Current epidemiology and trend of hypertension in Chinese adult_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LUO Yunmei , ZENG Zhi , HE Wenbo ,  ZHANG Wei

Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

ZHANG Wei, Email: weizhanghx@163.com

Keywords：

Hypertension; prevalence; incidence; review

DOI：

10.7507/1007-4848.202310058

Video：

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Hypertension and its associated cardiovascular diseases such as stroke and ischemic heart disease result in a high burden of disease and health losses, making it the most burdensome disease in the world and one of the important public health issues in China. Currently Chinese scholars have carried out a large number of studies on the prevalence of hypertension, including regional and national prevalence studies. However, long-term follow-up studies on incidence of hypertension are relatively few and mostly limited to specific ages and regions. This paper summarizes the prevalence, incidence and epidemiological trend of hypertension in Chinese adults. The hypertension prevalence increased from 5.1% in 1959 to 27.5% in 2018, and presents an overall trend of high in the north and low in the south. The hypertension incidence is at a high level (the cumulative incidence was 33.4% after 22 years-follow-up), but there are few researches on the trend of hypertension incidence in huge region.

Citation： LUO Yunmei, ZENG Zhi, HE Wenbo, ZHANG Wei. Current epidemiology and trend of hypertension in Chinese adult. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(6): 922-928. doi: 10.7507/1007-4848.202310058 Copy

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13.	Tao S, Wu X, Duan X, et al. Hypertension prevalence and status of awareness, treatment and control in China. Chin Med J (Engl), 1995, 108(7): 483-489.
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17.	Li W, Gu H, Teo KK, et al. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens, 2016, 34(1): 39-46.
18.	Wang W, Zhang M, Xu CD, et al. Hypertension prevalence, awareness, treatment, and control and their associated socioeconomic factors in China: A spatial analysis of a national representative survey. Biomed Environ Sci, 2021, 34(12): 937-951.
19.	Li Y, Teng D, Shi X, et al. Changes in the prevalence of obesity and hypertension and demographic risk factor profiles in China over 10 years: Two national cross-sectional surveys. Lancet Reg Health West Pac, 2021, 15: 100227.
20.	Ma Z, Hummel SL, Sun N, et al. From salt to hypertension, what is missed? J Clin Hypertens (Greenwich), 2021, 23(12): 2033-2041.
21.	Li Z, Cao L, Zhou Z, et al. Factors influencing the progression from prehypertension to hypertension among Chinese middle-aged and older adults: A 2-year longitudinal study. BMC Public Health, 2023, 23(1): 339.
22.	孙丽艳. 寒冷暴露与高血压的关系. 中华地方病学杂志, 2015, 34(8): 621-624.
23.	房玥晖, 何宇纳, 白国银, 等. 2012年中国20~79岁男性饮酒现状分析. 中华流行病学杂志, 2018, 39(3): 280-285.
24.	Chen K, Shen Z, Gu W, et al. Prevalence of obesity and associated complications in China: A cross-sectional, real-world study in 15.8 million adults. Diabetes Obes Metab, 2023, 25(11): 3390-3399.
25.	于冬梅, 何宇纳, 房红芸, 等. 2010-2012年中国成年居民食盐摄入状况. 中华预防医学杂志, 2016, 50(3): 217-220.
26.	Wang M, Luo X, Xu S, et al. Trends in smoking prevalence and implication for chronic diseases in China: Serial national cross-sectional surveys from 2003 to 2013. Lancet Respir Med, 2019, 7(1): 35-45.
27.	Millwood IY, Walters RG, Mei XW, et al. Conventional and genetic evidence on alcohol and vascular disease aetiology: A prospective study of 500 000 men and women in China. Lancet, 2019, 393(10183): 1831-1842.
28.	Mills KT, Bundy JD, Kelly TN, et al. Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation, 2016, 134(6): 441-450.
29.	NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet, 2021, 398(10304): 957-980.
30.	Egan BM, Stevens-Fabry S. Prehypertensio—Revalence, health risks, and management strategies. Nat Rev Cardiol, 2015, 12(5): 289-300.
31.	Guo J, Zhu YC, Chen YP, et al. The dynamics of hypertension prevalence, awareness, treatment, control and associated factors in Chinese adults: Results from CHNS 1991-2011. J Hypertens, 2015, 33(8): 1688-1696.
32.	Wu X, Liang D, Sun J, et al. Association between sex-specific serum gamma-glutamyltransferase and incidence of hypertension in a Chinese population without metabolic syndrome: A prospective observational study. Front Cardiovasc Med, 2021, 8: 644044.
33.	Dorjgochoo T, Shu XO, Zhang X, et al. Relation of blood pressure components and categories and all-cause, stroke and coronary heart disease mortality in urban Chinese women: A population-based prospective study. J Hypertens, 2009, 27(3): 468-475.
34.	Cai C, Liu F C, Li JX, et al. Effects of the total physical activity and its changes on incidence, progression, and remission of hypertension. J Geriatr Cardiol, 2021, 18(3): 175-184.
35.	Liu Q, Huang K, Liang F, et al. Long-term exposure to fine particulate matter modifies the association between physical activity and hypertension incidence. J Sport Health Sci, 2022, 11(6): 708-715.
36.	Yao F, Liu W, Zhao R, et al. BMI modified the association of current smoking with the incidence of hypertension in Chinese population: A 22-year cohort study. BMC Public Health, 2020, 20(1): 295.
37.	韩雪玉, 齐玥, 赵冬, 等. 中国人群长期血压变化与心血管病发病风险关系的前瞻性队列研究. 中华心血管病杂志, 2018, 46(9): 695-670.
38.	Lu YK, Dong J, Sun Y, et al. Gender-specific predictive ability for the risk of hypertension incidence related to baseline level or trajectories of adiposity indices: A cohort study of functional community. Int J Obes (Lond), 2022, 46(5): 1036-1043.
39.	Liao CT, Wu PC, Shih JC, et al. Higher hypertension prevalence, lower incidence, and aggressive treatment with decreasing mortality, cardiovascular, and cerebrovascular incidence in Taiwan from 2005 to 2010: A 2 population-based cohorts study. Medicine (Baltimore), 2020, 99(39): e22437.

1. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1204-1222.
2. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1223-1249.
3. GBD 2019 Risk Factors Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: A comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1160-1203.
4. Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
5. Nambiar L, LeWinter MM, VanBuren PC, et al. Decade-long temporal trends in U. S. hypertension-related cardiovascular mortality. J Am Coll Cardiol, 2020, 75(20): 2644-2646.
6. 李立明, 饶克勤, 孔灵芝, 等. 中国居民2002年营养与健康状况调查. 中华流行病学杂志, 2005, 26(7): 478-484.
7. 赵丽云, 于冬梅, 付萍, 等. 2010—2012年中国18岁及以上成人高血压患病率—基于汞柱式和转换电子血压值. 卫生研究, 2018, 47(1): 7-12.
8. Wang Z, Chen Z, Zhang L, et al. Status of hypertension in China: Results from the China hypertension survey, 2012-2015. Circulation, 2018, 137(22): 2344-2356.
9. 张梅, 吴静, 张笑, 等. 2018年中国成年居民高血压患病与控制状况研究. 中华流行病学杂志, 2021, 42(10): 1780-1789.
10. Li Y, Yang L, Wang L, et al. Burden of hypertension in China: A nationally representative survey of 174, 621 adults. Int J Cardiol, 2017, 227: 516-523.
11. Lu J, Lu Y, Wang X, et al. Prevalence, awareness, treatment, and control of hypertension in China: Data from 1.7 million adults in a population-based screening study (China PEACE Million Persons Project). Lancet, 2017, 390(10112): 2549-2558.
12. Campbell NRC, Zhang XH. Hypertension in China: Time to transition from knowing the problem to implementing the solution. Circulation, 2018, 137(22): 2357-2359.
13. Tao S, Wu X, Duan X, et al. Hypertension prevalence and status of awareness, treatment and control in China. Chin Med J (Engl), 1995, 108(7): 483-489.
14. Gu D, Chen J, Wu X, et al. Prehypertension and risk of cardiovascular disease in Chinese adults. J Hypertens, 2009, 27(4): 721-729.
15. Gu D, Reynolds K, Wu X, et al. Prevalence, awareness, treatment, and control of hypertension in china. Hypertension, 2002, 40(6): 920-927.
16. Wu Y, Huxley R, Li L, et al. Prevalence, awareness, treatment, and control of hypertension in China: Data from the China National Nutrition and Health Survey 2002. Circulation, 2008, 118(25): 2679-2686.
17. Li W, Gu H, Teo KK, et al. Hypertension prevalence, awareness, treatment, and control in 115 rural and urban communities involving 47 000 people from China. J Hypertens, 2016, 34(1): 39-46.
18. Wang W, Zhang M, Xu CD, et al. Hypertension prevalence, awareness, treatment, and control and their associated socioeconomic factors in China: A spatial analysis of a national representative survey. Biomed Environ Sci, 2021, 34(12): 937-951.
19. Li Y, Teng D, Shi X, et al. Changes in the prevalence of obesity and hypertension and demographic risk factor profiles in China over 10 years: Two national cross-sectional surveys. Lancet Reg Health West Pac, 2021, 15: 100227.
20. Ma Z, Hummel SL, Sun N, et al. From salt to hypertension, what is missed? J Clin Hypertens (Greenwich), 2021, 23(12): 2033-2041.
21. Li Z, Cao L, Zhou Z, et al. Factors influencing the progression from prehypertension to hypertension among Chinese middle-aged and older adults: A 2-year longitudinal study. BMC Public Health, 2023, 23(1): 339.
22. 孙丽艳. 寒冷暴露与高血压的关系. 中华地方病学杂志, 2015, 34(8): 621-624.
23. 房玥晖, 何宇纳, 白国银, 等. 2012年中国20~79岁男性饮酒现状分析. 中华流行病学杂志, 2018, 39(3): 280-285.
24. Chen K, Shen Z, Gu W, et al. Prevalence of obesity and associated complications in China: A cross-sectional, real-world study in 15.8 million adults. Diabetes Obes Metab, 2023, 25(11): 3390-3399.
25. 于冬梅, 何宇纳, 房红芸, 等. 2010-2012年中国成年居民食盐摄入状况. 中华预防医学杂志, 2016, 50(3): 217-220.
26. Wang M, Luo X, Xu S, et al. Trends in smoking prevalence and implication for chronic diseases in China: Serial national cross-sectional surveys from 2003 to 2013. Lancet Respir Med, 2019, 7(1): 35-45.
27. Millwood IY, Walters RG, Mei XW, et al. Conventional and genetic evidence on alcohol and vascular disease aetiology: A prospective study of 500 000 men and women in China. Lancet, 2019, 393(10183): 1831-1842.
28. Mills KT, Bundy JD, Kelly TN, et al. Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation, 2016, 134(6): 441-450.
29. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet, 2021, 398(10304): 957-980.
30. Egan BM, Stevens-Fabry S. Prehypertensio—Revalence, health risks, and management strategies. Nat Rev Cardiol, 2015, 12(5): 289-300.
31. Guo J, Zhu YC, Chen YP, et al. The dynamics of hypertension prevalence, awareness, treatment, control and associated factors in Chinese adults: Results from CHNS 1991-2011. J Hypertens, 2015, 33(8): 1688-1696.
32. Wu X, Liang D, Sun J, et al. Association between sex-specific serum gamma-glutamyltransferase and incidence of hypertension in a Chinese population without metabolic syndrome: A prospective observational study. Front Cardiovasc Med, 2021, 8: 644044.
33. Dorjgochoo T, Shu XO, Zhang X, et al. Relation of blood pressure components and categories and all-cause, stroke and coronary heart disease mortality in urban Chinese women: A population-based prospective study. J Hypertens, 2009, 27(3): 468-475.
34. Cai C, Liu F C, Li JX, et al. Effects of the total physical activity and its changes on incidence, progression, and remission of hypertension. J Geriatr Cardiol, 2021, 18(3): 175-184.
35. Liu Q, Huang K, Liang F, et al. Long-term exposure to fine particulate matter modifies the association between physical activity and hypertension incidence. J Sport Health Sci, 2022, 11(6): 708-715.
36. Yao F, Liu W, Zhao R, et al. BMI modified the association of current smoking with the incidence of hypertension in Chinese population: A 22-year cohort study. BMC Public Health, 2020, 20(1): 295.
37. 韩雪玉, 齐玥, 赵冬, 等. 中国人群长期血压变化与心血管病发病风险关系的前瞻性队列研究. 中华心血管病杂志, 2018, 46(9): 695-670.
38. Lu YK, Dong J, Sun Y, et al. Gender-specific predictive ability for the risk of hypertension incidence related to baseline level or trajectories of adiposity indices: A cohort study of functional community. Int J Obes (Lond), 2022, 46(5): 1036-1043.
39. Liao CT, Wu PC, Shih JC, et al. Higher hypertension prevalence, lower incidence, and aggressive treatment with decreasing mortality, cardiovascular, and cerebrovascular incidence in Taiwan from 2005 to 2010: A 2 population-based cohorts study. Medicine (Baltimore), 2020, 99(39): e22437.

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