Prevalence and characteristics of hypertension in mainland Chinese adults over decades: a systematic review

Hypertension is considered to be the leading risk factor for cardiovascular mortality and accounts for a large proportion of premature deaths in China. An empirical understanding of the pattern of disease burden, such as reliable information about the trend and prevalence of hypertension, is essential in developing effective prevention and control strategies and is also important in the decision-making and planning processes of health. However, there are limited comprehensive reviews or nationwide studies that reveal the current burden of hypertension in China. This review is to systematically evaluate hypertension prevalence and determinants as well as its awareness, treatment and control over decades in China. A systematic search was performed for epidemiological studies on hypertension, published between 1982 and January 2013. MeSH major topic terms 'hypertension' and 'prevalence' and 'China' were used in the search. Data on hypertension prevalence, determinants and awareness, as well as its treatment and control, were extracted and compared. Sixty articles were included for data extraction. The prevalence reported in the studies varied from 7.17 to 51.2%. Awareness, treatment and control rates also varied regionally. Except in the central region of China, where a declining trend in hypertension prevalence was witnessed, a rising trend in hypertension prevalence over time could still be observed in other parts of China. Higher hypertension prevalence was found among men and in the urban population, whereas lower prevalence was found in the southern region. Hypertension awareness and treatment rate varied extensively, with a low control rate, nationwide.