Prevalence, awareness, treatment, and control of diabetes in relation to hypertension status in Chinese adults: a nationwide cross-sectional survey

Abstract

BackgroundPrevious studies have shown that hypertension is an important risk factor for diabetes, and the coexistence of hypertension and diabetes can substantially increase morbidity and mortality of cardiovascular disease. The aim of this study was to estimate the prevalence, awareness, treatment, and control of diabetes in Chinese adults with different status of hypertension. MethodsA cross-sectional survey in a nationally representative sample of 98 658 Chinese adults was done in 2010 using a complex, multistage, probability sampling design. Diabetes was defined according to the 2010 American Diabetes Association criteria. All estimates were weighted to represent the overall Chinese adult population. The study protocol was approved by the Ethical Review Committee of the Chinese Center for Disease Control and Prevention. Written informed consent was obtained from all study participants. FindingsThe estimated prevalence of diabetes was 45·9 million (7·1%) in Chinese adults with non-hypertension, 45·5 million (18·0%) in those with newly diagnosed hypertension, and 22·3 million (28·0%) in those with previously diagnosed hypertension. The corresponding rates were 25·1% (11·5 million), 28·1% (12·8 million), and 44·5% (9·9 million) for awareness; 83·4% (9·6 million), 85·6% (10·9 million), and 88·5% (8·8 million) for treatment; and 40·2% (3·8 million), 37·3% (4·0 million), and 42·1% (3·6 million) for control, respectively. Multivariable logistic regression showed that, compared with men with non-hypertension, men with previously diagnosed hypertension were significantly more likely to be diagnosed with (odds ratio [OR] 1·96 [95% CI 1·75–2·21]; p<0·0001), aware of (1·92 [1·57–2·35]; p<0·0001), or treated for (1·78 [1·16–2·74]; p=0·0204) diabetes. In women, those with previously diagnosed hypertension are more likely to be diagnosed with (2·47 [2·22–2·74]; p<0·0001) or aware of (1·83 [1·52–2·19]; p<0·0001) diabetes than those with non-hypertension. Men with previously diagnosed hypertension were more likely to be aware of (46·0% vs 27·6%) and treated for (90·0% vs 84·3%) diabetes than those with newly diagnosed hypertension; women with previously diagnosed hypertension were more likely to be aware of (43·2% vs 28·6%) and controlled for (43·8% vs 34·3%) diabetes than those with newly diagnosed hypertension. InterpretationThe awareness, treatment, and control rates of diabetes in Chinese adults with hypertension are not satisfactory. Screening of diabetes in individuals with hypertension and strategies to ensure these individuals get treated are of vital importance to reduce morbidity and mortality resulting from cardiovascular disease in China. FundingChinese Ministry of Finance, Ministry of Health, and Ministry of Science and Technology