title: Urban-rural disparities in hypertension prevalence, detection, and medication use among Chinese Adults from 1993 to 2011.
abstract: China has experienced a rapid increase in hypertension over the past decade, especially in rural. Therefore, the aim of this research is to examine the dynamic trends in urban-rural disparities in hypertension prevalence, detection, and medication use among Chinese adults from 1993 to 2011.
  
  
  
  Data were extracted from the seven latest waves of the China Health and Nutrition Survey (CHNS). We used the hukou system to distinguish between urban and rural residents. Chi-square tests were performed to examine urban-rural gaps in hypertension prevalence, detection and medication use. Multiple logistic regressions were used to confirm these disparities and to explore whether the urban-rural gaps have narrowed or widened from 1993 to 2011, after controlling for health-related behaviors, BMI, demographic variables and socioeconomic characteristics. Blinder-Oaxaca decomposition technique was also used to calculate the extent to which urban-rural disparities reflect an endowments effect or a coefficients effect.
  
  
  
  Hypertension prevalence, detection, and medication use among rural adults were significantly lower than urban adults, with the significant level at p < 0.001. The urban-rural gaps in hypertension prevalence and medication use gradually narrowed during the period 1993-2011, whereas the gaps in hypertension detection grew wider. After controlling for confounding variables, urban adults were about 24.5, 49.4, and 89.5% more likely to be hypertensive, detected, and medicated than their rural counterparts (p < 0.01), respectively. The Blinder-Oaxaca decomposition suggested that approximately 22 and 26% of the urban-rural gap in hypertension detection and medication use could be attributed to coefficient difference, respectively.
  
  
  
  Although hypertension prevalence among rural adults was comparable to that of urban adults, hypertension detection and medication use of rural adults were still suboptimal. Unusually large urban-rural gaps and an expanding trend in hypertension detection deserve the attention of health policymakers and researchers.
authors.affiliation: Shandong University, Jinan, People's Republic of China.
authors.forename: Jiajia
authors.identifier: 0000-0001-7458-7682
authors.initials: J
authors.lastname: Li
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. lshi@jhsph.edu.
authors.forename: Leiyu
authors.initials: L
authors.lastname: Shi
authors.affiliation: Shandong University, Jinan, People's Republic of China.
authors.forename: Shixue
authors.initials: S
authors.lastname: Li
authors.affiliation: Shandong University, Jinan, People's Republic of China.
authors.forename: Lingzhong
authors.initials: L
authors.lastname: Xu
authors.affiliation: Infirmary of Shandong University, Jinan, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Qin
authors.affiliation: The Second Hospital of Shandong University, Jinan, People's Republic of China.
authors.forename: Heng
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents
keywords: China; Dynamic trends; Hypertension; Urban/rural; hukou system