title: Prevalence, awareness, treatment and control of hypertension in elderly Chinese.
abstract: We studied the prevalence, awareness, treatment and control of hypertension in an elderly Chinese population. The study subjects (age ≥60 years) were recruited from a suburban town of Shanghai from 2006 to 2008. We administered a standardized questionnaire to collect information on medical history, the use of medications and lifestyle. We measured blood pressure three times consecutively using a validated Omron 7051 oscillometric device (Kyoto, Japan) after the subjects had rested for at least 5 min in the sitting position. We defined hypertension as a blood pressure of at least 140 mm Hg systolic or 90 mm Hg diastolic or as the use of antihypertensive drugs. The 3949 participants (mean age of 68.3 years) included 2185 (55.3%) women, 182 (4.6%) obese subjects (body mass index ≥30 kg m(-2)) and 366 (9.3%) diabetic patients. The prevalence of hypertension was 59.4%. In the 2345 hypertensive patients, the awareness, treatment and control (<140/90 mm Hg) rates were 72.5%, 65.8% and 24.4%, respectively. In the 1542 treated hypertensive patients, 1196 (77.6%) used fixed-dose combinations of thiazide and reserpine or clonidine (n=1157, 75.0%) or of an angiotensin receptor blocker and hydrochlorothiazide (n=1) or free combinations (n=38, 2.5%), and 346 (22.4%) used a monotherapy of short-acting calcium channel blockers (n=217, 14.1%) or other classes of antihypertensive drugs (n=129, 8.3%). The corresponding control rates were 37.3% and 36.4%, respectively. In a stepwise logistic regression, the risk of uncontrolled hypertension was higher with older age (+10 years, odds ratio (OR) 1.19, P=0.03), female sex (OR 1.40, P=0.01), obesity (OR 2.35, P=0.0002) and heavy drinking (≥300 g per week, OR 2.18, P=0.0007). In conclusion, in elderly Chinese, the prevalence of hypertension is high. In spite of reasonably high awareness and treatment rates, the control rate remains low, most likely due to an unhealthy lifestyle and the underuse and/or underdose of antihypertensive drugs.
authors.affiliation: Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Sheng
authors.forename: Ming
authors.initials: M
authors.lastname: Liu
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Kang
authors.forename: Fang-Fei
authors.initials: FF
authors.lastname: Wei
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.forename: Ge-Le
authors.initials: GL
authors.lastname: Li
authors.forename: Qian
authors.initials: Q
authors.lastname: Dong
authors.forename: Qi-Fang
authors.initials: QF
authors.lastname: Huang
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D044466:Asian People; D001364:Awareness; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002681:China / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D000959:Antihypertensive Agents