Hypertension prevalence, awareness, treatment, and control and sodium intake in Shandong Province, China: baseline results from Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011.
BACKGROUND
In China, population-based blood pressure levels and prevalence of hypertension are increasing. Meanwhile, sodium intake, a major risk factor for hypertension, is high. In 2011, to develop intervention priorities for a salt reduction and hypertension control project in Shandong Province (population 96 million), a cross-sectional survey was conducted to collect information on sodium intake and hypertension prevalence, awareness, treatment, and control.


METHODS
Complex, multistage sampling methods were used to select a provincial-representative adult sample. Blood pressure was measured and a survey conducted among all participants; condiments were weighed in the household, a 24-hour dietary recall was conducted, and urine was collected. Hypertension was determined by blood pressure measured on a single occasion and self-reported use of antihypertension medications.


RESULTS
Overall, 23.4% (95% confidence interval [CI], 20.9%-26.0%) of adults in Shandong were estimated to have hypertension. Among those classified as having hypertension, approximately one-third (34.5%) reported having hypertension, approximately one-fourth (27.5%) reported taking medications, and one-seventh (14.9%) had their blood pressure controlled (<140/<90 mm Hg). Estimated total average daily dietary sodium intake was 5,745 mg (95% CI, 5,428 mg-6,063 mg). Most dietary sodium (80.8%) came from salt and high-salt condiments added during cooking: a sodium intake of 4,640 mg (95% CI, 4,360 mg-4,920 mg). The average daily urinary sodium excretion was 5,398 mg (95% CI, 5,112 mg-5,683 mg).


CONCLUSIONS
Hypertension and excessive sodium intake in adults are major public health problems in Shandong Province, China.
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Zhenqiang
Z
Bi
Chinese Center for Disease Control and Prevention, Beijing, China.
Xiaofeng
X
Liang
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Aiqiang
A
Xu
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Linghong
L
Wang
Chinese Center for Disease Control and Prevention, Beijing, China.
Xiaoming
X
Shi
Chinese Center for Disease Control and Prevention, Beijing, China.
Wenhua
W
Zhao
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Jixiang
J
Ma
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Xiaolei
X
Guo
Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China.
Xiaofei
X
Zhang
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Jiyu
J
Zhang
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Jie
J
Ren
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Liuxia
L
Yan
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Zilong
Z
Lu
Chinese Center for Disease Control and Prevention, Beijing, China.
Huicheng
H
Wang
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Junli
J
Tang
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Xiaoning
X
Cai
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Jing
J
Dong
Chinese Center for Disease Control and Prevention, Beijing, China.
Juan
J
Zhang
Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China.
Jie
J
Chu
Centers for Disease Control and Prevention, Atlanta, Georgia.
Michael
M
Engelgau
Centers for Disease Control and Prevention, Atlanta, Georgia.
Quanhe
Q
Yang
Centers for Disease Control and Prevention, Atlanta, Georgia.
Yuling
Y
Hong
Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, 102206, People's Republic of China. E-mail: wangyu@chinacdc.cn.
Yu
Y
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001364:Awareness; D002681:China / Q000453:epidemiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D015930:Diet Records; D004039:Diet, Sodium-Restricted / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012494:Sampling Studies; D012964:Sodium / Q000652:urine; D012982:Sodium, Dietary / Q000008:administration & dosage* / Q000009:adverse effects / Q000032:analysis; D011795:Surveys and Questionnaires; D055697:Taste Perception; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
D000959:Antihypertensive Agents; D012982:Sodium, Dietary; D012964:Sodium