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(Circulation. 2008;118:2679-2686.)
© 2008 American Heart Association, Inc.

Heart Disease in Asia

Prevalence, Awareness, Treatment, and Control of Hypertension in China

Data from the China National Nutrition and Health Survey 2002

Yangfeng Wu, PhD; Rachel Huxley, DPhil; Liming Li, MD; Vibeke Anna, MIPH; Gaoqiang Xie, PhD; Chonghua Yao, MD; Mark Woodward, PhD; Xian Li, MSc; John Chalmers, PhD; Runlin Gao, MD; Lingzhi Kong, MD; Xiaoguang Yang, PhD, for the China NNHS Steering Committee and the China NNHS Working Group

From the Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, China (Y.W., L.L.); George Institute for International Health, University of Sydney, Sydney, Australia (R.H., V.A., M.W., J.C.); Department of Epidemiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (G.X., X.L., R.G.); Department of Community Health, Beijing Anzhen Hospital and Heart, Lung, and Blood Vessel Institute, Capital Medical University, Beijing, China (C.Y.); Mount Sinai Medical School, New York, NY (M.W.); Department of Disease Prevention and Control, Ministry of Health, Beijing, China (L.K.); and National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China (X.Y.).

Reprint requests to Xiaoguang Yang, PhD, National Institute of Nutrition and Food Safety, Chinese Centre for Disease Control and Prevention, No. 29 Nanweilu, Xuanwu District, Beijing 100050, China. E-mail xgyangcdc{at}vip.sina.com

Background— The present article aims to provide accurate estimates of the prevalence, awareness, treatment, and control of hypertension in adults in China.

Methods and Results— Data were obtained from sphygmomanometer measurements and an administered questionnaire from 141 892 Chinese adults 18 years of age who participated in the 2002 China National Nutrition and Health Survey. In 2002, 153 million Chinese adults were hypertensive. The prevalence was higher among men than women (20% versus 17%; P<0.001) and was higher in successive age groups. Overall, the prevalence of hypertension was higher in urban compared with rural areas in men (23% versus 18%; P<0.01) and women (18% versus 16%; P<0.001). Of the 24% affected individuals who were aware of their condition, 78% were treated and 19% were adequately controlled. Despite evidence to suggest improved levels of treatment in individuals with hypertension over the past decade, compared with estimates from 1991, the ratio of controlled to treated hypertension has remained largely unchanged at 1:4.

Conclusions— One in 6 Chinese adults is hypertensive, but only one quarter are aware of their condition. Despite increased rates of blood pressure–lowering treatment, few have their hypertension effectively controlled. National hypertension programs must focus on improving awareness in the wider community, as well as treatment and control, to prevent many tens of thousands of cardiovascular-related deaths.

Key Words: awareness • China • hypertension • prevalence • prevention and control • therapeutics