What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=13583). Primary outcome: Hypertension prevalence.

What does this research mean for the field?

Among Chinese adults aged 45 years and older, the overall weighted prevalence of hypertension is 41.7%, with significant geographic variations such as high prevalence but low control in Guizhou, and high prevalence, awareness, and treatment in Shanghai and Beijing. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 14, 2016Open Access

Geographic Distributions in Hypertension Diagnosis, Measurement, Prevalence, Awareness, Treatment and Control Rates among Middle-aged and Older Adults in China

Key Result

Among Chinese adults aged 45 years and older, the overall weighted prevalence of hypertension was 41.7%, with significant geographic variations such as high prevalence (56.3%) but low control (14.9%) in Guizhou.

Study Design

Type

Cross-Sectional (n=13,583)

Multicenter

Yes

Structured PICO

Population

13,583 Chinese adults aged 45 years or older from the China Health and Retirement Longitudinal Study

Outcome

Geographic distributions at the provincial level of hypertension diagnosis, measurement, prevalence, awareness, treatment, and control rates

Significant geographic variations exist in hypertension prevalence, awareness, treatment, and control among middle-aged and older adults in China, highlighting regions needing targeted public health interventions.

Limitations

Some provinces are not included in the CHARLS, including Tibet, Ningxia and Hainan
CHARLS does not collect information on respondents' dietary patterns
Could not adequately analyze the effects of physical activity because only a random subsample of households was asked about time spent on physical activities

Abstract

Hypertension is of public health importance in China, but information on geographic distribution on hypertension by map visualization is limited for middle-aged and older adults. Regional geographic variations remain unexplained. Our study is to present geographic distributions at the provincial level and identify provinces and municipalities with high hypertension diagnosis, measurement and prevalence rates and/or low awareness, treatment, control rates among aged 45+ adults in China. We used data collected from the China Health and Retirement Longitudinal Study (n = 13,583) of Chinese people aged 45 years or older. We used weighted rates for our analysis. The rates by provinces and municipalities were compared using map visualization, and explore the main factors of the disparity using ordinal logistic regression. Higher hypertension prevalence rates (56.3%) but lower hypertension awareness, treatment and control rates (37.3%, 21.1% and 14.9%, respectively) were observed in Guizhou. Shanghai and Beijing had the highest hypertension prevalence, awareness and treatment rates (65.0%, 87.8% and 80.0% for Shanghai, 57.5%, 88.6% and 77.5% for Beijing, respectively). Remarkable variations were observed among surveyed provinces and municipalities. Several Chinese regions show particularly higher prevalence rates and/or lack of hypertension awareness and poor control.

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