Hypertension Prevalence Rates Among Urban and Rural Older Adults of China, 1991–2015: A Standardization and Decomposition Analysis

Abstract

Objectives: The prevalence of hypertension (HTN) among older adults is becoming an important issue in public health in China as it is now stepping into the super-aged society with high pressure of a chronic disease burden. With urban–rural differences in population composition and health facilities, this study aimed to assess the gaps in the prevalence trends of HTN among older adults by considering demographic factors such as age, gender, education level, and regional differences during 1991–2015 in China.Methods: We adopted the consistent sampling design and measure of HTN of the cross-longitudinal surveys of the China Health and Nutrition survey, and we compared the HTN prevalence rates between urban and rural older adults by taking each wave of the survey as a cross-sectional sample of the Chinese population by the following and supplementary samples. The classic standardization and decomposition analysis method was utilized with four factor-specific rates, and contributions were calculated, i.e., age, gender, education, and region, which reflects the aspect of demographic and social development differences between urban and rural areas of China.Results: The prevalence rates of HTN of the whole of older adults were increasing in 1991–2015. However, the gaps of prevalence rates of HTN between urban and rural areas show different trends accompanied by the health policies launched by the government. Namely, the gap was narrowed during 1993–1997 and then enlarged during 1997–2011 and narrowing again. Those trends reflect the policy effects with the health resource allocation and utilization of health services for urban and rural older adults.Conclusions: With the four factors of decomposition analysis, the differences reflect the results of health policy effects, considering the urban–rural discrepancy on older adults with different demographic characteristics. Hence, the differentiated policies should be considered with the urban–rural population, such as HTN prevention and the population health promotion.

Association of adiposity indices with prehypertension among Chinese adults: A cross‐sectional study

“…Besides sex, age, smoking, drinking, diabetes, and dyslipidemia, the residence, educational attainment, and household wealth also impacted prehypertension, consistent with previous studies 23 . These results demonstrated the demographic and social development differences between urban and rural areas of China 24 . In this large‐scale cross‐sectional study, we investigated both traditional adiposity indices and the newly developed index positively associated with prehypertension in Southern Chinese adults.…”

Evaluation of Immunogenicity and Safety of Vero Cell-Derived Inactivated COVID-19 Vaccine in Older Patients with Hypertension and Diabetes Mellitus

“…In China, nearly half (44.7%) of Chinese adults aged 35–75 years had hypertension [ 10 ] and 11.2% of adults aged ≥18 years had diabetes [ 11 ]. Among adults aged ≥60 years in China, the prevalence rates of hypertension increased rapidly from 1991 to 2015 (32.38% in urban areas and 30.46% in rural areas) [ 12 ]. Another study conducted in Haikou showed the prevalence of hypertension was 26.0% and that of diabetes mellitus was 8.0% in 2018 [ 13 ].…”

Urban-rural disparities in hypertension prevalence and its influencing factors among Chinese middle-aged and older adults: Results from the China Health and Retirement Longitudinal Study (CHARLS), 2018

“…Our results showed that, based on the total measure that combines diagnosed and measured hypertension, the prevalence rates of diagnosed, measured, total and undiagnosed hypertension are higher in urban areas than in rural ones among middle-aged and older adults in China. 25 Firstly, regarding the role of factors in explaining urban-rural disparity of hypertension prevalence, we nd that smoking is a signi cant factor through probit models. Smokers, including past smokers and current smokers, are more likely to have high blood pressure in rural areas but not in urban ones, which was found in the diagnosed, measured, total, and undiagnosed hypertension probit models.…”

“…The results of statistical analysis for urban and rural settings differences are also displayed. Prevalence of diagnosed, measured, total and undiagnosed hypertension is higher in urban areas than in rural areas (25 Hypertension prevalence: diagnosed prevalence, whether a doctor told the respondent they were hypertensive; measured prevalence, SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg; total prevalence, either self-reported or measured; undiagnosed prevalence, the fraction of total prevalence that is not diagnosed.…”