Research Article
Prevalence, awareness, treatment, and control of hypertension among very elderly Chinese: results of a community-based study

https://doi.org/10.1016/j.jash.2017.05.008Get rights and content

Highlights

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    This study provides first-hand information about the epidemiologic distribution of hypertension among very elderly population in Southwest China-Chengdu.

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    Among very elderly in Chengdu, the prevalence of hypertension is predominantly high, whereas awareness, treatment, and control are considerably low.

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    The hypertension prevalence among very elderly women is higher than in men.

Abstract

The epidemiologic distribution of hypertension among very elderly Chinese is still not clear. This study aimed to investigate the prevalence, awareness, treatment, and control rate of hypertension among very elderly in Chengdu. From May 2013 to May 2015, a total of 1056 participants from 20 residential communities were sampled. Standard face-to-face interviews, physical examinations, and biochemical analysis were undertaken. Participants had a mean age of 83.6 ± 3.4 years (range: 80–100), and 49.8% were men. Mean systolic blood pressure (BP) and diastolic BP were 146.4 ± 20.6 and 74.1 ± 11.9 mm Hg, respectively, and both of the highest BP levels were among participants aged 80–84 years. Mean pulse pressure was 72.5 ± 17.1 mm Hg, and the highest pulse pressure level was among participants aged 90 years and older. The overall estimated hypertension prevalence was 75.3% (95% confidence interval: 72.6%–77.9%), and among overall participants, 51.9% were aware of their hypertensive condition and 45.5% were treated. However, only 18.1% of hypertensive participants were controlled (BP < 140/90 mm Hg). Among very elderly Chinese in Chengdu, the prevalence of hypertension is predominantly high, whereas awareness, treatment, and control rates are considerably low. Effective primary and secondary prevention strategies are needed.

Introduction

Hypertension is believed as one of the most important disease burdens not only in western countries but also in China.1 The prevalence of hypertension increases with aging gradually.2 In China, cardiovascular diseases (CVDs) account for more than one-third of all adult deaths.3 Moreover, hypertension accounts for about one-third of deaths due to CVDs at age 35–79 years.4

During the past few decades, epidemiologic surveys have reported updated epidemiologic data of hypertension prevalence5, 6, 7 and regional distribution variance in China.8 However, few of these surveys enrolled individuals older than 80 years, even as subgroup subjects. While according to data in 2012 from World Health Organization, the average life expectancy at birth for Chinese is currently already about 75 years.9 Therefore, with a rapidly increasing incidence of hypertension in China, it becomes urgent to examine the epidemiologic distribution of hypertension among population aged 80 years and older in real world. As a part of the community-based epidemiologic CVDs survey among very elderly in Chengdu, we report the blood pressure (BP) levels, prevalence, awareness, treatment, and control rate of hypertension among very elderly residents in Chengdu.

Section snippets

Study Participants

From May 2013 to May 2015, participants were recruited by use of a stratified three-stage cluster sampling design.10 First, five districts in Chengdu were randomly selected. Second, four neighborhoods were randomly selected from each district. Third, from each neighborhood, one residential community was randomly selected. Finally, 20 residential communities and 1056 participants were sampled according to house registration data from Chengdu government (Figure 1).

Study participants were invited

Demographic Characteristics

Totally, 1056 participants from 20 residential communities were enrolled in this study. The overall response rate was 92.6%. Finally, 1038 participants (49.8% men) were included in final analysis (Figure 1). The mean age of participants was 83.6 ± 3.4 years (age range: 80–100 years), and the median age was 83 years. Men were slightly older than women (P = .342). Among all participants, more than 11% were current smokers and 8% of them were current alcohol drinker (Table 1).

Mean Level of BP

The mean levels of

Discussion

Among very elderly in Chengdu, the hypertension prevalence and ISH prevalence are extremely high, whereas the control rate is considerably low. Moreover, hypertension and ISH prevalence are higher among very elderly women.

The mean SBP level among very elderly Chinese in this study is consistent with the level in Americans 80 years and older during 1988–1994 and 1999–2004,17 very elderly Israel18 and Polish.19 Moreover, the mean DBP level in our study is almost the same as among very elderly

Acknowledgments

The authors appreciate all study participants for their participation and collaborators for their efforts which made the survey possible. The authors also thank Miss. Hui-xing Yang for secretarial contribution and Ms. Qiong Wang for organizational support for this survey.

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    • Cited by (0)

    Gang Huang and Jun-bo Xu contribute equally and are cofirst authors.

    Supplemental Material can be found at www.ashjournal.com.

    Conflict of interest: The authors declare that there is no conflict of interest.

    This study was supported by the Science and Technology Bureau of Chengdu (Grant number: 11PPYB034SF).

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