Current status of hypertension prevalence, treatment and control rate among young and middle-aged population in China / 中华心血管病杂志

Objective: To estimate the prevalence, awareness, treatment and control rate of hypertension among young and middle-aged population in China. Methods: The analysis was based on the results of 2012-2015 China Hypertension Survey, which was a cross-sectional stratified multistage random sampling survey. A total of 229 593 subjects were included in the final analysis. The data including sex, age, living in urban and rural areas, prevalence of hypertension, history of stroke, family history of coronary heart disease and drinking, physical examination, heart rate were collected. Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mmHg (1 mmHg=0.133 kPa), and (or) diastolic blood pressure (DBP) ≥90 mmHg, and (or) self-report a history of hypertension, and (or) use of antihypertensive medicine within 2 weeks before survey. Prehypertension was defined as SBP between 120-139 mmHg, and (or) DBP between 80-89 mmHg. Control of hypertension was considered for hypertensive individuals with SBP<140 mmHg and DBP<90 mmHg. The prevalence of prehypertension, hypertension, awareness, treatment, control rate were calculated, and the control rate among those with antihypertensive medication was also calculated. Results: The prevalence of prehypertension and hypertension was 43.8% (95%CI: 42.3%-45.4%), and 22.1% (95%CI: 20.8%-23.3%), respectively. The prevalence of prehypertension and hypertension was significantly higher among male than female across different age groups. The awareness, treatment, control rate of hypertension and control rate among treated hypertensive participants were 43.8%, 33.2%, 16.7%, and 40.2%, respectively. The prevalence was higher, and the control rate was lower among individuals with higher heart rate. Conclusion: The prevalence of prehypertension and hypertension among young and middle-aged population is high, the awareness, treatment and control rate need to be further improved in this population. The prevention and treatment of hypertension should be strengthened in the future to improve the control rate of hypertension in China.

Prevalence of Ideal Cardiovascular Health Status and Its Association With Socioeconomic Status in Chinese Enterprise Employees / 中国循环杂志

Objectives: To investigate the prevalence of ideal cardiovascular health behaviors and factors, and its association with socioeconomic status (SES) in enterprise employees. Methods: The cluster sampling method was adopted to recruit 27 607 employees aged 18 to 60 years from 45 enterprises across China. The ideal cardiovascular health metrics including behaviors and factors, which were defined according to the AHA criteria, were obtained, and SES was measured by education and occupational class. Multilevel logistic regression models were used to analyze the association between SES and ideal cardiovascular health metrics. Results: Overall, the prevalence of ideal cardiovascular health behavior (smoking, body mass index, salt intake, physical activity) was 51.3%, 67.9%, 14.0%, 31.2%, respectively; prevalence of the ideal cardiovascular factors (fasting blood glucose, total cholesterol, blood pressure) was 72.9%, 81.6%, 27.3%,respectively in this cohort. Among the employees, only 0.6% population met all 7 cardiovascular health metrics. After adjusting the individual and workplace factors, employees with high school (OR=1.18, 95%CI: 1.08-1.29) and college or above education (OR=1.52, 95%CI: 1.37-1.69) were more likely to have ideal cardiovascular health status compared with those with less education; white-collar workers were more likely to have ideal cardiovascular health status compared with blue-collar workers (OR=1.18; 95%CI: 1.08-1.29). Conclusions: The prevalence of ideal cardiovascular health behaviors and factors is low, and is positively associated with SES, suggesting the importance of promoting the cardiovascular health behavior, monitoring/controlling the related cardiovascular factors and reducing the socioeconomic inequalities among Chinese enterprise employees.

The current situation of blood pressure control and the influencing factors on hypertensive patients in residential communities of China / 中华流行病学杂志

Objective To understand the situation of blood pressure control and the major factors influencing the programs among those hypertensive patients living in the communities from different parts of China.Methods A protocol of community-based standardized blood pressure management was developed based on the current Chinese guideline for prevention,treatment of hypertension.Grass-roots caretakers from community health service centers across China were trained under the requirement of this protocol to manage the hypertensive patients.In this study,the hypertensive patients who had been registered in the project centers from Beijing,Hebei,Gansu,Jiangsu,Zhejiang,Guangdong provinces,were selected as the study subjects,and the baseline data for these patients was analyzed.Results By the end of 2010,a total of 242 182 patients were registered.The mean age was 61.0 ± 10.5,with 48.5％ of them being males.The overall control rate of blood pressure was 27.4％.The control rate was significant lower among patients who were in lower age group,being male,with higher BMI,smoking,drinking or with more salt consumption.However,the control rate was significant higher among those patients who had family history of hypertension,always undertook physical exercise or receiving medical treatment.Conclusion The blood pressure control rate for community hypertensive patients in China was still in a relatively low level.Standardization management measures should be strengthened so as to improve the rate of control on high blood pressure.

Outline of the report on cardiovascular disease in China, 2010 / 生物医学与环境科学（英文）

Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens.

Association between chronic kidney disease and cardiovascular events in middle-to-old-aged Chinese population / 中华流行病学杂志

Objective This study aimed to determine the relationships between estimated glomerular filtration rate (eGFR) and cardiovascular events. Methods 2500 residents aged more than 40 years old were selected from Shougang community, Shijingshan district, in Beijing. 2315 of them took part in the survey. First morning urinary sample was collected for all the participants.Albumin and creatinine were measured and eGFR was calculated using simplified MDAD formula.Cardiovascular risk factors were also investigated. The participants were followed up for 4 years, and all-cause mortality and cardiovascular events were collected. The subjects were divided into three groups according to eGFR[ml/(min·1.73 m2)]: ＜60, 60-90,＞90.Cox regression model was used to analyze the relationships between eGFR, all events, and cardiovascular events after adjusting for confounders. Results The prevalence of eGFR ＜60 was 3.3%. The incidence rates of cardiovascular events were 43.9, 21.8 and 11.5/1000 person-years among three groups, and the incidence rates of all events (all-cause mortality and cardiovascular events) were 53.7, 28.8 and 14.6/1000 person-years,respectively. After adjusting for age, gender, smoking, body mass index, serum lipids, diabetes mellitus, cardiovascular disease, the hazard risk (HR) for cardiovascular events was 1.29 (95%CI:0.85-1.96) in eGFR＜60 group and 2.14 (95% CI: 1.02-4.50) in 60≤eGFR＜90 group, when compared with the eGFR＞90 group; the HR for all events were 1.25 (95%CI: 0.86-1.81 ) and 1.95(95% CI: 1.00-3.80) , respectively. Conclusion In the population studied, eGFR＜60 seemed an independent predictor for cardiovascular events and all-cause events.

Hypertension Control in Communities (HCC): evaluation result of blood pressure management among hypertensive / 中华流行病学杂志

Objective To determine the effects related to community-based standardized blood pressure management programs on the control of hypertension. Methods A protocol of community-based standardized blood pressure management was developed based on the current Chinese guideline for prevention, treatment of hypertension. Grass-roots caretakers from community health service centers across China were trained using this protocol and required to manage hypertensive patients according to the protocol. Patients were treated on therapeutic life style change or/and medication, and followed up based on the criteria of risk stratification. The control rate of hypertension was evaluated after 1 year. Effect of intervention (EI) was estimated as '1 year rate (mean)' minus the number showed at the baseline. Results By the end of 2008, a total of 29 411 hypertensive patients (47.2% for male, mean age 61.4+10.9 years) with full information had been under management for one year according to the protocol. Among all patients, 8.9% were classified as under low risk, 50.8% as moderate risk and 40.3% as high and very high risk showed in baseline data. After standardized management, the EI of smoking, drinking and systolic/diastolic blood pressure were -7.1% (P<0.05) , -7.3% (P<0.05) , and-14.8/-8.3 mm Hg (P<0.05) , respectively. However, EI of overweight/obesity was 0.3% (P>0.05). For all patients, the control rate rose to 74.7%,with EI as 53.1%, and all of the sub-groups, including age, risk stratification, had significant increases. The longer the management was under, the higher the control rate was seen. Results from the multivariate logistic regression showed that older age, male and having higher blood level were adverse factors for the undertaking the control and management programs of hypertension. Conclusion Results from our study showed that standardized management could significantly improve the program on the control of hypertension at the community level, in China.