Trends in hypertension prevalence, awareness, treatment and control rates among Chinese adults, 1991-2015

Objective: The upward trends in the prevalence and control of hypertension in Chinese adults have been described, but recent trends based on the most recent guidelines are unavailable. We examined recent trends in the prevalence, awareness, treatment and control of hypertension among Chinese adults from 1991 to 2015 based on the 2018 Chinese Guideline.

Methods: A total of 72 452 adults aged 20-79 years from the China Health and Nutrition Survey conducted between 1991 and 2015 were included in the study. Hypertension status and control rate were defined according to the 2018 Chinese Guideline. Age-standardized estimates were calculated based on the age distribution of the WHO standard population.

Results: From 1991 to 2015, the crude/age-standardized hypertension prevalence (14.0/15.3 to 34.1/25.6%), awareness (29.4/24.2 to 43.8/27.2%), treatment (19.2/15.1 to 39.2/23.6%) and control rates (3.5/3.6 to 13.8/8.4%) increased (all P for trend <0.001). The prevalence of hypertension increased at a greater rate in rural regions compared with that in urban regions, whereas the control rate was higher in urban regions than that in rural regions. Compared with middle-aged and older adults aged 40-79 years, young adults aged 20-39 years had a larger increase in the prevalence of hypertension, but the awareness, treatment and control rates in the young adults did not increase.

Conclusion: The prevalence of hypertension has increased markedly over the past two decades among Chinese adults, and the awareness, treatment and control rates have increased slightly or moderately and they have remained very low. These data underscore the need for effective measures to prevent hypertension and to increase the control of hypertension in Chinese adults.