Hypertension in China
Time to Transition From Knowing the Problem to Implementing the Solution
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Article, see p 2344
The Global Burden of Disease Study estimated that increased blood pressure was the world’s leading risk for death, contributing to >10 million deaths in 2016.1 Hypertension is very common, with 40% of those >25 years of age having high blood pressure, representing ≈1.4 billion people worldwide.2 Almost half of those with hypertension are unaware, and although many of those who are aware are treated with antihypertensive drugs, most do not have their blood pressure lowered to recommended targets.3
How does China, the most populous nation in the world, fare? Wang et al4 report in this issue of Circulation results from a large population blood pressure survey providing up-to-date data for China. The survey methods included stratified multistage random sampling to provide data representative of the Chinese population >15 years of age and the assessment of blood pressure using a standardized technique with a validated electronic manometer. Specifically, the survey was designed to examine blood pressure in 14 age-sex groups, in rural and urban settings, and in all 31 provinces of China. The survey methodology and the overall response rate of 66.4% are similar to those of other high-quality population blood pressure surveys. The survey data largely reflect global data in many regards, but in such a large population, the numbers are staggering4: Almost 250 million people have hypertension, >125 million are unaware, close to 150 million are not on antihypertensive drug therapy (59.3%), and “only” 37 million (15.3%) are controlled.4 Just over 435 million (40%) adult Chinese had prehypertension. Minority ethnic populations had lower rates of awareness (36.9% versus 48.0%), treatment (29.5% versus 42.0%), and control (8.4% versus 16.1%) compared with urban populations of Han ethnicity.4
Recently, the American College of Cardiology/American Heart Association …