Epidemiology of prehypertension and associated risk factors in urban adults from 33 communities in China--the CHPSNE study.

BACKGROUND: The Seventh Report of The Joint National Committee has recently introduced the prehypertension category of blood pressure (BP) status that needs monitoring and intervention. Little is known about the epidemiology of prehypertension in urban China, so this study aimed at estimating the prevalence of prehypertension and identifying risk factors in urban Chinese adults. METHODS AND RESULTS: Using a multistage cluster and random sampling method, a representative sample of 25,196 urban adults aged 18-74 years in northeast of China was selected from 2009 to 2010. The survey of BP and associated risk factors was carried out in 33 communities. Multiple logistic regression methods were used to identify risk factors for prehypertension. Overall, 40.5% of urban Chinese adults had prehypertension, with a prevalence of 47.7% and 33.6% in men and women, respectively. Multivariate logistic regression analysis revealed the risk factors of being overweight (adjusted odds ratio [aOR]=1.38, 95% confidence interval [CI]: 1.26-1.52), obesity (aOR=3.94, 95%CI: 2.99-5.20), central obesity (aOR=2.13, 95%CI: 1.96-2.32). Being female, and having a higher education level, higher family income and diet control were protective factors. CONCLUSIONS: Prehypertension is common among urban residents in China, and is associated with many risk factors. Comprehensive lifestyle modifications need to be taken to decrease the incidence of prehypertension and to prevent prehypertension progressing to hypertension and cardiovascular disease.

Sex difference of the prevalence and risk factors associated with prehypertension among urban Chinese adults from 33 communities of China: the CHPSNE study.

BACKGROUND: As a new category of blood pressure (BP) classification according to the Seventh Report of The Joint National Committee, prehypertension has aroused people's great concern in recent years due to its associations with increased incidence of cardiovascular disease. However, there is little information about the epidemiology of prehypertension in urban China. The aim of this study is to estimate the prevalence of prehypertension and to identify its risk factors among urban Chinese men and women. METHODS: A cross-sectional survey in a representative sample of 25 196 Chinese adults aged 18-74 years was conducted in three cities of northeast of China during 2009 and 2010. Body weight, height, waist circumference, and BP were measured by trained observers. RESULTS: Overall, the prevalence of prehypertension was 56.9%, men 71.1% and women 44.6%, respectively. Multivariate analysis revealed that higher education or a higher family income were risk factors of prehypertension among men, but shown as protective factors among women. Among men, high odds ratios (ORs) of prehypertension were found in overweight [OR 2.31; 95% confidence interval (CI) 2.02-2.71] and obese (OR 7.92, 95% CI 4.36-14.42) adults (defined as body mass index), whereas abdominal obesity (OR 2.94, 95% CI 2.48-3.57) (defined as waist circumference) was the main determinant for prehypertension status in women. CONCLUSION: Our results indicate that hypertension is highly prevalent in urban China and there is a sex difference in the relationships between risk factors and prehypertension.

Factors associated with prevalence, awareness, treatment and control of hypertension in urban adults from 33 communities in China: the CHPSNE Study.

Using a randomized multistage cluster sampling, we studied the factors associated with the prevalence, awareness, treatment and control of hypertension (defined as systolic and diastolic blood pressure (BP) measurements ≥140 and 90 mm Hg, respectively, or current drug treatment for hypertension) in a representative sample of the urban Chinese population. The participants were 18-74 years of age and had lived for at least 5 years in an area comprising 33 communities in three cities (Shenyang, Anshan and Jinzhou) in China. A total of 28 830 people were selected; the overall response rate was 87.4% (25 196/28 830). The overall prevalence of hypertension was 28.7% (7237/25 196). Of those with hypertension, 42.9% (3107/7237) were aware of their condition, 28.2% (2042/7237) were receiving treatment and 3.7% (264/7237) were considered controlled. More than half (57.8%) of the hypertensives did not think that high BP would endanger their lives. Multivariate analysis revealed that age, gender, education, occupation, income, body mass index, waist circumference and a family history of hypertension correlated significantly with the prevalence of hypertension. Among all the hypertensives, higher awareness (determined by odds ratios; 95% confidence intervals) was noted for persons who were white-collar workers (1.29; 1.08, 1.53, respectively), overweight (1.48; 1.30, 1.69), obese (3.37; 2.76, 4.11) or had a family history of hypertension (3.07; 2.76, 3.42). Among the individuals aware of their hypertension, treatment was more common in those with a higher level of education and less common among individuals consuming ≥2 alcoholic drinks per day (0.65; 0.52, 0.83). Controlled hypertension was much less common among older persons, and participants who were former smokers (0.49; 0.26, 0.91). The results indicate that more attention is needed to improve the awareness of the potentially fatal nature of hypertension in urban China.

Prevalence, awareness, treatment, control, and risk factors associated with hypertension in urban adults from 33 communities of China: the CHPSNE study.

OBJECTIVE: To assess the prevalence, awareness, treatment, and control of hypertension and their associated factors in an urban Chinese population. METHODS: A cross-sectional study was conducted in three cities in northeast China from 2009 to 2010, using a multistage cluster sampling method to select a representative sample. A total of 25 196 adults, aged 18-74 years, were examined in 33 communities. Hypertension was defined as a mean SBP of at least 140 mmHg, DBP at least 90 mmHg, and/or use of antihypertensive medications. RESULTS: Overall, the prevalence of hypertension was 28.7% for urban residents, and 39.1% for middle-aged and elderly residents (aged ≥35 years). Among all the hypertensive patients examined in the study (n = 7237), 42.9% were aware of their condition, 28.2% were receiving treatment, and only 3.7% had their blood pressure adequately controlled. Female hypertensive patients had more effectively controlled blood pressure than their male counterparts. Among the study participants, 37.9% did not think that high blood pressure would endanger their lives. Among hypertensive patients aware of their conditions, the primary reason for not taking antihypertensive medication was a lack of money (34.8%). Age, sex, education, occupation, income, body mass, waist circumference, and family hypertension history significantly correlated with the prevalence of hypertension. CONCLUSION: Hypertension is highly prevalent in the urban population of China, and the effects of being overweight/obesity on hypertension were much larger than any other examined factors. The percentage of hypertensive patients aware of their condition, receiving proper treatment, and keeping their hypertension under control is unacceptably low.