Control of hypertension in China: Challenging

Abstract

The most recent data shows that during the period of 2005–2009, about 42% of Chinese adults aged 35–70 years were hypertensive and only 8.2% of hypertensive patients were well controlled [1]. Compared with the data in 2000–2001, prevalence of hypertension has drastically increased while hypertension control rate maintained at low level as well as awareness and treatment rates in midlife Chinese adults (Fig. 1) [1,2]. It is estimated that in China, the number of premature death due to hypertension is more than 2 million, and the corresponding direct medical costs are more than 3.66 billion [3]. In addition, 70% of stroke and 50% of myocardial infarction are attributable to hypertension in China [3]. High salt intake and obesity are main risk factors for hypertension. Data from the China Health and Nutrition Survey showed that an average of 12 g salt per day are consumed by Chinese adults [4], twice more than the recommended salt intake (less than 5 g/d) by World Health Organization (WHO). In addition, approximately 11% of Chinese adults were generally obese and 37% of them were abdominally obese in 2009 and the prevalence of general and abdominal obesity increased greatly from 1993 to 2009 [5]. Besides, lack of physical activity and sedentary behavior (e.g., TV viewing and computer use) are common in Chinese adults, which are other important risk factors for hypertension, as well as smoking and alcohol consumption [3]. Based on the current situation, it is time for China to establish intervention programs to control hypertension and its related risk factors. Indeed, several national intervention programs, such as “National Action of Healthy Lifestyle” and “National Fitness Program (2012–2015)”, have been conducted to reduce hypertension related risk factors. Although there was still a gap on coverage of hypertensive patients in China, community-based standardized management of hypertension (launched by the China Ministry of Health in 2006) and “2010 Guidelines for Prevention and Control of Hypertension in China” played an important role in hypertension management and control. In addition, “China Hypertension Education and Management Action” was launched in August, 2013 in Beijing. The aim of this action was to improve discipline level and service ability of grassroots units of China by standardizing the procedure of diagnosis and treatment and implementing comprehensive management and control strategy. Given the high prevalence, and low awareness, treatment and control of hypertension, national strategies aimed at this disease is urgently needed. As for hypertension prevention, control and management, Chinese government should be the leader and should cooperate with other components, including experts, media, and grassroots units. We believe prevention and control of hypertension will make periodical success through the joint effort of the whole society. Funding: This work was supported by the National “Twelfth FiveYear” Plan for Science & Technology Support Program (2012BAI03B03), the Research Fund for the Doctoral Program of Higher Education of China (20120131120004) and the Foundation for Outstanding Young Scientist in Shandong Province (BS2011YY026).