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Examining the potential impacts of intensive blood pressure treatment on the socioeconomic inequity in hypertension prevalence in China: a nationally representative cross-sectional study

Hypertension Research volume 46, pages 2746–2753 (2023)Cite this article

Abstract

Few studies focused on the equity of hypertension prevalence before and after the diagnostic threshold change. The study aimed to analyze the 130/80 mmHg hypertension diagnostic threshold on the equity of hypertension prevalence in China. The baseline survey data from the China Health and Retirement Longitudinal Study (CHARLS) conducted from 2011 to 2012 were utilized to evaluate the impact of the 130/80 mmHg diagnostic threshold on the equity of hypertension prevalence in China using the concentration index and its decomposition which was an index reflecting the health inequality caused by social and economic factors. The prevalence of hypertension was 41.56% and 57.33% under the diagnostic thresholds of 140/90 mmHg and 130/80 mmHg, respectively. The concentration index for hypertension prevalence in China was −0.017 (95%CI: −0.028, −0.006) under the 140/90 mmHg threshold and −0.010 (95%CI: −0.018, −0.002) under the 130/80 mmHg threshold. Concentration index decomposition analysis of hypertension prevalence diagnosed at both diagnostic thresholds showed that age, BMI, and economic status contributed more to the inequitable situation of hypertension prevalence. Higher age, higher BMI, and poorer economic status increased the inequity of hypertension prevalence. No significant difference in the increase in hypertension among individuals of different economic status after implementing the blood pressure control standard (130/80 mmHg), and the prevalence of hypertension in the region did not show a significant bias towards the low economic status population. Therefore, implementing this standard will not increase the risk of hypertension prevalence biased toward people of low economic status.

Implementing the 130/80 mmHg diagnostic threshold will not increase the risk of hypertension prevalence biased towards people of low economic status.

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Data availability

All datasets are available from the China Health and Retirement Longitudinal Study (CHARLS) database (http://charls.pku.edu.cn/). Researchers who want to use these data can register accounts via the website.

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Acknowledgements

This article received support from the Education Department of Shaanxi Provincial Government under Grant No. 21JK0340. We thank all the CHARLS (China Health and Retirement Longitudinal Study) study participants and trial investigators. This article was prepared using research materials obtained from the Peking University Open Research Data Platform.

Funding

This work was supported by the Education Department of Shaanxi Provincial Government under Grant No. 21JK0340.

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Authors and Affiliations

  1. School of Health Services Management, Xi’an Medical College, Xi’an, Shaanxi, China

    Zhuo Zhang & Yijia Zhang

  2. School of Public Health, Xi’an Medical College, Xi’an, Shaanxi, China

    Guoshuai Shi, Yuan Xing, Ke Men, Jing Lei & Yonghong Ma

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Correspondence to Guoshuai Shi.

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All procedures performed in studies involving human participants were in accordance with the Declaration of Helsinki. The original CHARLS was approved by the Ethical Review Committee of Peking University, and all the participants from CHARLS provided signed informed consent.

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Zhang, Z., Shi, G., Xing, Y. et al. Examining the potential impacts of intensive blood pressure treatment on the socioeconomic inequity in hypertension prevalence in China: a nationally representative cross-sectional study. Hypertens Res 46, 2746–2753 (2023). https://doi.org/10.1038/s41440-023-01441-5

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