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

ABSTRACT

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.