A comparison study of prevalence, awareness, treatment and control rates of hypertension and associated factors among adults in China and the United States based on national survey data

Objective

This study compared the prevalence, awareness, treatment and control of hypertension and associated factors in China and the United States (US).

Methods

Adult data from nationally representative samples were derived from the Chronic Disease and Risk Factors Surveillance in 2010 and 2013 in China and the National Health and Nutrition Examination Survey in 2010 and 2013 in the US. Multivariable logistic and Poisson regression analysis were conducted to assess associations of the four outcomes with body weight status and behavioral factors.

Results

Age-standardized prevalence rates of hypertension was 35.7% (95% confidence interval [CI]: 35.4% to 36.1%) in 2010 and 29.8% (95% CI: 29.4% to 30.2%) in 2013 in China, and 35.3% (95% CI: 33.6% to 37.1%) in 2010 and 37.9% (95% CI: 36.0% to 39.7%) in 2013 in the US. Among hypertensive participants, the age-standardized rates of treatment were 18.4% (95% CI: 17.9% to 18.9%) in 2010 and 23.8% (95% CI: 23.1% to 24.6%) in 2013 in China and 54.5% (95% CI: 50.3% to 58.7%) in 2010 and 50.9% (95% CI: 46.5% to 55.3%) in 2013 in the US; the age-standardized hypertension control rates were 3.2% (95% CI: 3.0% to 3.5%) and 5.7% (95% CI: 5.3% to 6.0%) in 2010 and 2013 in China and 50.6% (95% CI: 46.2% to 55.0%) and 55.3% (95% CI: 50.3% to 60.3%) in the US. Obesity was significantly associated with prevalence, awareness and control rates in both countries. Different from the US, obesity was negatively associated with hypertension control in China.

Conclusion

Hypertension prevalence in China is similar to that in the US, but the control rate in China was significantly lower. Obesity was a critical risk factor for poor hypertension control in China.