中国疾病预防控制中心王丽敏团队研究了2004-2018年中国高血压患病率、认知率、治疗率和控制率。相关论文于2023年1月11日发表在《英国医学杂志》上。

为了评估中国全国和各人群高血压患病率和管理的近期趋势，研究组在中国进行了六轮全国调查，对2004-2018年中国慢性病和危险因素进行监测。共招募了642523名18-69岁的社区居住成年人（2004年30501人，2007年47353人，2010年90491人，2013年156836人，2015年162293人，2018年155049人）。

高血压定义为血压≥140/90 mm Hg或服用抗高血压药物。主要结局指标是高血压患病率和知晓高血压、接受高血压治疗且血压控制在140/90mm Hg以下的高血压患者比例。

中国18-69岁成年人高血压标准化患病率从2004年的20.8%上升到2010年的29.6%，然后在2018年下降到24.7%。2010-2018年间，女性高血压患病率的绝对年下降幅度是男性的两倍多（-0.83个百分点与−0.40个百分点）。尽管自2004年以来，高血压的知晓率、治疗率和控制率有所改善，但2018年总体仍然偏低，分别为38.3%、34.6%和12.0%。

2018年，在2.74亿18-69岁的高血压成年人中，估计有2.4亿人控制不佳。在所有调查中，受教育程度较低的女性高血压患病率高于受教育程度较高的女性，但男性的调查结果却喜忧参半。尽管农村地区在诊断和控制方面比城市地区有更大的改善，但城市和农村地区在高血压控制方面的差距仍然存在。

综上，自2010年以来，中国高血压患病率略有下降，但治疗和控制水平仍然很低。研究结果突出表明，需要通过加强中国，特别是农村地区的初级保健来改善高血压的检测和治疗。

附：英文原文

Title: Prevalence, awareness, treatment, and control of hypertension in China, 2004-18: findings from six rounds of a national survey

Author: Mei Zhang, Yu Shi, Bin Zhou, Zhengjing Huang, Zhenping Zhao, Chun Li, Xiao Zhang, Guiyuan Han, Ke Peng, Xinhua Li, Youfa Wang, Majid Ezzati, Limin Wang, Yichong Li

Issue&Volume: 2023/01/11

Abstract:

Objective To assess the recent trends in prevalence and management of hypertension in China, nationally and by population subgroups.

Design Six rounds of a national survey, China.

Setting China Chronic Disease and Risk Factors Surveillance, 2004-18.

Participants 642523 community dwelling adults aged 18-69 years (30501 in 2004, 47353 in 2007, 90491 in 2010, 156836 in 2013, 162293 in 2015, and 155049 in 2018).

Main outcome measures Hypertension was defined as a blood pressure of ≥140/90 mm Hg or taking antihypertensive drugs. The main outcome measures were hypertension prevalence and proportion of people with hypertension who were aware of their hypertension, who were treated for hypertension, and whose blood pressure was controlled below 140/90 mm Hg.

Results The standardised prevalence of hypertension in adults aged 18-69 years in China increased from 20.8% (95% confidence interval 19.0% to 22.5%) in 2004 to 29.6% (27.8% to 31.3%) in 2010, then decreased to 24.7% (23.2% to 26.1%) in 2018. During 2010-18, the absolute annual decline in prevalence of hypertension among women was more than twice that among men (0.83 percentage points (95% confidence interval 1.13 to 0.52) v 0.40 percentage points (0.73 to 0.07)). Despite modest improvements in the awareness, treatment, and control of hypertension since 2004, rates remained low in 2018, at 38.3% (36.3% to 40.4%), 34.6% (32.6% to 36.7%), and 12.0% (10.6% to 13.4%). Of 274 million (95% confidence interval 238 to 311 million) adults aged 18-69 years with hypertension in 2018, control was inadequate in an estimated 240 million (215 to 264 million). Across all surveys, women with low educational attainment had higher prevalence of hypertension than those with higher education, but the finding was mixed for men. The gap in hypertension control between urban and rural areas persisted, despite larger improvements in diagnosis and control in rural than in urban areas.

Conclusions The prevalence of hypertension in China has slightly declined since 2010, but treatment and control remain low. The findings highlight the need for improving detection and treatment of hypertension through the strengthening of primary care in China, especially in rural areas.

DOI: 10.1136/bmj-2022-071952

Source: https://www.bmj.com/content/380/bmj-2022-071952