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Incidence and predictors of hypertension over 8 years among Chinese men and women

Gu, Dongfenga,*; Wildman, Rachel Pb,*; Wu, Xiquia; Reynolds, Kristic; Huang, Jianfenga; Chen, Chung-Shiuanc; He, Jiangc

doi: 10.1097/HJH.0b013e328013e7f4
Original papers: Epidemiology

Objective To determine the 8-year incidence of hypertension and its risk factors among Chinese adults.

Methods A population-based sample of 10 525 Chinese adults aged ≥40 years and free from hypertension at baseline was followed up from 1991 to 1999–2000. Incident hypertension was defined as systolic pressure ≥140 mmHg, diastolic pressure ≥90 mmHg, or current use of antihypertensive medication.

Results Over a mean of 8.2 years of follow-up, 28.9% of men and 26.9% of women developed hypertension. Among men, independent predictors of incident hypertension were baseline age [relative risk (RR) per 5 years: 1.10; 95% confidence interval (CI): 1.07, 1.13], living in urban regions versus rural regions (RR: 0.74; 95% CI: 0.64, 0.85), alcohol drinking versus non-drinking (RR: 1.13; 95% CI: 1.02, 1.24), prehypertension versus normotension (RR: 1.70; 95% CI: 1.53, 1.88), heart rate (RR of third versus first tertile: 1.27; 95% CI: 1.13, 1.44), body mass index (RR of third versus first tertile: 1.28; 95% CI: 1.12, 1.46) and low versus high physical activity (RR: 1.27; 95% CI: 1.10, 1.47). Results were similar for women, with current smoking in place of alcohol drinking and opposite results for region. The population-attributable risk of modifiable risk factors was between 25 and 50%.

Conclusions These data indicate that the incidence of hypertension is high among these Chinese adults, and suggest that 25–50% of new hypertension cases could be prevented with risk factor modification. Given the excess cardiovascular mortality associated with hypertension, these data call for urgent improvements in hypertension prevention and control programs in China.

aThe Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China

bThe Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York

cThe Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA

*D.G. and R.P.W. contributed equally to this work.

Received 24 July, 2006

Accepted 8 November, 2006

Correspondence and requests for reprints to Dongfeng Gu, MD, MS, Professor of Epidemiology and Director, Division of Population Genetics and Prevention, Cardiovascular Institute and Fu Wai Hospital, No. 167 Beilishi Rd., Beijing 100037, PR China Tel: +86 (10) 68331752; fax: +86 (10) 88363812; e-mail: gudf@yahoo.com

Conflict of interest: none.

© 2007 Lippincott Williams & Wilkins, Inc.