The Burden of Hypertension and Associated Risk for Cardiovascular Mortality in China
Sarah Lewington,Ben Lacey,Robert Clarke,Yu Guo,Xiang Ling Kong,Ling Yang,Yiping Chen,Zheng Bian,Junshi Chen,Jinhuai Meng,Youping Xiong,Tianyou He,Zengchang Pang,Shuo Zhang,Rory Collins,Richard Peto,Liming Li,Zhengming Chen +17 more
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TLDR
The levels of diagnosis, treatment, and control of hypertension in this national cohort population in China were much lower than in Western populations, and were associated with significant excess mortality.Abstract:
Importance Hypertension is a leading cause of premature death in China, but limited evidence is available on the prevalence and management of hypertension and its effect on mortality from cardiovascular disease (CVD). Objectives To examine the prevalence, diagnosis, treatment, and control of hypertension and to assess the CVD mortality attributable to hypertension in China. Design, Setting and Participants This prospective cohort study (China Kadoorie Biobank Study) recruited 500 223 adults, aged 35 to 74 years, from the general population in China. Blood pressure (BP) measurements were recorded as part of the baseline survey from June 25, 2004, to August 5, 2009, and 7028 deaths due to CVD were recorded before January 1, 2014 (mean duration of follow-up: 7.2 years). Data were analyzed from June 9, 2014, to July 17, 2015. Exposures Prevalence and diagnosis of hypertension (systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or receiving treatment for hypertension) and treatment and control rates overall and in various population subgroups. Main Outcomes and Measures Cox regression analysis yielded age- and sex-specific rate ratios for deaths due to CVD comparing participants with and without uncontrolled hypertension, which were used to estimate the number of CVD deaths attributable to hypertension. Results The cohort included 205 167 men (41.0%) and 295 056 women (59.0%) with a mean (SD) age of 52 (10) years for both sexes. Overall, 32.5% of participants had hypertension; the prevalence increased with age (from 12.6% at 35-39 years of age to 58.4% at 70-74 years of age) and varied substantially by region (range, 22.7%-40.7%). Of those with hypertension, 30.5% had received a diagnosis from a physician; of those with a diagnosis of hypertension, 46.4% were being treated; and of those treated, 29.6% had their hypertension controlled (ie, systolic BP Conclusions and Relevance About one-third of Chinese adults in this national cohort population had hypertension. The levels of diagnosis, treatment, and control were much lower than in Western populations, and were associated with significant excess mortality.read more
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Prevalence, awareness, treatment, and control of hypertension in China: data from 1·7 million adults in a population-based screening study (China PEACE Million Persons Project)
Jiapeng Lu,Yuan Lu,Xiaochen Wang,Xinyue Li,George C. Linderman,Chaoqun Wu,Xiuyuan Cheng,Lin Mu,Haibo Zhang,Jiamin Liu,Meng Su,Hongyu Zhao,Erica S. Spatz,John A. Spertus,Frederick A. Masoudi,Harlan M. Krumholz,Lixin Jiang +16 more
TL;DR: A study of the prevalence, awareness, treatment, and control of hypertension in China and assessed their variations across many subpopulations, finding that among Chinese adults aged 35-75 years, nearly half have hypertension, fewer than a third are being treated, and fewer than one in twelve are in control of their blood pressure.
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Epidemiology of cardiovascular disease in China: current features and implications.
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2018 Chinese Guidelines for Prevention and Treatment of Hypertension—A report of the Revision Committee of Chinese Guidelines for Prevention and Treatment of Hypertension
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TL;DR: In this paper, the appropriate target for systolic blood pressure to reduce cardiovascular risk in older patients with hypertension remains unclear, and a multicenter, randomized, co-occurrence study is presented.
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TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex, using the Cause of Death Ensemble model.
Journal ArticleDOI
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.
TL;DR: Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.
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Global burden of hypertension: analysis of worldwide data
Patricia M. Kearney,Patricia M. Kearney,Megan Whelton,Kristi Reynolds,Paul Muntner,Paul K. Whelton,Jiang He +6 more
TL;DR: The overall prevalence and absolute burden of hypertension in 2000 and the global burden in 2025 were estimated to be about 1.56 billion (1.54-1.58 billion) and the number of adults with hypertension in 2025 was predicted to increase by about 60% respectively.
Journal ArticleDOI
A Randomized Trial of Intensive versus Standard Blood-Pressure Control
Jackson T. Wright,Jeff D. Williamson,Paul K. Whelton,Joni K. Snyder,Kaycee M. Sink,Michael V. Rocco,David M. Reboussin,Mahboob Rahman,Mahboob Rahman,Suzanne Oparil,Cora E. Lewis,Paul L. Kimmel,Karen C. Johnson,David C. Goff,Lawrence J. Fine,Jeffrey A. Cutler,William C. Cushman,Alfred K. Cheung,Walter T. Ambrosius +18 more
TL;DR: In this article, the most appropriate targets for systolic blood pressure to reduce cardiovascular morbidity and mortality among persons without diabetes remain uncertain, and the authors propose a target of less than 120 mm Hg.
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