S-47-4: THE BURDEN OF CARDIOVASCULAR DISEASE ATTRIBUTABLE TO HIGH SYSTOLIC BLOOD PRESSURE ACROSS CHINA AND ITS PROVINCES FROM 2005 TO 2018

Abstract

Background: The temporal trends and geographical disparity in the burden of cardiovascular diseases (CVD) attributable to high systolic blood pressure (SBP) have not been fully discussed before in Chinese population. The current study was performed to quantify the CVD burden attributable to high SBP in China, which is crucial to inform and improve blood pressure control measures. Methods: We evaluated death numbers, age-standardized mortality rate and years of life lost (YLLs) and corresponding estimated annual percentage changes (EAPC) for CVD and its subcategories attributable to high SBP from 2005 to 2018. We polled data from China Chronic Disease and Risk Factor Surveillance, the China Health and Nutrition Survey and China Hypertension Survey to estimate the BP level between 2005 and 2018. A comparative risk assessment method was applied to compute the deaths and health burden attributable to high SBP for CVD and its subtypes by age, sex, year and provinces. Findings: We estimated that 2·67 million (95%UI 2·61 to 2·73) CVD deaths in China were attributable to elevated SBP in 2018. Age-standardized CVD mortality rate associated with high SBP decreased by 17·89% for China overall between 2005 and 2018, and the EAPC was -1·50 (95% UI -1·55 to -1·45). The death numbers for ischemic heart disease, ischemic stroke due to high SBP showed a relative growth in most provinces, while age standardized mortality rates declined in 2018 compared with 2005 in most provinces, which were in line with the national trend. YLLs for total CVD attributable to high SBP increased from 40·13 million (95%UI, 39·70 to 40·52) in 2005 to 48·16 million (95%UI, 47·44 to 48·90) in 2018 for China overall. YLL rates varied considerably across provinces, ranging from 3217·15 per 100 000 (95%UI 2947·43 to 3441·83) in Fujian to 7196·20 per 100 000 (95%UI 6864·28 to 7498·94) in Heilongjiang in 2018. Age-standardized YLL rates for ischemic heart disease and ischemic stroke attributable to high SBP were high in northeast provinces, including Heilongjiang, Liaoning and Jilin. Interpretation: The deaths and YLLs for CVD attributable to high SBP increased substantially in recent years, especially for the elderly, although age-standardized CVD mortality rate has decreased in China between 2005 and 2018. Preventive interventions should be implemented to lower the prevalence of high SBP among Chinese overall in order to reduce the SBP-related CVD adverse health effect.