Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey

Abstract

Objective To assess the recent trends in prevalence and management of hypertension in China, nationally and by population subgroups. Design Six rounds of a national survey, China. Setting China Chronic Disease and Risk Factors Surveillance, 2004-18. Participants 642 523 community dwelling adults aged 18-69 years (30 501 in 2004, 47 353 in 2007, 90 491 in 2010, 156 836 in 2013, 162 293 in 2015, and 155 049 in 2018). Main outcome measures Hypertension was defined as a blood pressure of ≥140/90 mm Hg or taking antihypertensive drugs. The main outcome measures were hypertension prevalence and proportion of people with hypertension who were aware of their hypertension, who were treated for hypertension, and whose blood pressure was controlled below 140/90 mm Hg. Results The standardised prevalence of hypertension in adults aged 18-69 years in China increased from 20.8% (95% confidence interval 19.0% to 22.5%) in 2004 to 29.6% (27.8% to 31.3%) in 2010, then decreased to 24.7% (23.2% to 26.1%) in 2018. During 2010-18, the absolute annual decline in prevalence of hypertension among women was more than twice that among men (−0.83 percentage points (95% confidence interval −1.13 to −0.52) v −0.40 percentage points (−0.73 to −0.07)). Despite modest improvements in the awareness, treatment, and control of hypertension since 2004, rates remained low in 2018, at 38.3% (36.3% to 40.4%), 34.6% (32.6% to 36.7%), and 12.0% (10.6% to 13.4%). Of 274 million (95% confidence interval 238 to 311 million) adults aged 18-69 years with hypertension in 2018, control was inadequate in an estimated 240 million (215 to 264 million). Across all surveys, women with low educational attainment had higher prevalence of hypertension than those with higher education, but the finding was mixed for men. The gap in hypertension control between urban and rural areas persisted, despite larger improvements in diagnosis and control in rural than in urban areas. Conclusions The prevalence of hypertension in China has slightly declined since 2010, but treatment and control remain low. The findings highlight the need for improving detection and treatment of hypertension through the strengthening of primary care in China, especially in rural areas.

Association between the prudent dietary pattern and blood pressure in Chinese adults is partially mediated by body composition

“…Hypertension is the primary risk factor for cardiovascular disease (CVD) (1), which is the leading cause of death in China (2). Recently, the prevalence of hypertension in China increased from 24.9% in 2004 to 38.1% in 2018 (3), and the prevalence was as high as 44.7% among adults aged 35-75 from 2014-2017 (4). In addition, the awareness, treatment, and control rates of hypertension are at a relatively low level (3,4), increasing the burden of CVD morbidity and mortality.…”

“…Recently, the prevalence of hypertension in China increased from 24.9% in 2004 to 38.1% in 2018 (3), and the prevalence was as high as 44.7% among adults aged 35-75 from 2014-2017 (4). In addition, the awareness, treatment, and control rates of hypertension are at a relatively low level (3,4), increasing the burden of CVD morbidity and mortality. Thus, an improved understanding of hypertension prevention and control from the perspective of modifiable risk factors is of significant public health interest (5).…”

The perspective of hypertension and salt intake in Chinese population

“…According to the six rounds of national survey reports, there were 274 million adults aged 18-69 years with HTN, and the standardized prevalence of HTN was 24.7% in 2018 in China (24). However, the awareness, treatment, and control levels of HTN were low at 38.3, 34.6, and 12.0%, respectively, in 2018.…”

Association of APP gene polymorphisms and promoter methylation with essential hypertension in Guizhou: a case–control study

“…In a national survey of hypertension in 2018, the prevalence of hypertension among Chinese adults was 24.7% (approximately 274 million). Hypertension is a serious health problem in China [ 1 ]. Notably, essential hypertension (EH) is a complex multifactorial disease.…”