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The burden, management rates and influencing factors of high blood pressure in a Chinese rural population: the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study

Journal of Human Hypertension volume 32, pages 236–246 (2018)Cite this article

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Abstract

The aim of the present study was to examine the prevalence, awareness, treatment, control, and potentially influencing factors of high blood pressure (HBP) in Chinese rural adults based on a cross-sectional study. Using data from the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study, a total of 30,834 participants aged 18–74 years were enrolled for the epidemiological study. The multivariate logistic regression model including all selected potentially influencing factors was carried out for the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Overall, a total of 9872 individuals were diagnosed as HBP (32.02%) with substantial imparity between men and women (32.87% vs. 30.58%), and the corresponding age-standardized prevalence of HBP were 19.50% (20.94% in men and 18.85% in women). Among the HBP patients, 6654 were aware of the diagnosis (67.40%), 5391 were taking medication (54.61%), and 2572 had their blood pressure controlled (26.05%).The corresponding age-adjusted awareness, treatment, and control of HBP were 59.35%, 45.91%, and 23.87%, respectively, and the corresponding rates were higher in women than those in men. The age-specific prevalence and management rates of HBP displayed increased trends with aging in both sexes(P trend  < 0.05). Aging, low level of education, unhealthy lifestyle, positive family history of hypertension, overweight, obesity, diabetes, and dyslipidemia were associated with the prevalence, awareness, treatment, and control of HBP. In conclusion, uncontrolled HBP was common with high prevalence in Chinese rural residents. Strengthening the primary prevention through lifestyle modifications is necessary for reducing the disease burden and improving the management rates of HBP.

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References

  1. Cooper RS, Kaufman JS, Bovet P. Global burden of disease attributable to hypertension. J Am Med Assoc. 2017;317:2017–8.

    Article  Google Scholar 

  2. Wolf-Maier K, Cooper RS, Banegas JR, Giampaoli S, Hense HW, Joffres M, et al. Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. J Am Med Assoc. 2003;289:2363–9.

    Article  Google Scholar 

  3. Wu L, He Y, Jiang B, Liu M, Wang J, Yang S, et al. The association between the prevalence, treatment and control of hypertension and the risk of mild cognitive impairment in an elderly urban population in China. Hypertens Res. 2016;39:367–735.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wu Y, Huxley R, Li L, Anna V, Xie G, Yao C, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation. 2008;118:2679–86.

    Article  PubMed  Google Scholar 

  5. Wang JW, Zhang LX, Wang F, Liu LS, Wang HY, the China National Survey of Chronic Kidney Disease Working Group. Prevalence, awareness, treatment, and control of hypertension in China: results from a National Survey. Am J Hypertens. 2014;27:1355–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Yang G, Wang Y, Zeng Y, Gao GF, Liang X, Zhou M, et al. Rapid health transition in China, 1990–2010: findings from the global burden of disease study 2010. Lancet. 2013;381:1987–2015.

    Article  PubMed  Google Scholar 

  7. Chen WW, Gao RL, Liu LS, Zhu ML, Wang W, Wang YJ, et al. The report of cardiovascular diseases in China–2013 profiles. Chin Circ J. 2014;29:487–91.

    Google Scholar 

  8. Gu D, Reynolds K, Wu X, Chen J, Duan X, Muntner P, et al. Prevalence, awareness, treatment, and control of hypertension in china. Hypertension. 2002;40:920–7.

    Article  CAS  PubMed  Google Scholar 

  9. Yang J, Lu F, Zhang C, Liu Z, Zhao Y, Gao F, et al. Prevalence of prehypertension and hypertension in a Chinese rural area from 1991 to 2007. Hypertens Res. 2010;33:331–7.

    Article  PubMed  Google Scholar 

  10. Writing group of 2010 Chinese guidelines for the management of hypertension. 2010 Chinese guidelines for the management of hypertension. Chin J Hypertens. 2011;19:701–43.

  11. Chinese Nutrition Society. The dietary guidelines for Chinese residents. Lhasa: The Tibet people’s Publishing House; 2011. 97, 197–8.

    Google Scholar 

  12. World Health Organization. International guide for monitoring alcohol consumption and related harm. Geneva: WHO; 2000. p. 51.

    Google Scholar 

  13. International Physical Activity Questionnaire: Short Last 7 Days Self-Administered Format 2005. http://www.ipaq.ki.se/downloads.htm. Accessed 26 October 2015

  14. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009;32:S62–7.

    Article  PubMed Central  Google Scholar 

  15. Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. Chinese guidelines on prevention and treatment of dyslipidemia in adults. Zhonghua Xin Xue Guan Bing Za Zhi. 2007;35:390–419.

    Google Scholar 

  16. National Bureau of Statistics of the People’s Republic of China. China statistical yearbook, 2010. Beijing, China: China statistic press; 2010. http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm Accessed 25 April 2016

    Google Scholar 

  17. Li Z, Guo X, Zheng L, Sun Z, Yang H, Sun G, et al. Prehypertension in rural northeastern China: results from the northeast China rural cardiovascular health study. J Clin Hypertens. 2014;16:664–70.

    Article  Google Scholar 

  18. Li D, Lv J, Liu F, Liu P, Yang X, Feng Y, et al. Hypertension burden and control in mainland China: analysis of nationwide data 2003–2012. Int J Cardiol. 2015;184:637–44.

    Article  PubMed  Google Scholar 

  19. Du S, Batis C, Wang H, Zhang B, Zhang J, Popkin BM. Understanding the patterns and trends of sodium intake, potassium intake, and sodium to potassium ratio and their effect on hypertension in China. Am J Clin Nutr. 2014;99:334–43.

    Article  CAS  PubMed  Google Scholar 

  20. Wang Y, Zhang J, Ding Y, Zhang M, Liu J, Ma J, et al. Prevalence of hypertension among adults in remote rural areas of Xinjiang, China. Int J Environ Res Public Health. 2016;13. pii: E524. https://doi.org/10.3390/ijerph13060524.

  21. Li W, Gu H, Teo KK, Bo J, Wang Y, Yang J, et al. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens. 2016;34:39–46.

    Article  CAS  PubMed  Google Scholar 

  22. American Heart Association Statistics Committee. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133:e38–360.

    Article  Google Scholar 

  23. Li G, Wang H, Wang K, Wang W, Dong F, Qian Y, et al. Prevalence, awareness, treatment, control and risk factors related to hypertension among urban adults in Inner Mongolia 2014: differences between Mongolian and Han populations. BMC Public Health. 2016;16:294.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Meng XJ, Dong GH, Wang D, Liu MM, Lin Q, Tian S, et al. Prevalence, awareness, treatment, control, and risk factors associated with hypertension in urban adults from 33 communities of China: the CHPSNE study. J Hypertens. 2011;29:1303–10.

    Article  CAS  PubMed  Google Scholar 

  25. Wei Q, Sun J, Huang J, Zhou HY, Ding YM, Tao YC, et al. Prevalence of hypertension and associated risk factors in Dehui City of Jilin Province in China. J Hum Hypertens. 2015;29:64–68.

    Article  CAS  PubMed  Google Scholar 

  26. Wang H, Zhang X, Zhang J, He Q, Hu R, Wang L, et al. Factors associated with prevalence, awareness, treatment and control of hypertension among adults in Southern China: a community-based, cross-sectional survey. PLoS ONE. 2013;8:e62469 https://doi.org/10.1371/journal.pone.0062469

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Qureshi AI, Suri MF, Kirmani JF, Divani AA, Mohammad Y. Is prehypertension a risk factor for cardiovascular diseases? Stroke. 2005;36:1859–63.

    Article  PubMed  Google Scholar 

  28. Suri MF, Qureshi AI. Prehypertension as a risk factor for cardiovascular diseases. J Cardiovasc Nurs. 2006;21:478–82.

    Article  PubMed  Google Scholar 

  29. Gu D, He J, Coxson PG, Rasmussen PW, Huang C, Thanataveerat A, et al. The cost-effectiveness of low-cost essential antihypertensive medicines for hypertension control in China: a modelling study. PLoS Med. 2015;12:e1001860.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Dong G, Sun Z, Zheng L, Li J, Zhang X, Zhang X, et al. Prevalence, awareness, treatment, and control of hypertension in rural adults from Liaoning Province, Northeast China. Hypertens Res. 2007;30:951–8.

    Article  PubMed  Google Scholar 

  31. Meng XJ, Dong GH, Wang D, Liu MM, Lin Q, Tian S, et al. Prevalence, awareness, treatment, control, and risk factors associated with hypertension in urban adults from 33 communities of China: the CHPSNEstudy. J Hypertens. 2011;29:1303–10.

    Article  CAS  PubMed  Google Scholar 

  32. Black ML, Wise CA, Wang W, Bittles AH. Combining genetics and population history in the study of ethnic diversity in the People’s Republic of China. Hum Biol. 2006;78:277–93.

    Article  CAS  PubMed  Google Scholar 

  33. Wang Y, Klarić L, Yu X, Thaqi K, Dong J, Novokmet M, et al. The association between glycosylation of immunoglobulin g and hypertension: a multiple ethnic cross-sectional study. Medicine. 2016;95:e3379.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This research was supported by the National Key Research and Development Program “Precision Medicine Initiative” of China (Grant No. 2016YFC0900803), National Natural Science Foundation of China (Grant No. 81573243, 81602925, U1304821), Henan Provincial Science Fund for Distinguished Young Scholars (Grant No. 164100510021), Science and Technology Innovation Talents Support Plan of Henan Province Colleges and Universities (Grant No. 14HASTIT035), High-level Personnel Special Support Project of Zhengzhou University (Grant No. ZDGD13001). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. In addition, we like to thank the participants, the coordinators, and administrators for their supports during the study. To Dr. Fatiha Karam, the authors would like to express their gratitude for their critical reading of the manuscript.

Author contributions

CW conceived and designed the experiments. XL, YL, YG, LL, KY, RL, ZM, and RB performed and conducted the experiments. XL, YL, KY, and RL analyzed the data and take responsibility for the integrity and accuracy of the information. XL, ZM, and RB contributed to the reagents/materials/analysis tools. XL and YL drafted and revised the manuscript. All authors have approved the final manuscript.

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    Authors and Affiliations

    1. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China

      Xiaotian Liu, Linlin Li, Kaili Yang, Ruihua Liu, Zhenxing Mao, Ronghai Bie & Chongjian Wang

    2. Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, China

      Yuqian Li

    3. Department of Health Education, Yuzhou Center for Disease Control and Prevention, Xuchang, Henan, China

      Ying Guo

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    Liu, X., Li, Y., Guo, Y. et al. The burden, management rates and influencing factors of high blood pressure in a Chinese rural population: the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study. J Hum Hypertens 32, 236–246 (2018). https://doi.org/10.1038/s41371-018-0039-0

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