Abstract
Hypertension is one of the most preventable chronic conditions. Improving hypertension awareness is a critical first step to reducing morbidity and mortality from hypertension in the elderly, yet the factors associated with hypertension awareness in China are poorly understood. The objective of this paper is to examine the extent to which older Chinese adults are aware of their hypertension, and factors associated with this awareness. We included 2404 adults aged 60 years or older clinically identified as hypertensive from panel data surveyed in 1997, 2000, 2004, and 2006 as part of the China Health and Nutrition Survey. Comparing this data with respondents’ self-reported diagnosis of hypertension enabled us to characterize hypertension awareness. Covariates included socio-demographic, health status, functional disability, and behavioral factors. Generalized estimating equations were used to identify factors for hypertension awareness. We found 22.9% in 1997 and 42.7% in 2006 of study participants were aware of their hypertensive status. Lower awareness was found among those who lived in rural areas [odds ratio (OR) = 0.64, 95% Confidence Interval (CI), 0.47–0.88]. Higher awareness was noted for persons who were aware of their hypertensive status in a previous survey wave (OR = 7.43, 95% CI, 5.45–10.13), had high income (OR = 1.55, 95% CI, 1.05–2.28), had stage two hypertension (OR = 2.28, 95% CI, 1.69–3.06), had acute condition (OR = 2.54, 95% CI, 1.89–3.42), and had greater activities of daily living limitations (OR = 1.24, 95% CI, 1.08–1.43). Studying dynamics of hypertension awareness can help inform both clinical and public health approaches to improve healthcare.
Highlights
As its economy has dramatically grown over the past 30 years, China has undergone profound changes in disease prevention and control including increased vaccination coverage, better sanitation, and improved access to medical care [1]
Overall, the proportions of respondents who were aware of their hypertensive status in this study based on China Health and Nutrition Survey (CHNS) ranged between 22.9% in 1997 and 42.7% in 2006
77.1% in 1997 and 57.3% in 2006 were unaware of their hypertension. This level of awareness of hypertension among older Chinese adults is lower than an awareness level suggested by Muntner and colleagues analyzing the InterAsia data in a prior study: 44.1% (≥65 years) [10]
Summary
As its economy has dramatically grown over the past 30 years, China has undergone profound changes in disease prevention and control including increased vaccination coverage, better sanitation, and improved access to medical care [1]. The rapidly aging population coupled with accelerated urbanization places older adults in greater jeopardy of health disparities and inadequate access to health care services [2, 3]. Hypertension presents challenges to individual health and to healthcare delivery and financial systems in China [1]. The burdens of hypertension are more pronouncing older adults [7]. The prevalence of diagnosed hypertension among Chinese adults aged 65 years and older has increased rapidly to 64% in urban and 57% in rural areas [8]
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