Geographical variations in hypertension prevalence, awareness, treatment and control in China: findings from a nationwide and provincially representative survey
Geographical variations in hypertension prevalence, awareness, treatment and control in China: findings from a nationwide and provincially representative survey
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DOI：
10.1097/hjh.0000000000001531
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发表时间：
2018-01-01
影响因子：
4.9
通讯作者：
Wang, Linhong
中科院分区：
文献类型：
--
作者：
Li, Yichong;Wang, Limin;Wang, Linhong
目的：高血压已成为中国疾病负担最重要的危险因素。我们的目的是对中国的高血压状况、知晓率、治疗和控制情况进行首次全国性空间分析。方法：使用等值线图来检查 2013 年至 2014 年中国慢性病和危险因素监测中 174 389 名全国和省级代表性成年人的高血压、知晓率、治疗和控制的空间格局。采用多水平回归分析各省、县、镇、村/居委会的各项结果，并检验已知危险因素解释的地区水平差异的比例。结果：高血压患病率在北方最高（例如辽宁= 37.7％），在南方最低（例如海南= 17.9％）。在发现患有高血压的参与者中，知晓率普遍较低，特别是在南方（例如贵州 = 18.0%）。除西藏（37.7%）和贵州（54.5%）外，所有省份高血压知晓率均在70%以上。接受治疗的人群（收缩压<140和舒张压<90毫米汞柱）的高血压控制率普遍较低，特别是在东北和西南省份。人口、社会经济和行为因素、体重状况、医疗保健使用和居住城市化程度的调整导致高血压状况省际差异的57.7%，知晓率48.5%，治疗率47.6%，控制率18.0%。结论：中国高血压具有空间格局，从诊断到接受治疗和控制高血压的每个步骤都存在未满足的需求。中国需要采取有针对性的战略来加强高血压的预防和管理。
Objectives: Hypertension has been the most important risk factor for disease burden in China. We aimed to conduct the first national spatial analysis of hypertension status, awareness, treatment and control in China.Methods: Choropleth maps were used to examine the spatial patterning of hypertension, awareness, treatment and control in a nationally and provincially representative sample of 174 389 adults from the 2013 to 2014 China Chronic Disease and Risk Factors Surveillance. Multilevel regressions were used to analyze each outcome across provinces, counties, towns and villages/residential committees and to test the proportion of area-level variances explained by known risk factors.Results: Hypertension prevalence was highest in the north (e.g. Liaoning = 37.7%) and lowest in the south (e.g. Hainan = 17.9%). Among participants found to have hypertension, awareness was generally low, especially in the south (e.g. Guizhou = 18.0%). Receipt of treatment among those who were aware of their hypertension status was above 70% in all provinces except for Tibet (37.7%) and Guizhou (54.5%). Control of hypertension among those receiving treatment (SBP < 140 and DBP < 90 mmHg) was generally low, especially in northeastern and southwestern provinces. Adjustment for demographic, socioeconomic and behavioral factors, weight status, healthcare use and urbanization of residence accounted for 57.7% of variation between provinces in hypertension status, 48.5% in awareness, 47.6% in treatment and 18.0% in control.Conclusion: Hypertension is spatially patterned in China and there is an unmet need at each step from diagnosis to receiving treatment and achieving controlled hypertension. Geographically targeted strategies are required to enhance hypertension prevention and management in China.