][12][13] Sex differences in the awareness, treatment, and control of the condition have not been assessed in detail in China. However, these may differ from those in the West because of major cultural and sociodemographic differences, as well as differences in health care delivery and utilization. Accurate information about sex differences in the awareness, treatment, and control of the condition is important, not only to provide a baseline picture from which progress can be monitored, but also to inform the development of better approaches to improve the control of hypertension in both women and men in China.The aim of this study was to conduct a systematic review with meta-analyses to provide most comprehensive contemporary estimates of sex differences in the awareness, treatment, and control of hypertension in China.
Methods
Search strategyWe systematically s...