Prevalence and treatment of hypertension in China: impacts of 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline

Abstract

a b s t r a c tThe definition, recommended treatment thresholds and targets of hypertension have been updated in the recent 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. However, the impacts of this guideline on Chinese population are currently unknown. In this study, we aim to provide updated data in China using criteria from the updated guideline. A multistage, stratified sampling method was used to obtain a representative sample of 50,171 adults aged 18 years and above. Hypertension was defined as an average systolic blood pressure !130 mm Hg, or an average diastolic blood pressure !80 mm Hg, or self-reported use of antihypertensive medications in past 2 weeks. The weighted prevalence of hypertension was 60.1% (95% confidence interval [CI] 59.3%-61.0%). The treatment rate and recommended treatment rate were 16.8% (95% CI 16.1%-17.6%) and 53.7% (95% CI 52.6%-54.9%), respectively; the gap was more prominent among men and participants from rural areas. Hence, the adoption of the 2017 ACC/AHA guideline will lead to a substantial increase in both prevalence and number of patients needing treatment in China. The applicability of this guideline should be carefully evaluated based on evidence from Chinese population.

Secular trends of hypertension prevalence based on 2017 ACC/AHA and 2018 Chinese hypertension guidelines: Results from CHNS data (1991‐2015)

“…3 and China among adults aged 45-75 years, respectively. Using longitudinal CHNS data, the present study protracted the previous prevalence of hypertension from several cross-sectional studies in China [6][7][8] and demonstrated an increasing secular trend of hypertension prevalence based on 2017 ACC/AHA guideline, which is different from the long-term trend among US adults. 16,17 In addition, we observed that the rate of increase in the prevalence of hypertension based on 2017 ACC/AHA guideline is significantly steeper than that estimated by the 2018 Chinese guideline (β = 1.00% per year versus β = 0.67% per year, P = 0.041).…”

Research on the application of health management model based on the perspective of mobile health

“…“Expert consensus and Group Standard on body weight Management of overweight or obese population,” [6] 2010 revised edition of “Chinese guidelines for the Prevention and treatment of Hypertension,” [7] “The guidelines for the Prevention and treatment of Adult dyslipidemia,” [8] and “the Dietary guidelines for Chinese residents” [9] were used as the basis for the determination of overweight and obesity, hypertension, dyslipidemia, and lifestyle. Judging standard of bad life style: Physical activity was insufficient: daily work was mainly light activity, or moderate physical activity was <5 days per week, cumulative weekly activity time was <150 minutes; Smoking: it refers to those who smoke >1 cigarette a day on average and drink alcohol for >1 year; Drinking: men drink >25 g and females drink >15 g per day; Insufficient intake of cereal potato: <250 g of potato intake per day; Excessive intake of livestock and poultry meat: more than 75 g per day; Insufficient intake of fruit: <200 g of fresh fruit per day; Insufficient intake of vegetables: <300 g of fresh vegetables per day.…”

Death burden of high systolic blood pressure in Sichuan Southwest China 1990–2030

“…The impact of hypertension on NCDs has been recognized for more than 60 years. Evidence showed that when the SBP exceeded 115 mmHg, the incidences for stroke and coronary heart disease began to rise, regardless of the inconsistent criteria for hypertension [31][32][33].…”