Characterization, risk stratification and the hypertension control rate at hospital-based clinics: a survey of 25,336 hypertensives in Beijing, Shanghai and Guangzhou.

OBJECTIVE: To characterize hypertensive patients living in metropolitan cities in China. METHODS: This was a cross-sectional survey conducted in Beijing, Shanghai and Guangzhou. The eligibility criteria included outpatients 35-85 years of age with a systolic blood pressure (SBP) of ≥140 mmHg or a diastolic blood pressure (DBP) of ≥90 mmHg or both and/or patients receiving antihypertensive medications. The patients' demographic characteristics, medical history and findings of physical examinations, laboratory tests and cardiovascular imaging (i.e., ultrasonic cardiogram) were included in the survey. Risk stratification and the rate of hypertension control were evaluated. RESULTS: A total of 25,336 individuals were surveyed, of which 79.1% were from cardiology clinics and 51.8% were male hypertensives. The average SBP/DBP was 139.3±18.6/82.3±12.0 mmHg. The mean age was 63.6±11.5 years. The mean BMI was 25.1±3.8 kg/m(2). Among the men, 55.9% had a waist circumference of >90 cm. Among the women, 50.9% had a waist circumference of >85 cm. The percentages of patients with diabetes mellitus, heart disease and cerebral vascular disease were 20.3%, 39.2% and 10.4%, respectively. The smoking rate was 17.6%. Overall, 60.9% of the patients were in the very high risk group. While 97.7% of the patients were receiving antihypertensive drug therapy, only 40.2% had controlled SBP/DBP (i.e., under 140/90 mmHg). The control rate was statistically higher in Beijing and Shanghai than in Guangzhou and among older patients than among younger patients (43% among the patients >75 years of age vs. 28.1% among the patients 35-45 years of age). CONCLUSION: In Beijing, Shanghai and Guangzhou, most hypertensive patients have various cardiovascular risk factors and cardiovascular diseases. High blood pressure is not under appropriate control in all cases, especially among young hypertensives and patients living in Guangzhou city. Approaches designed to target multiple risk factors and concomitant cardiovascular diseases and boost the hypertension control rate are warranted.