Urban–Rural disparities in status of hypertension in northeast China: a population-based study, 2017–2019

Liying Xing; Jing Li; Yuanmeng Tian; Min Lin; Zhi Du; Yan Han; Guocheng Ren; Yingna Dong; Qun Sun; Shuang Liu

doi:10.2147/clep.s218110

September 1, 2019Clinical EpidemiologyOpen Access

Urban–Rural disparities in status of hypertension in northeast China: a population-based study, 2017–2019

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Why the study?

The study was conducted to investigate the status of hypertension and related risk factor disparities between urban and rural areas of northeast China.

Structured PICO

P

Population

18,796 participants aged ≥40 years from Liaoning Province, northeast China (28.9% urban, 71.1% rural), mean age 60.4±9.9 years, 61.0% women.

O

Outcome

Prevalence, awareness, treatment, and control rates of hypertension

There are significant urban-rural disparities in hypertension prevalence, awareness, and control in northeast China, highlighting the need for region-specific management strategies.

Implication

Disparities in hypertension prevalence and control between urban and rural northeast China require localized strategies; leaves open mechanisms for prospective confirmation.

Abstract

Background: To investigate the status of hypertension and related risk factor disparities between urban and rural areas of northeast China. Methods: A multi-stage, stratified, and cluster random sampling method was used to conduct the cross-sectional survey in Liaoning Province in 2017–2019. Finally, included 18,796 participants (28.9% urban, 71.1% rural) aged ≥40 years. The prevalence and control rate of hypertension were estimated based on Chinese hypertension guidelines and the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines. Results: The mean age of the population was 60.4±9.9 years, and 61.0% were women. The overall prevalence of hypertension was 56.8%. Compared to urban areas, hypertension was more prevalent, but the awareness, treatment, and control rates were lower in rural areas (59.2 vs 50.2, 52.5% vs 47.0%, 46.9% vs 34.9%, and 11.4% vs 3.7%, P <0.001, respectively). Multivariate regression analysis identified that the lack of exercise (odds ratio (OR), 1.24; 95% confidence interval (CI), 1.10–1.38) in rural areas, whereas overweight/obesity (OR, 2.01; 95% CI, 1.79–2.27) and alcohol consumption (OR, 1.20; 95% CI, 1.01–1.41) in urban areas were specific risk factors for hypertension, besides common risk factors. Under the 2017 ACC/AHA guidelines, the prevalence of hypertension was 80.6% (urban 76.6%, rural 82.2%), increased 1.4-fold compared with the current Chinese guidelines, with increased rates of 27.9% in urban areas and 25.7% in rural areas. Conclusion: A highly diverse prevalence for hypertension was found between urban and rural areas in northeast China. Region-specific strategies targeting the prevention and management of hypertension should be highlighted.