The past two to three decades have seen a steady increase in the prevalence of hypertension in China, largely owing to increased life expectancy and lifestyle changes (particularly among individuals aged 35–44 years). Data from the China hypertension survey conducted in 2012–2015 revealed a high prevalence of grade 3 hypertension (systolic blood pressure ≥180 mmHg and diastolic blood pressure ≥110 mmHg) in the general population, which increased with age to up to 5% among individuals aged ≥65 years. The risk profile of patients with hypertension in China has also been a subject of intense study in the past 30 years. Dietary sodium and potassium intake have remained largely the same in China in the past three decades, and salt substitution strategies seem to be effective in reducing blood pressure levels and the risk of cardiovascular events and death. However, the number of individuals with risk factors for hypertension and cardiovascular disease in general, such as physical inactivity and obesity, has increased dramatically in the same period. Moreover, even in patients diagnosed with hypertension, their disease is often poorly managed owing to a lack of patient education and poor treatment compliance. In this Review, we summarize the latest epidemiological data on hypertension in China, discuss the risk factors for hypertension that are specific to this population, and describe several ongoing nationwide hypertension control initiatives that target these risk factors, especially in the low-resource rural setting.
The prevalence of hypertension in China has increased substantially in the past 30 years, and hypertension now affects approximately a quarter of all Chinese adults; this increase is mainly attributable to increased life expectancy among the general population, but also to lifestyle changes among individuals aged 35–44 years.
The north–south gradient in the prevalence of hypertension in China, which was apparent from data in 1991, is no longer prominent given the increasing prevalence of hypertension in the entire region.
The prevalence of grade 3 hypertension is high (1.6%) and increases substantially with age to up to 5% in patients aged ≥65 years.
The blood pressure control rate among patients in China is generally low owing to poor awareness and poor treatment adherence; several ongoing initiatives are aimed at improving blood pressure control, especially in the low-resource rural setting.
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J.-G.W. was financially supported by grants from the National Natural Science Foundation of China (91639203 and 81770455), Beijing, China.
The authors declare no competing interests.
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Wang, JG., Zhang, W., Li, Y. et al. Hypertension in China: epidemiology and treatment initiatives. Nat Rev Cardiol (2023). https://doi.org/10.1038/s41569-022-00829-z