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

Abstract

This study aimed to assess the impact of the 2017 American College of Cardiology and American Heart Association (ACC/AHA) guideline and the 2018 Chinese hypertension guidelines on the different secular trends for hypertension prevalence. A total of 82 665 eligible individuals aged ≥20 years were selected from nine cross‐sectional study periods (1991‐2015) from the China Health and Nutrition Survey (CHNS). Over the 24‐year period, the long‐term trend for the prevalence of the 2017 ACC/AHA‐defined age‐adjusted hypertension showed an increase from 32.2% (95% confidence interval (CI): 31.0%‐33.3%) in 1991 to 60.0% (95% CI: 58.6%‐61.3%) in 2015 (Ptrend < 0.001). According to the 2018 Chinese guideline for hypertension, the weighted hypertension prevalence increased from 10.0% (95% CI: 9.4%‐10.5%) in 1991 to 28.7% (95% CI: 27.9%‐29.6%) in 2015 (Ptrend < 0.001). However, slopes of increasing prevalence of hypertension were significantly greater according to the 2017 ACC/AHA guideline than that based on Joint National Committee (JNC 7) report (β = 1.00% vs β = 0.67% per year, respectively, P = 0.041). Based on the 2017 ACC/AHA definition, the prevalence of stage 1 hypertension and elevated blood pressure significantly increase from 22.3% and 6.9% in 1991 to 31.2% and 10.1% in 2015 (all P < 0.05), respectively. The secular trend for the prevalence of hypertension according to the 2017 ACC/AHA guideline showed a greater rate of increase compared with the prevalence based on the 2018 Chinese hypertension guidelines. Public health initiatives should focus on the current status of hypertension in China because of the possible high prevalence of hypertension and concomitant vascular risks.

Cognitive status and its risk factors in patients with hypertension and diabetes in a low‐income rural area of China: A cross‐sectional study

“…Multiple cross‐sectional and cohort studies have also confirmed the relationship between hypertension and the occurrence and progression of clinical symptoms of AD, demonstrating that hypertension was also common in patients with AD 29–31 . Interventions that normalize blood pressure and promote microvascular health may prevent cognitive decline during old age 32 …”

“…[29][30][31] Interventions that normalize blood pressure and promote microvascular health may prevent cognitive decline during old age. 32 In this study, hypertension and diabetes were identified as the main causes of cognitive impairment. In addition, older people are more susceptible to stress, depression, and sleep deprivation, which also contribute to the development of AD and other types of dementia.…”

Association of Obesity and Hypertension: A Cohort Study in China

“…Meanwhile, we found in this study that the prevalence of hypertension increased more than doubled from 13.11% in 1993 to 32.14% in 2015. Other studies in China also revealed the high increase of prevalence of hypertension [ 30 , 31 ]. However, it is estimated that the prevalence would grow 55% by year 2050 if no interventions on hypertension control are taken [ 32 ].…”

Trends of Hypertension Stages among Iranian Adults from 2005 to 2025 using WHO STEPS studies: A Comparison among 2017 ACC/AHA, JNC7, and 2020 ISH Guidelines

“…In Tehran 22 , Yazd 23 , and Khuzestan 24 , hypertension prevalence was estimated to change from 20.4-47.1%, 28.9-61.0%, and dramatically from 15.81-42.85% with ACC/AHA adoption instead of JNC7. Internationally, adopting the ACC/AHA guideline in China doubled hypertension prevalence 25 , and also showed a steeper trend, while Brazil experienced a 2.6-fold increase, from 21.1-54.7% 26 . In Bangladesh, JNC7 and 2017 ACC/AHA classi ed 25.7% and 48.0% of the population as having hypertension, respectively 27 .…”