The Rates and the Determinants of Hypertension According to the 2017 Definition of Hypertension by ACC/AHA and 2014 Evidence-Based Guidelines Among Population Aged ≥40 Years Old
Wenzhen Li,
Dajie Chen,
Shuai Liu,
Xiaojun Wang,
Xiaojie Chen,
Jiafeng Chen,
Jing Ma,
Fujian Song,
Hui Li,
Shijiao Yan,
Xiaoxv Yin,
Shiyi Cao,
Yanhong Gong,
Junan Liu,
Wei Yue,
Feng Yan,
Chuanzhu Lv,
Zhihong Wang,
Zuxun Lu
Affiliations
Wenzhen Li
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Dajie Chen
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Shuai Liu
Health and Family Planning Commission of Wuhan Municipality, Wuhan
Xiaojun Wang
Department of Tuberculosis Prevention, Wuhan Tuberculosis Institution, Wuhan
Xiaojie Chen
China Urban Construction Design and Research Institute, Beijing
Jiafeng Chen
Department of Software Engineering, School of Cyber Science and Engineering, Wuhan University, Wuhan
Jing Ma
Department of Population Medicine, Harvard Medical School, Harvard University, Boston, MA
Fujian Song
Department of Population Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich
Hui Li
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Shijiao Yan
School of International Education, Hainan Medical University, Haikou
Xiaoxv Yin
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Shiyi Cao
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Yanhong Gong
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Junan Liu
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
Background: In November 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated their definition of hypertension from 140/90 mm Hg to 130/80 mm Hg. Objectives: We sought to assess the situation of hypertension and the impact of applying the new threshold to a geographically and ethnically diverse population. Methods: We analyzed selected data on 237,142 participants aged ≥40 who had blood pressure taken for the 2014 China National Stroke Screening and Prevention Project. Choropleth maps and logistic regression analyses were performed to estimate the prevalence, geographical distribution and risk factors of hypertension using both 2017 ACC/AHA guidelines and 2014 evidence-based guidelines. Results: The present cross-sectional study showed the age- and sex-standardized prevalence of hypertension was 37.08% and 58.52%, respectively, according to 2014 evidence-based guidelines and 2017 ACC/AHA guidelines. The distribution of hypertension and risk factors changed little between guidelines, with data showing a high prevalence of hypertension around Bohai Gulf and in south central coastal areas using either definition. The age- and sex-standardized prevalence of newly labeled as hypertensive was 21.44%. Interestingly, the high prevalence region of newly labeled as hypertensive was found in the north China. Conclusion: The prevalence of hypertension increased significantly on 2017 ACC/AHA guidelines compared to the prevalence when using 2014 evidence-based guidelines, with high prevalence areas of newly labeled as hypertensive now seen mainly in north China. There need to be correspondingly robust efforts to improve health education, health management, and behavioral and lifestyle interventions in the north.
