Hypertension in China

Abstract

Article, see p 2344 T he Global Burden of Disease Study estimated that increased blood pressure was the world's leading risk for death, contributing to >10 million deaths in 2016.1 Hypertension is very common, with 40% of those >25 years of age having high blood pressure, representing ≈1.4 billion people worldwide.2 Almost half of those with hypertension are unaware, and although many of those who are aware are treated with antihypertensive drugs, most do not have their blood pressure lowered to recommended targets. How does China, the most populous nation in the world, fare? Wang et al 4 report in this issue of Circulation results from a large population blood pressure survey providing up-to-date data for China. The survey methods included stratified multistage random sampling to provide data representative of the Chinese population >15 years of age and the assessment of blood pressure using a standardized technique with a validated electronic manometer. Specifically, the survey was designed to examine blood pressure in 14 age-sex groups, in rural and urban settings, and in all 31 provinces of China. The survey methodology and the overall response rate of 66.4% are similar to those of other high-quality population blood pressure surveys. The survey data largely reflect global data in many regards, but in such a large population, the numbers are staggering 4 : Almost 250 million people have hypertension, >125 million are unaware, close to 150 million are not on antihypertensive drug therapy (59.3%), and "only" 37 million (15.3%) are controlled. 4 Just over 435 million (40%) adult Chinese had prehypertension. Minority ethnic populations had lower rates of awareness (36.9% versus 48.0%), treatment (29.5% versus 42.0%), and control (8.4% versus 16.1%) compared with urban populations of Han ethnicity. 4 Recently, the American College of Cardiology/American Heart Association hypertension guidelines were released, with 2 major features being a change in the definition of hypertension from 140/90 to 130/80 mm Hg and a recommendation to treat those at high cardiovascular risk who meet or exceed 130/80 mm Hg. 5Almost 50% of adults in China meet the new definition for hypertension, but a relatively small increment (≈2%) meet the new criteria to be prescribed hypertension pharmacotherapy.6 Nevertheless, the current task of identifying those who have hypertension by the 140/90 mm Hg criterion is enormous and likely to exceed primary care capacity for many years to come. Adoption of the 130/80 mm Hg criterion is likely to occur over time with a focus on identification of those at high cardiovascular risk. 6 The needless human morbidity and suffering from chronic disease led by hypertension-related diseases have been viewed as a major threat to global economic development.7 As a result, the World Health Assembly agreed to 9 targets to reduce

Neck circumference as an indicator of elevated blood pressure independent from body composition: implications from the China nation health survey (CNHS)

“…As one of the most important risk factors of cardiovascular disease, hypertension was the world’s leading risk for death [9, 10]. China, as the most populous nation in the world, has nearly 244.5 million (23.2%) hypertension (HTN) patients according to a recent national survey [11].…”

A Study of Machine-Learning Classifiers for Hypertension Based on Radial Pulse Wave

“…Hypertension is a clinical syndrome whose principal characteristic is an increase in systemic arterial pressure and it is the one of the most common cardiovascular diseases in the world [ 1 – 3 ]. According to 2017 Chinese guidelines for the management of hypertension [ 4 ], the prevalence of hypertension has been increasing in China for decades, reaching 23.2%, which has greatly affected the health status of people.…”

Regularity of clinical visits and medication adherence of patients with hypertension or diabetes in rural Yunnan province of China

“…This highlights the urgency for more investments in primary health care, which is the rst line of defense in the control of diabetes and hypertension. Improvements in primary healthcare could strengthen the ability of the state to educate the people on, and to supervise the management of, chronic diseases in rural China (Campbell & Sheldon, 2010;Campbell & Zhang, 2018).…”