Time Trends in Comorbidity and Management of Hypertension and Diabetes: A 15-year Nationwide Longitudinal Study of 18,380 Adults in China

Abstract Objectives To examine time trends in comorbidity of hypertension and self-reported type 2 diabetes (T2DM) and their diagnosis, treatment, and management in China during 2000-2015 and study factors associated with these outcomes. Methods Longitudinal data collected from the China Health and Nutrition Survey (CHNS) during 2000-2015 were analyzed. 143, 351 and 338 had both hypertension and self-reported T2DM were selected in 2000, 2011 and 2015, respectively. Average systolic blood pressure (SBP) and diastolic blood pressure (DBP) and hypertension prevalence among T2DM participants, and treatment and control of hypertension and self-reported T2DM among participants with both conditions were examined for all and by sex and weight status. Poisson regression model assessed the associations. Results From 2000 to 2015, among participants with self-reported T2DM, hypertension prevalence dropped from 88.4% to 83.0% and BPs decreased (P < 0.05). Men and overweight/obese participants had greater decreases in hypertension prevalence and DBP, while women had a larger decrease in SBP than men. Over time, among participants with both hypertension and self-reported T2DM, rates of hypertension treatment (45.3% to 57.7%), hypertension control (3.0% to 10.9%) and self-reported T2DM treatment (90.0% to 95.6%) increased (all P < 0.001). Older, women, ever-smoking, heavier drinking, better income level, higher education level, and obesity had higher rates of prevalence, treatment, and control of hypertension, and self-reported T2DM treatment among participants with both hypertension and self-reported T2DM. Conclusions Rates of hypertension treatment and control among participants with both hypertension and self-reported T2DM have improved in recent years, but were still low.

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Factors associated with awareness, treatment and control of hypertension among 3579 hypertensive adults in China: data from the China Health and Nutrition Survey

BMC Public Health ◽

10.1186/s12889-021-10417-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Junxiang Wei ◽

Yang Mi ◽

Yan Li ◽

Bo Xin ◽

Youfa Wang

Keyword(s):

Public Health ◽

Blood Pressure ◽

Hypertension Treatment ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Factors Associated ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background The prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mmHg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results Overall, 3579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR = 2.57; 95%CI, 1.65–4.02), urban residency (1.50; 1.14–1.97), living in the Eastern region (1.52; 1.14–2.01), and being overweight/obese (1.99; 1.39–2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12–1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42–0.76) and minority ethnicity (0.52; 0.31–0.86). Conclusion Hypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.

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Factors associated with awareness, treatment and control of hypertension among 3,579 hypertensive adults in China: data from the China Health and Nutrition Survey

10.21203/rs.3.rs-18826/v4 ◽

2020 ◽

Author(s):

junxiang Wei ◽

Yang Mi ◽

Yan Li ◽

Bo Xin ◽

Youfa Wang

Keyword(s):

Public Health ◽

Blood Pressure ◽

Hypertension Treatment ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Factors Associated ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background: The prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods: Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mm Hg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results: Overall, 3,579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR=2.57; 95%CI, 1.65-4.02), urban residency (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), and being overweight/obese (1.99; 1.39-2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12-1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). Conclusion: Hypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.

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Factors associated with awareness, treatment and control of hypertension among 3,579 hypertensive adults in China: data from the China Health and Nutrition Survey

10.21203/rs.3.rs-18826/v5 ◽

2020 ◽

Author(s):

Junxiang Wei ◽

Yang Mi ◽

Yan Li ◽

Bo Xin ◽

Youfa Wang

Keyword(s):

Public Health ◽

Blood Pressure ◽

Hypertension Treatment ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Factors Associated ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background: The prevalence of hypertension is high and rising in China, but most people with hypertension do not have their blood pressure under control. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods: Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mm Hg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results: Overall, 3,579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure under control. Higher hypertension treatment was associated with older age (OR=2.57; 95%CI, 1.65-4.02), urban residency (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), and being overweight/obese (1.99; 1.39-2.84). Hypertension awareness was associated with similar factors as hypertension treatment but was also associated with being female (1.37, 1.12-1.66). Poor hypertension control was associated with being overweight/obese (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). Conclusion: Hypertension is a major public health challenge in China. The prevalence of hypertension awareness, treatment, and control are still low despite existing public health policies and programs to reduce the burden of hypertension. More intensive hypertension screening and treatment programs are warranted in China.

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Abstract 604: Differences In The Prevalence And Control Of Hypertension Between Mercury Sphygmomanometer And Omron (hem_907xl): Nhanes 2009-2010

Hypertension ◽

10.1161/hyp.60.suppl_1.a604 ◽

2012 ◽

Vol 60 (suppl_1) ◽

Author(s):

Sarah Yoon ◽

Tatiana Nwankwo ◽

Margaret Carroll ◽

Yechiam Ostchega

Keyword(s):

Blood Pressure ◽

Data Interpretation ◽

Hypertension Control ◽

Blood Pressure Monitor ◽

Pressure Monitor ◽

Hypertension Prevalence ◽

Health And Nutrition ◽

Subgroup Analyses ◽

And Control ◽

Mercury Sphygmomanometer

Objectives - Precise, reliable blood pressure (BP) measurement, whether in clinical practice or in epidemiological research, is essential for diagnosis and data interpretation. The study objectives were to compare differences in the prevalence and control of hypertension among adults aged 18 years and older using two standard devices: the mercury sphygmomanometer and the Omron Digital Blood Pressure Monitor (HEM_907XL). Methods - 5,185 individuals aged 18 years and older participated in the National Health and Nutrition Examination Survey 2009-2010 BP methodology study. Hypertension was defined as a mean systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg, or currently taking BP medication. Mean BP was the average of up to three readings for each device. Controlled Hypertension among hypertensives was defined as SBP <140 mmHg and DBP < 90 mmHg. Results - Overall the age-adjusted prevalence of hypertension among adults was higher by mercury measurement (27.7%) than by Omron (26.4%, p <0.05). There were significant differences in hypertension prevalence between the two devices among men (mercury: 28.9% vs. Omron: 26.5%, p < 0.05) and Hispanics (mercury: 25.1% vs. Omron: 22.8%, p < 0.05). The overall hypertension control rate among hypertensives was significantly higher using Omron (64.6%) vs. mercury measurement (57.5%, p <0.05). In subgroup analyses, rates of hypertension control among hypertensives were systematically higher using Omron: for those 40-59 years (mercury: 60.0%; Omron: 67.9%); for those 60 years and older (mercury: 59.7%; Omron: 65.4%); for men (mercury: 54.9%; Omron: 63.9%); women (mercury: 61.5%; Omron: 66.1%,); non-Hispanic whites (mercury: 60.9%; Omron: 68.4%); non-Hispanic blacks(mercury: 48.8%; Omron: 54.3%); and Hispanics (mercury: 34.6%; Omron: 44.8%), ( p <0.05 for all groups). Conclusion - Hypertension prevalence measured by mercury was significantly higher than that measured by the Omron device. Lower Omron readings resulted in apparently higher estimates for the rate of controlled hypertension.

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Associated factors with awareness, treatment and control of hypertension among 3,579 hypertensive adults in China: data from the China Health and Nutrition Survey

10.21203/rs.3.rs-18826/v1 ◽

2020 ◽

Author(s):

junxiang Wei ◽

Bo Xin ◽

Yan Li ◽

Youfa Wang

Keyword(s):

Blood Pressure ◽

Associated Factors ◽

Eastern Region ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Public Health Burden ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background: Hypertension prevalence is high and rising in China, but it is inadequately controlled. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods: Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mm Hg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results: Overall, 3,579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure controlled. Rates of hypertension awareness and treatment varied across population subgroups; higher likelihood was associated with being female (OR = 1.37; 95%CI, 1.12-1.66), older age (1.57; 1.65-4.02), urban residence (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), having overweight/obesity (1.99; 1.39-2.84), and engaging in less healthy lifestyles. Lower control rate was associated with obesity (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). Conclusion: Hypertension is a major public health burden in China. Rates of hypertension awareness, treatment, and control are still low despite efforts that have been made. More intensive screening and treatment intervention programs are needed in the future.

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U-shaped association between dietary calcium density intake during adolescence and hypertension in adulthood— a 20-y longitudinal nationwide study in China

British Journal Of Nutrition ◽

10.1017/s0007114521002701 ◽

2021 ◽

pp. 1-22

Author(s):

Xiaomin Sun ◽

Zumin Shi ◽

Yixuan Li ◽

Bao Xin ◽

Xi Li ◽

...

Keyword(s):

Calcium Intake ◽

Dietary Pattern ◽

Weight Status ◽

Dietary Calcium ◽

Study Data ◽

Dietary Calcium Intake ◽

Nutrition Survey ◽

Hypertension Prevalence ◽

Health And Nutrition ◽

Longitudinal Association

Abstract Background and Aims: We assessed longitudinal association between calcium intake during adolescence and hypertension in adulthood. Methods and Results: Longitudinal study data of 1611 participants from the China Health and Nutrition Survey during 1991-2011 were used. On average they were followed for 11.4 years. Dietary calcium intake during adolescence was assessed based on three 24-hour dietary recalls collected in each visit/survey between 1991 and 2009 (seven waves). The intake was recoded into quartiles. Cumulative mean±SD calcium intake was 199.9±144.8 mg/1000 kcal/day during adolescence. In total 102 participants had hypertension in adulthood (97 men and 5 women). There was a clear U-shaped association between adolescence calcium intake quartiles and adulthood hypertension: across the quartiles, hypertension prevalence was 6.7%, 4.0%, 5.2% and 9.5%, respectively. After adjustment for potential confounders including weight status and dietary pattern, odds ratios (OR, 95%CI) for hypertension were 2.32 (95%CI 1.07-5.00) for lowest quartile, 1.00 (reference), 1.34 (95%CI 0.61-2.97), and 3.10 (95%CI 1.49-6.46) across the quartiles. Conclusions: Lower or higher calcium intake during adolescence was associated with hypertension in adulthood independent of weight status and dietary pattern.

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Factors associated with awareness, treatment and control of hypertension among 3,579 hypertensive adults in China: data from the China Health and Nutrition Survey

10.21203/rs.3.rs-18826/v3 ◽

2020 ◽

Author(s):

junxiang Wei ◽

Bo Xin ◽

Yan Li ◽

Youfa Wang

Keyword(s):

Blood Pressure ◽

Eastern Region ◽

Treatment Rate ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Factors Associated ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background: Hypertension prevalence is high and rising in China, but it is inadequately controlled. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods: Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mm Hg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results: Overall, 3,579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure controlled. Higher hypertension treatment rate was associated with older age (OR, 2.57; 95%CI, 1.65-4.02), urban residence (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), and having overweight/obesity (1.99; 1.39-2.84); Awareness rate showed the same association as treatment rate with an additional protect factor of being female (1.37, 1.12-1.66). Lower control rate was associated with obesity (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). Conclusion: Hypertension is a major public health burden in China. Rates of hypertension awareness, treatment, and control are still low despite efforts that have been made. More intensive screening and treatment intervention programs are needed in the future.

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Associated factors with awareness, treatment and control of hypertension among 3,579 hypertensive adults in China: data from the China Health and Nutrition Survey

10.21203/rs.3.rs-18826/v2 ◽

2020 ◽

Author(s):

Junxiang Wei ◽

Bo Xin ◽

Yan Li ◽

Youfa Wang

Keyword(s):

Blood Pressure ◽

Associated Factors ◽

Eastern Region ◽

Chinese Adults ◽

Nutrition Survey ◽

Antihypertensive Medications ◽

Public Health Burden ◽

Health And Nutrition ◽

Hypertension Awareness ◽

And Control

Abstract Background: Hypertension prevalence is high and rising in China, but it is inadequately controlled. This study investigated hypertension awareness, treatment, and control and their associated factors among Chinese adults. Methods: Data collected from the 2011 China Health and Nutrition Survey (CHNS) from 12,991 Chinese adults were used. Hypertension was defined as systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg, self-reported prior diagnosed hypertension, or taking antihypertensive medications. Hypertension awareness, treatment, and control were defined as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure < 140/90 mm Hg, respectively. Multivariate logistic regression was performed to examine factors associated with hypertension awareness, treatment, and control. Results: Overall, 3,579 (27.6%) of the CHNS adult participants had hypertension, of whom 55.7% were aware of their diagnosis, 46.5% were treated with antihypertensive medications, but only 20.3% had their blood pressure controlled. Rates of hypertension awareness and treatment varied across population subgroups; higher likelihood was associated with being female (OR = 1.37; 95%CI, 1.12-1.66), older age (1.57; 1.65-4.02), urban residence (1.50; 1.14-1.97), living in the Eastern region (1.52; 1.14-2.01), having overweight/obesity (1.99; 1.39-2.84), and engaging in less healthy lifestyles. Lower control rate was associated with obesity (0.56; 0.42-0.76) and minority ethnicity (0.52; 0.31-0.86). Conclusion: Hypertension is a major public health burden in China. Rates of hypertension awareness, treatment, and control are still low despite efforts that have been made. More intensive screening and treatment intervention programs are needed in the future.

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Association between risk of type 2 diabetes and changes in energy intake at breakfast and dinner over 14 years: a latent class trajectory analysis from the China health and nutrition Survey, 1997–2011

BMJ Open ◽

10.1136/bmjopen-2020-046183 ◽

2021 ◽

Vol 11 (7) ◽

pp. e046183

Author(s):

Xiyun Ren ◽

Jian Gao ◽

Tianshu Han ◽

Changhao Sun

Keyword(s):

Type 2 Diabetes ◽

Energy Consumption ◽

Energy Intake ◽

Latent Class ◽

Early Stage ◽

Harmful Effect ◽

Nutrition Survey ◽

Health And Nutrition ◽

Diabetes Status

ObjectiveThis study aimed to investigate the association between the trajectories of energy consumption at dinner versus breakfast and the risk of type 2 diabetes (T2D).DesignCohort study.SettingThe study was conducted in China.ParticipantsA total of 10 727 adults, including 5239 men and 5488 women, with a mean age of 42.7±11.2 years and a mean follow-up time of 9.1 years, met the study criteria and completed a questionnaire about energy intake and diabetes status from the China Health and Nutrition Survey in 1997–2011.Primary outcome measuresParticipants were divided into subgroups based on the trajectories of the ratio of energy consumption at dinner versus breakfast. Cox multivariate regression models were used to explore the associations between different trajectories and the risk of T2D after adjustment for confounders and their risk factors. Mediation analysis was performed to explore the intermediary effect of triacylglycerol (TG), total cholesterol (TC), uric acid (UA) and apolipoprotein B (ApoB) between the trajectories and the risk of T2D.ResultsFor energy consumption at dinner versus breakfast, compared with a low-stable trajectory, the adjusted HR of T2D in low-increasing from early-stage trajectory was 1.29 (95% CI 1.04 to 1.60). TG, TC, UA and ApoB were significantly higher in low-increasing from early-stage trajectory than other trajectories and play partial regulation roles between trajectories and T2D.ConclusionsThis study emphasised the harmful effect of a gradual increase in the ratio of energy consumption at dinner versus breakfast from early stage on the development of T2D and partially mediated by TG, TC, UA and ApoB, highlighting that it is necessary to intake more energy at breakfast compared with dinner to prevent T2D in adults.

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