[Prevalence and control of hypertension in adults in China, 2018].

Objective: To describe and compare the prevalence, sick status awareness, treatment and control of hypertension in adults aged 18 years and above in China. Methods: National Chronic Disease and Risk Factor Surveillance was conducted in 298 counties/districts in China in 2018, which covered 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method was used to select 194 779 permanent residents aged 18 years and above. Face to face questionnaire surveys were conducted to collect the information about their demographic characteristics, hypertension diagnosis and treatment as well as the blood pressures measurement. The systolic and diastolic blood pressure were measured using certified medical upper arm electronic sphygmomanometer for the adults. After excluding those with abnormal blood pressure, 179 873 adults were included in the final analyses. Gender, age and area or region specific mean blood pressure, the prevalence, sick status awareness, control and treatment rates of hypertension, and blood pressure measurement were evaluated for the adults surveyed. All the results were weighted according to complex sampling scheme and had post-stratification to represent the whole adult population in China. Results: The average systolic blood pressure was (127.7±18.8) mmHg (1 mmHg=0.133 kPa) and the average diastolic blood pressure was (76.8±11.2) mmHg in the adults aged 18 years and above in China in 2018. Among the adults without history of hypertension, 50.9%(95%CI:49.9%-51.9%) had prehypertension. The prevalence rate of hypertension in adults in China was 27.5% (95%CI: 26.6%-28.4%). In men, 30.8% (95%CI: 29.8%-31.9%) had hypertension, compared with 24.2% (95%CI: 23.3%-25.1%) in women. The rural adults had higher hypertension prevalence rate [29.4% (95%CI: 28.4%-30.3%)] compared with urban adults [25.7% (95%CI: 24.4%-27.1%), P<0.000 1]. The highest hypertension prevalence rate was observed in adults in northern China [33.3% (95%CI: 31.5%-35.2%)], followed by that in adults in northeastern China [32.7% (95%CI: 28.1%-37.4%)] compared with other regions in China, and with significant differences (P<0.000 1). Among the adults with hypertension, 41.0% (95%CI: 39.7%-42.4%) were aware of their sick status, 34.9% (95%CI: 33.6%-36.1%) were taking antihypertensive medicines, and 11.0% (95%CI: 10.2%-11.8%) had their blood pressure controlled. In the hypertensive patients, women and urban residents were more likely to have higher rates of sick status awareness, treatment and control of hypertension compared with men and rural residents (all P<0.000 1). Among the adults without history of hypertension, 41.9%(95%CI: 40.7%-43.2%) had active or passive measurement of blood pressure in the past 3 months. Conclusions: Given the higher prevalence rate of hypertension and lower blood pressure measurement rate in Chinese adults, as well as unsatisfied status of awareness, treatment and control of hypertension in patients, more efforts should be made in hypertension prevention and control, such as improved risk factor intervention and case management, especially in rural areas.目的： 了解中国≥18岁居民高血压患病、知晓、治疗与控制以及血压测量现况。 方法： 2018年中国慢性病及危险因素监测在全国31个省（直辖区、自治市）的298个县（区），采用多阶段分层整群随机抽样方法抽取≥18岁常住居民194 779人，以面对面问卷调查和身体测量方法收集调查对象的人口统计学、高血压诊断与治疗和血压测量状况等信息，并采用经认证的医用上臂式电子血压计测量调查对象的血压值。本研究将其中完成调查且高血压相关信息完整的179 873人作为研究对象。按性别及年龄、城乡、文化程度、地理区域等分组分别计算血压均值、高血压患病率、患病知晓率、控制率、治疗率以及血压测量率等指标。所有结果采用基于设计的复杂抽样加权调整，以更好地估计中国成年人的状况。 结果： 2018年，中国≥18岁居民SBP均值为（127.7±18.8）mmHg（1 mmHg=0.133 kPa），DBP为（76.8±11.2）mmHg。未诊断高血压的居民中，正常高值血压流行率为50.9%（95%CI：49.9%~51.9%）。成年居民高血压患病率为27.5%（95%CI：26.6%~28.4%），男性［30.8%（95%CI：29.8%~31.9%）］高于女性［24.2%（95%CI：23.3%~25.1%）］，农村［29.4%（95%CI：28.4%~30.3%）］高于城市［25.7%（95%CI：24.4%~27.1%）］，华北地区［33.3%（95%CI：31.5%~35.2%）］和东北地区［32.7%（95%CI：28.1%~37.4%）］高于其他地区，组间差异均有统计学意义（P<0.000 1）。高血压患者的患病知晓率、治疗率和控制率分别为41.0%（95%CI：39.7%~42.4%）、34.9%（95%CI：33.6%~36.1%）和11.0%（95%CI：10.2%~11.8%），女性和城市高血压患者的患病知晓率、治疗率和控制率均分别高于男性和农村居民（P<0.000 1）。未诊断高血压的居民中，41.9%（95%CI：40.7%~43.2%）曾在近3个月内主动或被动测量血压。 结论： 中国成年居民较高的高血压患病水平和较低的血压测量率，以及高血压患者未见明显改善的知晓、治疗和控制状况，提示高血压防治工作从危险因素干预到患者管理的各个环节仍有待加强，尤其是农村地区。.