CHARACTERISTICS OF DIFFERENT HYPERTENSION STAGES IN CHINA —RESULTS FROM A NATIONAL CROSS-SECTIONAL UPPDATE STUDY

Abstract

Objective: We sought to investigate the prevalence and characteristics of patients with hypertension stage 1, 2, and 3 according to 2023 ESH guidelines for the management of hypertension. Design and method: A cross-sectional study was carried out in 90 centers from 15 cities in China from 2017-2018. Patients aged over 18 years with essential hypertension were investigated. Hypertension stage 1 was defined as uncomplicated hypertension without hypertension-mediated organ damage (HMOD), diabetes, cardiovascular disease (CVD) and without chronic kidney disease (CKD) >=stage 3. Hypertension stage 2 was defined as presence of HMOD, diabetes, or CKD stage 3. Hypertension stage 3 was defined as presence of CVD or CKD stage 4 or 5. Results: A total of 4286 patients were included, 56% of whom were male. Hypertension stage 1, 2, and 3 account for 28%, 50%, and 22% respectively. Ninety-three % of the total patients were having antihypertensive therapy. The average BP was 133±12/85±11 mmHg, 146±17/83±12 mmHg, and 143±19/84±13 mmHg in hypertension stage 1, 2, and 3 respectively. Lipid lowering therapy accounted for 40%, 49%, and 71% respectively, which was relatively low. The average LDL-C level was 3.0±1.0mmol/L, 2.9±1.0mmol/L, and 2.6±1.4mmol/L respectively, which was far from the goal of LDL-C management. Homocysteine was 11.2±9.6 μmol/L, 13.6±9.1 μmol/L, and 19.0±11.2 μmol/L, which increased from stage 1 to stage3. Conclusions: Hypertension stage 2 accounted for half of the patients with hypertension in China. The average blood pressure was much higher in stage 2 and stage 3. Only 71% of hypertension stage 3 were having lipid lowering therapy and LDL-C levels were far from the recommended goal. Homocysteine was positively associated with hypertension stage.