Geographic Variations in the Prevalence, Awareness, Treatment, and Control of Dyslipidemia among Chinese Adults in 2018-2019: A Cross-sectional Study.

Objective: To investigate the spatial patterns of the prevalence, awareness, treatment, and control rates of dyslipidemia at the provincial level in China. Methods: A national and provincial representative cross-sectional survey was conducted among 178,558 Chinese adults in 31 provinces in mainland China in 2018-2019, using a multi-stage, stratified, cluster-randomized sampling design. Subjects, as households, were selected, followed by a home visit to collect information. Both descriptive and linear regression procedures were applied in the analyses. Results: The overall prevalence of dyslipidemia was 35.6%, and wide geographic variations of prevalence, treatment, and control rates of dyslipidemia were identified among 178,558 eligible participants with a mean age of 55.1 ± 13.8 years. The highest-lowest difference regarding the provincial level prevalence rates were 19.7% vs. 2.1% for high low-density lipoprotein cholesterol, 16.7% vs. 2.5% for high total cholesterol, 35.9% vs. 5.4% for high triglycerides, and 31.4% vs. 10.5% for low high-density lipoprotein cholesterol. The treatment rate of dyslipidemia was correlated with the socio-demographic index ( P < 0.001), urbanization rate ( P = 0.01), and affordable basic technologies and essential medicines ( P < 0.001). Conclusion: Prevailing dyslipidemia among the Chinese population and its wide geographic variations in prevalence, treatment, and control suggest that China needs both integrated and localized public health strategies across provinces to improve lipid management.

Hypertension Prevalence, Awareness, Treatment, and Control and Their Associated Socioeconomic Factors in China: A Spatial Analysis of A National Representative Survey.

OBJECTIVE: We aimed to investigate and interpret the associations between socioeconomic factors and the prevalence, awareness, treatment, and control of hypertension at the provincial level in China. METHODS: A nationally and provincially representative sample of 179,059 adults from the China Chronic Disease and Nutrition Surveillance study in 2015-2016 was used to estimate hypertension burden. The spatial Durbin error model was fitted to investigate socioeconomic factors associated with hypertension indicators. RESULTS: Overall, it was estimated that 29.20% of the participants were hypertensive nationwide, among whom, 34.32% were aware of their condition, 27.69% had received antihypertensive treatment, and 7.81% had controlled their condition. Per capita gross domestic product (GDP) was associated with hypertension prevalence (coefficient: -2.95, 95% CI: -5.46, -0.45) and control (coefficient: 6.35, 95% CI: 1.36, 11.34) among adjacent provinces and was also associated with awareness (coefficient: 2.93, 95% CI: 1.12, 4.74) and treatment (coefficient: 2.67, 95% CI: 1.21, 4.14) in local province. Beds of internal medicine (coefficient: 2.66, 95% CI: 1.08, 4.23) was associated with control in local province. Old dependency ratio (coefficient: -3.58, 95% CI: -5.35, -1.81) was associated with treatment among adjacent provinces and with control (coefficient: -1.69, 95% CI: -2.42, -0.96) in local province. CONCLUSION: Hypertension indicators were not only directly influenced by socioeconomic factors of local area but also indirectly affected by characteristics of geographical neighbors. Population-level strategies should involve optimizing supportive socioeconomic environment by integrating clinical care and public health services to decrease hypertension burden.

Vegetable and Fruit Consumption among Chinese Adults and Associated Factors: A Nationally Representative Study of 170,847 Adults.

OBJECTIVE: This study examined vegetable and fruit (VF) consumption rate and its associated factors among Chinese adults. METHODS: Nationally representative data from the 2013 China Chronic Disease Surveillance survey were used. Dietary intake data, including VF consumption during the last 12 months, were collected. All analyses were weighted to obtain nationally representative estimates. Associations between VF consumption and other factors (e.g., meal frequency and physical activity) were examined through logistic regression analysis. RESULTS: The average fruit consumption was 102.3 g/day (95% CI: 97.0-107.6) and the average vegetable consumption was 350.6 g/day (95% CI: 339.3-361.8). Over half (53.2%, 95% CI: 50.9-55.4) of Chinese adults met the VF consumption of 400 g/day recommended by the World Health Organization (WHO). Rural residents had a higher prevalence of low VF consumption rate than urban residents [49.20% (95% CI: 46.2%-52.2%) vs. 44.0% (95% CI: 41.7%-46.3%) P < 0.01]. Old age (OR = 1.01, 95% CI: 1.00-1.01), low educational level, low income, minority ethnicity (OR = 1.41, 95% CI: 1.15-1.74), underweight (OR = 1.17, 95% CI: 1.03-1.33), single marital status (OR = 1.20, 95% CI: 1.08-1.33), low health literacy, irregular breakfast (OR = 1.20, 95% CI: 1.04-1.38) or lunch (OR = 1.58, 95% CI: 1.26-1.99) habits, and no leisure-time physical activity were associated with low VF consumption. CONCLUSION: Only half of Chinese adults met the VF consumption recommended by the WHO. Low socio-economic status, irregular diet, and poor health literacy were likely associated with low VF consumption. National efforts and programs are needed to promote VF consumption.