Background: China is facing the challenges of the increasing burden of diabetes and obesity; the prevalence and numbers of diabetes patients with obesity or overweight are still unclear. Methods: Nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS) were used to estimate the prevalence of diabetes patients with elevated BMI, the recommendation rate for antidiabetic medication, the blood glucose control rate, and the corresponding population size. Results: The prevalence of diabetes patients with elevated BMI was 9.18% (95% CI: 7.88, 10.68; representing 31.54 million) in China. More than half of people with diabetes had elevated BMI (overweight or obesity). Among the participants who were not taking antidiabetic medication, 26.15% (95% CI: 18.00, 36.36; representing 3.79 million) were recommended for antidiabetic medication by the 2020 CDS guideline. There were 24.62% (95% CI: 16.88, 34.45; representing 3.64 million) patients, representing 11.13 (95% CI: 9.86, 12.41) million people, with diabetes combined with elevated BMI, taking antidiabetic medication, and still above the goal blood glucose. Conclusions: Our results indicate that diabetes combined with elevated BMI has become a major public health problem in China in people over 45 years of age. Moreover, the prevalence and population size of women are higher than those of men, and the prevalence of people over 65 years old is slightly lower than that of elderly people aged 45–65. The recommended rate of antidiabetic medication and the control rate of blood glucose were high, and prevention and treatment strategies for diabetes combined with elevated BMI are needed.

Aim:To examine which hypertension subtypes are primarily responsible for the difference in the hypertension prevalence and treatment recommendations, and to assess their mortality risk if 2017 American College of Cardiology (ACC)/American Heart Association (AHA) hypertension guideline were adopted among Chinese adults.MethodsWe used the nationally representative data of China Health and Retirement Longitudinal Study (CHARLS) to estimate the differences in the prevalence of isolated systolic hypertension (ISH), systolic diastolic hypertension (SDH) and isolated diastolic hypertension (IDH) between the 2017 ACC/AHA and the 2018 China Hypertension League (CHL) guidelines. We further assessed their mortality risk using follow-up data from the China Health and Nutrition Survey (CHNS) by the Cox model.ResultsThe increase from the 2017 ACC/AHA guideline on hypertension prevalence was mostly from SDH (8.64% by CHL to 25.59% by ACC/AHA), followed by IDH (2.42 to 6.93%). However, the difference was minuscule in the proportion of people recommended for antihypertensive treatment among people with IDH (2.42 to 3.34%) or ISH (12.00 to 12.73%). Among 22,184 participants with a median follow-up of 6.14 years from CHNS, attenuated but significant associations were observed between all-cause mortality and SDH (hazard ratio 1.56; 95% CI: 1.36,1.79) and ISH (1.29; 1.03,1.61) by ACC/AHA but null association for IDH (1.15; 0.98,1.35).ConclusionAdoption of the 2017 ACC/AHA may be applicable to improve the unacceptable hypertension control rate among Chinese adults but with cautions for the drug therapy among millions of subjects with IDH.

Background Epidemiological data showed that the comorbidities of cardiovascular disease and diabetes in China are very serious, but the comprehensive management of such patients is seriously inadequate and lack of standardization. Our study aimed to estimate the inequalities of those high CVD risk patients with or without diabetes in China, and analyze the contributors of inequalities problems. Method Data were derived from China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011. The criteria of American Systolic Blood Pressure Intervention Trial (SPRINT) were used to estimate the prevalence of high CVD risk patients with or without diabetes in China. Concentration index was calculated to describe the economic-related inequality degree in high CVD risk patients with or without diabetes. A decomposition method was employed to analyze the cause of inequalities problems. Results The prevalence of high CVD risk patients with or without diabetes in China were 3.46% and 22.03% respectively. The concentration index of high CVD risk patients with or without diabetes in China were 0.0639 [ 95% CI: (0.0630, 0.0648)] and − 0.0628 [95% CI: (-0.0629, -0.0627)] respectively, indicating a pro-rich inequality in high CVD risk patients with diabetes and a pro-poor inequality in high CVD risk patients without diabetes. Location(rural or urban), age and BMI were the key factors to influence the pro-rich inequality in high CVD risk patients with diabetes. Age, socioeconomic status and education were the key factors to influence the pro-poor inequality in high CVD risk patients without diabetes. Conclusion Our study determined pro-rich inequality in high CVD risk patients with diabetes, but pro-poor in high CVD-risk without diabetes patients in China. SES and BMI mainly associated with the social-economic inequality in high CVD risk patients with or without diabetes.