Table 1. Demographic characteristics of Chinese adults with hypertension based on China Health and Nutrition Survey 2011
|
All
|
Women
|
Men
|
P-value**
|
Sample size (N)
|
3,579
|
1,775
|
1,804
|
|
Age (year, mean±SD)
|
60.0±12.4
|
61.6±11.7
|
58.5±12.9
|
< 0.001
|
BMI (kg/m2)
|
25.3±5.4
|
25.4±5.2
|
25.2±5.6
|
0.13
|
Residence (%)
|
|
|
|
|
Urban
|
41.5
|
41.5
|
41.5
|
1.0
|
Rural
|
58.5
|
58.5
|
58.5
|
|
Geographic region† (%)
|
|
|
|
0.33
|
Western China
|
20.1
|
21.1
|
19.1
|
|
Eastern China
|
49.4
|
48.6
|
50.3
|
|
Central China
|
30.5
|
30.3
|
30.6
|
|
Marital status* (%)
|
|
|
|
< 0.001
|
Married
|
83.2
|
76.0
|
90.3
|
|
Single
|
16.8
|
24.0
|
9.7
|
|
Ethnicity
|
|
|
|
1.0
|
Han
|
92.0
|
92.0
|
90.0
|
|
Minority
|
8.0
|
8.0
|
8.0
|
|
Occupational status (%)
|
|
|
|
< 0.001
|
Employed
|
44.1
|
32.1
|
56.0
|
|
Unemployed
|
55.9
|
67.9
|
44.0
|
|
Health insurance (%)
|
|
|
|
|
Insured
|
95.8
|
95.9
|
95.7
|
0.82
|
Not insured
|
4.2
|
4.1
|
4.3
|
|
Education (%)
|
|
|
|
< 0.001
|
≤ Elementary school
|
48.2
|
60.8
|
35.7
|
|
Middle school
|
27.4
|
22.4
|
32.4
|
|
High school
|
17.1
|
13.0
|
21.1
|
|
≥ College
|
7.3
|
3.8
|
10.8
|
|
Smoking (%)
|
|
|
|
< 0.001
|
Non-smoker
|
65.9
|
94.3
|
38.0
|
|
Ex-smoker
|
6.4
|
0.8
|
11.8
|
|
Smoker
|
27.7
|
4.9
|
50.2
|
|
Alcohol consumption (%)
|
|
|
|
< 0.001
|
Drinking
|
34.5
|
8.7
|
59.9
|
|
Not drinking
|
65.5
|
91.3
|
40.1
|
|
Weight status (%)
|
|
|
|
0.01
|
Normal weight (18.5≤BMI<24)
|
36.4
|
36.0
|
36.8
|
|
Underweight (BMI<18.5)
|
2.2
|
2.3
|
2.0
|
|
Overweight (24≤BMI<28)
|
41.0
|
39.1
|
42.8
|
|
Obese (BMI≥28)
|
20.5
|
22.6
|
18.4
|
|
Hypertension was defined as having an average systolic blood pressure BP ≥ 140 mmHg, diastolic blood pressure ≥ 90mmHg, self-reported being previously diagnosed as hypertension by a physician or taking antihypertension drugs currently;
Non-smoker was defined as subjects who responded negatively to “have you ever smoked cigarettes?”; ex-smoker was defined as subjects who responded positively to questions “have you ever smoked cigarettes?” but negatively to “do you still smokes cigarettes?”; current smoker was defined as subjects who responded both positive answers to questions “have you ever smoked cigarettes?” and “do you still smokes cigarettes?”; drinking refers to subject who regularly drink alcohol since last year.
*Single includes never married, divorced, widowed and separated;
†Western China includes Guangxi, Guizhou and Chongqing; Eastern China includes Shanghai, Beijing, Jiangsu, Liaoning and Shandong; Central China includes Henan, Hubei, Henan and Heilongjiang;
**p-value was calculated from t-test for continuous variables and chi-square test for categorical variables.
Table 2. Proportion¶ (%) of hypertension awareness, treatment, and control among Chinese adults with hypertension (HTN) based on CHNS 2011
|
Awareness
(1,993)
|
Treatment
(1,664)
|
Control
(728)
|
HTN
|
Awarenessa
|
HTN
|
Treatedb
|
Age group (years)
|
|
|
|
|
|
18-49
|
36.2
|
25.9
|
71.7
|
12.7
|
49.0
|
50-64
|
58.1**
|
48.6**
|
83.6**
|
22.2**
|
45.7
|
65+
|
64.8**
|
56.8**
|
87.6**
|
22.8**
|
32.9
|
Residence
|
|
|
|
|
|
Rural
|
48.0
|
38.4
|
80.0
|
13.5
|
35.2
|
Urban
|
66.6**
|
58.0**
|
87.0**
|
30.0**
|
51.7**
|
Geographic region†
|
|
|
|
|
|
Central China
|
50.1
|
39.6
|
79.0
|
13.3
|
33.6
|
Western China
|
47.2
|
39.1
|
82.9
|
15.7
|
40.2
|
Eastern China
|
62.6**
|
53.8**
|
85.1**
|
26.6**
|
49.4**
|
Ethnicity
|
|
|
|
|
|
Han
|
56.7
|
47.5
|
83.7
|
21.3
|
44.9
|
Minority
|
44.1**
|
35.0**
|
79.4
|
9.1**
|
26.0‡
|
Marital status*
|
|
|
|
|
|
Unmarried
|
58.9
|
49.8
|
84.5
|
19.6
|
39.5
|
Single
|
55.0
|
45.8
|
83.3
|
20.5
|
44.7
|
Occupational status
|
|
|
|
|
|
Unemployed
|
64.5
|
56.4
|
87.4
|
24.4
|
43.3
|
Employed
|
44.6**
|
34.0**
|
76.3**
|
15.2**
|
44.7
|
Health insurance
|
|
|
|
|
|
Not insured
|
51.3
|
42.0
|
81.8
|
19.3
|
46.0
|
Insured
|
55.9
|
46.7
|
83.6
|
20.4
|
43.7
|
Education
|
|
|
|
|
|
≤ Elementary school
|
54.2
|
45.0
|
82.9
|
16.0
|
35.6
|
Middle school
|
52.9
|
43.8
|
82.9
|
21.2‡
|
48.4**
|
High school
|
60.0§
|
51.6‡
|
86.1
|
27.1**
|
52.5**
|
≥ Collage
|
65.9**
|
54.8‡
|
83.1
|
29.9**
|
54.5**
|
Smoking
|
|
|
|
|
|
Non-smoker
|
58.4
|
50.1
|
85.7
|
21.7
|
43.3
|
Ex-smoker
|
68.4‡
|
55.3
|
80.8
|
28.5§
|
51.6
|
Smoker
|
46.3**
|
36.0**
|
77.8**
|
15.3**
|
42.6
|
Alcohol consumption
|
|
|
|
|
|
Not drinking
|
58.7
|
50.9
|
86.8
|
21.5
|
42.1
|
Drinking
|
50.0**
|
38.1**
|
76.0**
|
18.2§
|
47.9
|
Weight status
|
|
|
|
|
|
Normal weight (BMI<24)
|
50.7
|
40.5
|
79.8
|
20.2
|
50.0
|
Overweight (24≤BMI<28)
|
58.6**
|
49.6**
|
84.8§
|
21.8
|
43.8
|
Obese (BMI≥28)
|
59.4**
|
51.6**
|
83.5‡
|
17.7
|
34.4**
|
¶3,579 adults with hypertension;
Hypertension was defined as having an average systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥ 90 mmHg, self-reported being previously diagnosed as hypertension by a physician or taking antihypertension drugs currently;
Non-smoker was defined as subjects who responded negatively to “have you ever smoked cigarettes?”; ex-smoker was defined as subjects who responded positively to questions “have you ever smoked cigarettes?” but negatively to “do you still smokes cigarettes?”; current smoker was defined as subjects who responded both positive answers to questions “have you ever smoked cigarettes?” and “do you still smokes cigarettes?”; drinking refers to subject who regularly drink alcohol since last year.
Awareness of hypertension was defined as a self-report of hypertension diagnosed by a doctor before, or taking any antihypertensive drugs;
Control of hypertension was defined as blood pressure (SBP/DBP) < 140/90 mmHg;
a Treatment among subjects who were aware of their hypertension;
b Control among participant who took antihypertension medications;
*Single includes never married, divorced, widowed and separated;
†Western China includes Guangxi, Guizhou and Chongqing; Eastern China includes Shanghai, Beijing, Jiangsu, Liaoning and Shandong; Central China includes Henan, Hubei, Henan and Heilongjiang;
- p<0.05, ‡p<0.01, **p<0.001.
Table 3. Comparison of average blood pressure, hypertension prevalence, awareness, treatment and control across China Health and Nutrition Survey (CHNS) 2011, CHNS 2001 and the International Collaborative Study of Cardiovascular Disease in ASIA (InterASIA 2000-2001) among Chinese adults
|
CHNS 2011
|
CHNS 2001(16)
|
InterASiA (2000-2001)(17)
|
Blood pressure‡
|
SBP/DBP
|
SBP/DBP
|
SBP/DBP
|
All subjects
|
143/89
|
N/A
|
149/90
|
Those took treatment
|
143/87
|
N/A
|
148/89
|
Those did not take treatment
|
143/90
|
N/A
|
149/91
|
Hypertension profile (%)
|
|
|
|
Prevalence
|
27.6
|
18.0
|
26.5
|
Awareness
|
55.7
|
24.0
|
43.0
|
Treatment‡
|
46.5
|
20.0
|
29.9
|
Treatment§
|
83.0
|
N/A
|
61.5
|
Control‡
|
20.3
|
4.5
|
7.7
|
Control¶
|
43.8
|
N/A
|
29.1
|
SBP systolic blood pressure, DPB diastolic blood pressure;
‡among subjects with hypertension;
- among subjects who were aware of their hypertension;
¶among subjects who took antihypertensive medications;
Control of hypertension was defined as SBP/DBP < 140/90 mm Hg among subjects receiving pharmacological treatment;
N/A indicated data not specified.
Table 4. Multivariable logistic regression analysis of factors associated with hypertension awareness, treatment and control among Chinese adults with hypertension (n=3,579) in CHNS 2011
|
Awareness
|
Treatment¶
|
Control
|
Control‡
|
Women (vs. men)
|
1.37 (1.12 - 1.66)
|
0.94 (0.65 - 1.34)
|
1.32 (1.04 - 1.68)
|
1.17 (0.88 - 1.57)
|
Age group (years)
|
|
|
|
|
18-49 (ref)
|
|
|
|
|
50-64
|
2.34 (1.92 - 2.85)
|
1.87 (1.32 - 2.65)
|
1.87 (1.43 - 2.44)
|
1.33 (0.92 - 1.92)
|
65+
|
3.13 (2.45 - 3.99)
|
2.57 (1.65 - 4.02)
|
1.84 (1.34 - 2.52)
|
1.06 (0.70 - 1.62)
|
Residence
|
|
|
|
|
Urban (vs. rural)
|
1.75 (1.50 - 2.04)
|
1.50 (1.14 - 1.97)
|
2.16 (1.79 - 2.60)
|
1.79 (1.43 - 2.24)
|
Geographic region†
|
|
|
|
|
Central (ref)
|
|
|
|
|
Western
|
0.92 (0.75 - 1.12)
|
1.35 (0.93 - 1.96)
|
1.33 (1.01 - 1.75)
|
1.33 (0.95 - 1.88)
|
Eastern
|
1.50 (1.27 - 1.77)
|
1.52 (1.14 - 2.01)
|
2.12 (1.72 - 2.63)
|
1.78 (1.37 - 2.31)
|
Ethnicity (vs. Han)
|
|
|
|
|
Minority
|
0.74 (0.57 - 0.96)
|
0.78 (0.49 - 1.26)
|
0.47 (0.31 - 0.73)
|
0.52 (0.31 - 0.86)
|
Occupational status (vs. unemployed)
|
|
|
|
|
Employed
|
0.78 (0.66 - 0.93)
|
0.74 (0.54 - 1.00)
|
0.92 (0.74 - 1.15)
|
0.96 (0.72 - 1.26)
|
Marital status* (vs. single)
|
|
|
|
|
Married
|
1.09 (0.89 - 1.34)
|
1.27 (0.89 - 1.83)
|
1.11 (0.87 - 1.43)
|
1.16 (0.86 - 1.57)
|
Health insurance (vs. not insured)
|
|
|
|
|
Insured
|
1.32 (0.93 - 1.87)
|
1.44 (0.77 - 2.68)
|
1.08 (0.70 - 1.66)
|
0.90 (0.52 - 1.55)
|
Weight status
|
|
|
|
|
Normal weight ((BMI<24) (ref)
|
|
|
|
|
Overweight (24≤BMI<28)
|
1.41 (1.20 - 1.66)
|
1.52 (1.15 - 2.01)
|
0.96 (0.79 - 1.16)
|
0.83 (0.65 - 1.05)
|
Obese (BMI≥28)
|
1.57 (1.29 - 1.92)
|
1.99 (1.39 - 2.84)
|
0.77 (0.60 - 0.98)
|
0.56 (0.42 - 0.76)
|
Education
|
|
|
|
|
≤ Elementary school (ref)
|
|
|
|
|
Middle school
|
1.11 (0.92 - 1.33)
|
1.08 (0.78 - 1.50)
|
1.39 (1.11 - 1.74)
|
1.57 (1.20 - 2.06)
|
High school
|
1.34 (1.07 - 1.67)
|
1.42 (0.97 - 2.08)
|
1.65 (1.28 - 2.12)
|
1.53 (1.13 - 2.07)
|
≥ College
|
1.69 (1.23 - 2.32)
|
1.04 (0.64 - 1.71)
|
1.77 (1.26 - 2.48)
|
1.80 (1.20 - 2.70)
|
Smoking status
|
|
|
|
|
Non-smoker (ref)
|
|
|
|
|
Ex-smoker
|
1.62 (1.16 - 2.24)
|
0.75 (0.46 - 1.23)
|
1.47 (1.04 - 2.09)
|
1.23 (0.80 - 1.88)
|
Smoker
|
0.86 (0.70 - 1.04)
|
0.83 (0.59 - 1.18)
|
0.81 (0.63 - 1.05)
|
0.83 (0.61 - 1.14)
|
Alcohol consumption
|
|
|
|
|
Drinking
(vs. not drinking)
|
0.95 (0.79 - 1.13)
|
0.53 (0.39 - 0.72)
|
0.96 (0.77 - 1.19)
|
1.03 (0.78 - 1.35)
|
¶Treatment among subjects who were aware of their hypertension;
‡control among participant who took antihypertension medications;
Hypertension was defined as having an average systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90mmHg, self-reported being previously diagnosed as hypertension by a physician or taking antihypertension drugs currently;
Non-smoker was defined as subjects who responded negatively to “have you ever smoked cigarettes?”; ex-smoker was defined as subjects who responded positively to questions “have you ever smoked cigarettes?” but negatively to “do you still smokes cigarettes?”; current smoker was defined as subjects who responded both positive answers to questions “have you ever smoked cigarettes?” and “do you still smokes cigarettes?”; drinking refers to subject who regularly drink alcohol since last year.
Awareness of hypertension was defined as a self-report of hypertension diagnosed by a Physician before, or taking any antihypertensive drugs;
Control of hypertension was defined as blood pressure (SBP/DBP) < 140/90 mmHg;
*Single includes never married, divorced, widowed and separated;
†Western China includes Guangxi, Guizhou and Chongqing; Eastern China includes Shanghai, Beijing, Jiangsu, Liaoning and Shandong; Central China includes Henan, Hubei, Henan and Heilongjiang.