Key result
The 2017 ACC/AHA hypertension guideline substantially increased the estimated prevalence of hypertension among Chinese adults to 58.0%, compared to 25.4% based on the 2010 Chinese guideline.
Why the study?
The study was conducted to estimate the percentage and number of Chinese adults with hypertension and those recommended for pharmacological antihypertensive treatment under the 2017 ACC/AHA guideline compared with the 2010 Chinese guideline.
How does the 2017 ACC/AHA high blood pressure guideline impact the estimated prevalence of hypertension and treatment recommendations in Chinese adults compared to the 2010 Chinese guideline?
Cross-Sectional (n=12,499)
Yes
How does the 2017 ACC/AHA high blood pressure guideline impact the estimated prevalence of hypertension and treatment recommendations in Chinese adults compared to the 2010 Chinese guideline?
The 2017 ACC/AHA hypertension guidelines would classify 58% of Chinese adults as hypertensive, substantially increasing the diagnosed population while modestly increasing the number recommended for medication.
Answers are grounded in this paper and cite their sources.
The higher prevalence under 2017 criteria signals greater hypertension burden and potential treatment needs in China; extends guideline impact studies to Chinese adults.
BACKGROUND: The current analysis was performed to estimate the percentage and number of Chinese adults with hypertension and the percentage and number of Chinese adults recommended to receive pharmacological antihypertensive treatment according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline compared with the same parameters according to the 2010 Chinese guideline. METHODS: We used 2011 data from the China Health and Nutrition Survey (CHNS). A total of 12,499 Chinese adults aged ≥18 years with complete blood pressure (BP) values were selected for the present analysis. RESULTS: The crude prevalence rates (95% CI) of hypertension according to the definitions from the 2017 ACC/AHA guideline and the 2010 Chinese guideline were 58.0% (57.2 to 58.9%) and 25.4% (24.7 to 26.2%), respectively. Moreover, the percentage of the participants recommended to take antihypertensive medications were 31.5 and 28.8%, respectively. Among adults who took antihypertensive medications, 88.8% had above-goal BP levels compared to 53.3%. Overall, 613.3 million Chinese adults (aged ≥18 years) met the criteria for hypertension according to the 2017 ACC/AHA guideline, and 267.7 million met the criteria according to 2010 Chinese guideline. An additional 28.4 million (2.7%) Chinese adults were recommended to take antihypertensive medication. CONCLUSIONS: The present analysis revealed that the 2017 ACC/AHA hypertension guideline will result in a substantial increase in the percentage and number of Chinese adults defined as having hypertension and a small increase in the percentage of adults who are recommended to take antihypertensive medications compared to the same parameters based on the 2010 Chinese guideline. More intensive management and antihypertensive medications use are suggested to improve the control rate of hypertension among Chinese adults.
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Jiao et al. (2020) conducted a cross-sectional in Hypertension (n=12,499). 2017 ACC/AHA hypertension guideline criteria vs. 2010 Chinese hypertension guideline criteria was evaluated on Prevalence of hypertension (Difference 32.6%, 95% CI 31.8-33.4). The 2017 ACC/AHA hypertension guideline substantially increased the estimated prevalence of hypertension among Chinese adults to 58.0%, compared to 25.4% based on the 2010 Chinese guideline.
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