Time Trends in Comorbidity and Management of Hypertension and Diabetes: A 15-year Nationwide Longitudinal Study of 18,380 Adults in China

Abstract

Background: To examine time trends in comorbidity of hypertension and type 2 diabetes (T2DM) and their diagnosis, treatment, and management in China during 2000-2015 and study factors associated with these outcomes. Methods: Longitudinal data collected from the China Health and Nutrition Survey (CHNS) during 2000-2015 were analyzed. Of the 28,204 adults, 832 had both hypertension and T2DM were selected. Average systolic blood pressure (SBP) and diastolic blood pressure (DBP) and hypertension prevalence among T2DM patients, and treatment and control of hypertension and T2DM among patients with both conditions were examined for all and by sex and weight status. Mixed effects models assessed the associations. Results: From 2000 to 2015, among patients with T2DM, hypertension prevalence dropped from 88.4% to 83.0% and BPs decreased (P < 0.05). Men and overweight/obese patients had greater decreases in hypertension prevalence and DBP, while women had a larger decrease in SBP than men. Over time, among patients with both hypertension and T2DM, rates of hypertension treatment (45.3% to 57.7%), hypertension control (3.0% to 10.9%) and T2DM treatment (90.0% to 95.6%) increased, but were still very low except for T2DM treatment (all P < 0.001). Age, gender, smoking, drinking, household income, education, residence, and weight status were significantly associated with prevalence, treatment, and control of hypertension, and T2DM treatment among patients with both hypertension and T2DM. Conclusion: Rates of hypertension treatment and control among patients with both hypertension and T2DM have improved in recent years, but were still low.