Factors associated with prevalence, awareness, treatment and control of hypertension in urban adults from 33 communities in China: the CHPSNE Study

Using a randomized multistage cluster sampling, we studied the factors associated with the prevalence, awareness, treatment and control of hypertension (defined as systolic and diastolic blood pressure (BP) measurements >= 140 and 90 mm Hg, respectively, or current drug treatment for hypertension) in a representative sample of the urban Chinese population. The participants were 18-74 years of age and had lived for at least 5 years in an area comprising 33 communities in three cities (Shenyang, Anshan and Jinzhou) in China. A total of 28 830 people were selected; the overall response rate was 87.4% (25 196/28 830). The overall prevalence of hypertension was 28.7% (7237/25 196). Of those with hypertension, 42.9% (3107/7237) were aware of their condition, 28.2% (2042/7237) were receiving treatment and 3.7% (264/7237) were considered controlled. More than half (57.8%) of the hypertensives did not think that high BP would endanger their lives. Multivariate analysis revealed that age, gender, education, occupation, income, body mass index, waist circumference and a family history of hypertension correlated significantly with the prevalence of hypertension. Among all the hypertensives, higher awareness (determined by odds ratios; 95% confidence intervals) was noted for persons who were white-collar workers (1.29; 1.08, 1.53, respectively), overweight (1.48; 1.30, 1.69), obese (3.37; 2.76, 4.11) or had a family history of hypertension (3.07; 2.76, 3.42). Among the individuals aware of their hypertension, treatment was more common in those with a higher level of education and less common among individuals consuming >= 2 alcoholic drinks per day (0.65; 0.52, 0.83). Controlled hypertension was much less common among older persons, and participants who were former smokers (0.49; 0.26, 0.91). The results indicate that more attention is needed to improve the awareness of the potentially fatal nature of hypertension in urban China. Hypertension Research (2011) 34, 1087-1092; doi:10.1038/hr.2011.99; published online 21 July 2011