Prevalence, Awareness, Treatment and Control of Hypertension in Macau: Results From a Cross-Sectional Epidemiological Study in Macau, China

Liang, Ke; Ho, Jacky; Feng, Jianzhang; Mpofu, Elias; Dibley, Michael J.; Li, Yan; Feng, Xiuhua; Van, Florance; Lau, Winne; Brock, Kaye E.

doi:10.1093/ajh/hpu121

Cited by 39 publications

(38 citation statements)

References 13 publications

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“…Our study also showed that highly educated people usually had a lower rate of hypertension than those with low education levels. This finding was consistent with several other studies [23][24][25]. It may reflect that factors associated with hypertension are similar among different ethnicities.…”

Section: Discussionsupporting

confidence: 93%

Hypertension prevalence, awareness, treatment, and control in northeast China: a population-based cross-sectional survey

et al. 2017

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Hypertension has been recognized as a major risk factor for cardiovascular disease. We aimed to analyze the current prevalence, awareness, treatment, and control of hypertension in northeast China. This cross-sectional survey adopted the multistage stratified random cluster sampling method to obtain a representative sample of adults aged 40 years or older in the general population of northeast China. Hypertension was defined as a systolic blood pressure (SBP) ≥ 140 mm Hg, or diastolic blood pressure (DBP) ≥ 90 mm Hg, or self-reported use of antihypertensive medications in the last 2 weeks irrespective of BP. Altogether 4052 participants were included with weighted prevalence of hypertension of 57.3%. Among them, 47.4% were aware of their condition; 78.8% took antihypertensive medication, but only 10.2% had their blood pressure controlled. Individuals who were overweight/obesity, with dyslipidemia, or diabetes were at a higher risk of hypertension; these people also more likely to be aware of their condition. Subjects with a personal history of stroke were more inclined to receive antihypertensive medication, but that did not necessarily translate to well-controlled hypertension. Moreover, dyslipidemia (OR = 0.600; 95% CI: 0.375, 0.960) were associated with poor hypertension control. Subjects using combination of antihypertensive medications (OR = 2.924; 95% CI: 1.606, 5.325) or with a family history of coronary heart disease were more likely to have their blood pressure controlled. Our study identified a high prevalence of hypertension in northeast China. Although awareness and treatment rates improved over the last decade, the control rate remained disproportionately and unacceptably low.

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Section: Discussionsupporting

confidence: 93%

Hypertension prevalence, awareness, treatment, and control in northeast China: a population-based cross-sectional survey

et al. 2017

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“…19 A national survey estimated the prevalence of high blood pressure in China to be 29.6%, whereas a systematic review estimated the overall prevalence in India at 29.8%. 25,26 High blood pressure is the most potent risk factor for stroke and the current and rising prevalence rates of this risk factor alone will contribute significantly to stroke burden globally. Given that nearly 70% incident stroke occur in LMICs, 16 health policies to reduce the prevalence of these risk factors is crucial.…”

Section: Global Burden Of Risk Factors For Strokementioning

confidence: 99%

New Strategy to Reduce the Global Burden of Stroke

Feigin

Krishnamurthi

Bhattacharjee

et al. 2015

Stroke

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The socioeconomic and health effect of stroke and other noncommunicable disorders (NCDs) that share many of the same risk factors with stroke, such as heart attack, dementia, and diabetes mellitus, is huge and increasing. [1][2][3][4] Collectively, NCDs account for 34.5 million deaths (66% of deaths from all causes) 3 and 1344 million disability-adjusted life years lost worldwide in 2010. 2 The burden of NCDs is likely to burgeon given the aging of the world's population and the epidemiological transition currently observed in many low-to middle-income countries (LMICs). 5,6 In addition, there is low awareness in the population about these NCDs and their risk factors, 7-10 particularly in LMICs.11 These factors, coupled with underuse of strategies for primary prevention of stroke/NCDs on an individual level and the lack of accurate data on the prevalence and effect of risk factors in different countries and populations have been implicated in the ever-increasing worldwide burden of the NCDs. [12][13][14][15] Of particular concern is a significant increase in the number of young adults (aged <65 years) affected by stroke, 16 and the increasing epidemic of overweight/obesity 17 and diabetes mellitus worldwide. 18 If these trends continue, the burden of stroke and other major NCDs will increase even faster. The increasing burden of stroke and other major NCDs provide strong support for the notion that the currently used primary prevention strategies for stroke and other major NCDs (business as usual) are not sufficiently effective. The most pertinent solution to this problem is the implementation of new, effective, widely available, and cost-effective prevention and treatment strategies to reduce the incidence and severity distribution of stroke and other major NCDs. Issues With Population-Wide Prevention StrategiesThe recent INTERSTROKE case-control study, conducted in 22 countries worldwide, provided evidence that, collectively, 10 risk factors accounted for 88.1% (99% confidence interval, 82.3%-92.2%) of the population-attributable risk for all stroke. 19 Because many (but not all) of these risk factors are modifiable, the INTERSTROKE data suggest that interventions that reduce blood pressure, promote physical activity, smoking cessation, and a healthy diet, could substantially reduce the burden of stroke. Although a combination of population-wide and individual high-risk prevention strategies were initially advocated >30 years ago, 20 and have since been repeatedly recommended as the most promising strategies to reduce stroke and NCDs burden, there is still no country in the world where both these prevention strategies have been implemented in full. There are major hurdles to implementing population-wide primary prevention strategies, including the need for policy and legislative changes that are often not supported by major industries (such as salt reduction in processed food, reduction of exposure to cigarette smoking, alcohol, and fast food). In addition, there are significant costs associated with the imple...

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“…Overall, the prevalence of hypertension is about 25% in adults, but this value is expected to increase to 29% by 2025 [1]. In China, by contrast, the prevalence of hypertension in adults rose from 14.5% in 1991 to 34.0% in 2012 [2,3]. Therefore, hypertension has become the major public health issue in the Chinese population.…”

Section: Introductionmentioning

confidence: 99%

Is Waist-to-Height Ratio Superior to Body Mass Index and Waist Circumference in Predicting the Incidence of Hypertension?

Tian

et al. 2019

Ann Nutr Metab

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Background: It is still controversial which anthropometric indicator could be the best predictor of the incident hypertension. Objectives: To examine the relative power of body mass index (BMI), waist circumference (WC), skinfold thickness, waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR) in predicting the incidence of hypertension in Chinese adults. Method: Data were obtained from the China Health and Nutrition Survey. Overweight was defined as BMI ≥23 kg/m² and general obesity as BMI ≥27.5 kg/m². Abdominal obesity was defined by WC values ≥90 cm for males and ≥80 cm for females. Skinfold thickness, WHR, and WHTR were divided into low and high groups according to receiver operating characteristics. Cox regressions and nomograms were employed to compare the relative power of 5 indicators in predicting incident hypertension. Results: When all indicators were analyzed simultaneously, the best predictor of incident hypertension was general obesity (p < 0.001, adjusted hazard ratio [HR] 1.9, 95% CI 1.6–2.2). The results stratified by sex showed that BMI and WC were the more powerful predictors of hypertension in males (adjusted HR 1.8 and 1.3, 95% CI 1.4–2.3 and 1.1–1.5, respectively) as well as in females (adjusted HR 2.0 and 1.4, 95% CI 1.6–2.4 and 1.2–1.6, respectively). Conclusions: BMI and WC may predict incident hypertension better than skinfold thickness, WHR, and WHTR in the Chinese population.

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Prevalence, Awareness, Treatment and Control of Hypertension in Macau: Results From a Cross-Sectional Epidemiological Study in Macau, China

Cited by 39 publications

References 13 publications

Hypertension prevalence, awareness, treatment, and control in northeast China: a population-based cross-sectional survey

Hypertension prevalence, awareness, treatment, and control in northeast China: a population-based cross-sectional survey

New Strategy to Reduce the Global Burden of Stroke

Is Waist-to-Height Ratio Superior to Body Mass Index and Waist Circumference in Predicting the Incidence of Hypertension?

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