Incidence and Predictors of Hypertension Among Rural Chinese Adults: Results From Liaoning Province

Abstract

OBJECTIVE We wanted to determine the incidence of hypertension and its risk factors among rural Chinese adults. RESULTS During a mean follow-up period of 28 months, 29.6% of men and 23.4% of women developed hypertension. The age-adjusted incidence was higher in men (12.75 per 100 person-years) than in women (10.04 per 100 person-years). Among men, independent predictors of incident hypertension were baseline age (hazard ratio [HR] = 1.11; 95% confi dence interval [CI], 1.10-1.13), Mongolian ethnicity (HR = 1.09; 95% CI, 1.01-1.18), use of alcohol, (HR = 1.14; 95% CI, 1.06-1.23), high income vs low income (HR = 1.11; 95% CI, 1.00-1.22; and HR = 1.11; 95% CI, 1.03-1.20), prehypertension vs normotension (HR = 1.18; 95% CI, 1.08-1.28), overweight and obesity (HR = 1.28; 95% CI, 1.17-1.40), baseline salt intake (HR = 1.00; 95% CI, 1.00-1.01) and family history of hypertension (HR = 1.14; 95% CI, 1.03-1.27). With the exception of use of alcohol and mean income, the results were similar for women, except that low physical activity was shown as a risk factors as well. The awareness, treatment, and control rates for newly developed hypertension were 29.9%, 19.5%, and 1.5%, respectively. CONCLUSIONS These data indicate that the incidence of hypertension is high among these rural Chinese adults and that it is associated with many risk factors. Our fi ndings further suggest that most newly developed hypertension cases are not treated. The increases in hypertension are probably related to rapid social changes in our country and may apply to other areas of the developing world. These fi ndings call for urgent improvements in hypertension prevention and control programs in rural China. 2010;8:19-24. doi:10.1370/afm.1018. METHODS Ann Fam Med INTRODUCTIONC ardiovascular disease, including both stroke and heart disease, is now the leading cause of death among Chinese adults.1 Hypertension is an important modifi able risk factor for cardiovascular disease and total mortality in the Chinese population. Because more than one-half of the Chinese population lives in rural regions, shifts in mortality that are due to cardiovascular disease have enormous public health and economic consequences. Studies published in the 1980s and 1990s suggested that the prevalence and incidence of hypertension in rural China were very low.2 During the past 2 decades, however, China in general, and rural China in particular, has been under- 20 HY PER T ENSION IN RUR A L CHINESE A DULT Sgoing rapid social changes. Rural residents periodically commute to urban regions, where they acquire urban and westernized lifestyles and dietary habits. These changes are occurring all over China, but they are particularly pronounced in the northeast and west, where agricultural production is not high and growth of urban centers is accelerating. More recent data suggest a rapid acceleration in the number of cases of hypertension in rural China.3,4 Salt consumption has been shown to be higher in northern than in southern China, 5 and activity levels in northeaste...

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