Impacts of undetected and inadequately treated hypertension on incident stroke in China

Abstract

ObjectivesChina carries the greatest burden of stroke given its largest volume of people with hypertension. This study assessed the impacts of suboptimal controls of hypertension on incident stroke and projected the number of patients with stroke saved after the control of blood pressure improved in population.SettingAnhui, China.ParticipantsWe examined data from the Anhui cohort of 2001–2011, consisting of 3336 participants aged ≥60 years who were randomly recruited from the urban and rural Anhui. 2852 participants had hypertensive status measured and no stroke at baseline, and were followed up until 2011 in three surveys using a standard method of interview.ResultsAt baseline, 1646 participants (57.7%) were identified to have hypertension, among whom 912 (55.4%) were previously undetected, 115 (7.0%) detected but not treated, 452 (27.5%) treated but not controlled and only 127 (7.7%) controlled. During the 10-year follow-up, 211 incident stroke cases (12.8/1000 person-years) occurred. Compared with normotensive individuals at baseline, multivariate adjusted HR for having stroke increased in those with undetected hypertension by 1.63 (95%CI 1.15 to 2.32), untreated by 2.21 (1.26–3.85) and uncontrolled hypertension by 3.34 (2.28–4.88), but did not differ from those with controlled hypertension (1.34; 0.60–2.99). Based on a two-fold increase in the detection and management of current levels of hypertension and algorithms on the current situation in China, approximately 250 000 incident stroke cases could be prevented annually.ConclusionsIn China, hypertension is frequently undetected or inadequately treated. With appropriate management of hypertension, a substantial number of people could be saved form stroke.

Development and validation of a 2-year new-onset stroke risk prediction model for people over age 45 in China

“…The classification of hypertension status in this study is quite different from other stroke prediction tools. In consideration of the difference in the risk of stroke among people with different awareness of hypertension and blood pressure control, [ 34 , 44 , 45 ] we divided hypertension status into 4 types of no, unknown, well-controlled, and poorly-controlled hypertension, so the model could be used to predict the risk of stroke in different states of hypertensive patients. The risks of stroke in patients with unknown, well-controlled and poorly-controlled hypertension were 2.202, 2.286, and 2.642 times higher than those without hypertension, respectively.…”

Tele-ECG consulting and outcomes on primary care patients in a low-to-middle income population: The first experience from Makassar Telemedicine Program, Indonesia

“…However, these numbers are still higher compared with the 16% unaware and 7% untreated hypertension cases in stroke patients recently studied in China. (7,8) Another report states that overtreatment appears to be detected in 0.1% population in Indonesia, i.e. where medication is privately consumed without diagnosis at healthcare facilities.…”

ZSCAN25 and CYP2E1 polymorphisms is risk factors for ischemic stroke in a Chinese Han population: a case control study

“…reported hypertension is a conventional risk factor for stroke, and stroke patients could be saved with appropriate management of hypertension [28] . Given that hypertension is the risk factor of IS, we evaluated the association of ZSCAN25 and CYP2E1 variants with hypertension in IS patients.…”