Date Published: January 17, 2017
Publisher: Public Library of Science
Author(s): Lihua Hu, Xiao Huang, Chunjiao You, Juxiang Li, Kui Hong, Ping Li, Yanqing Wu, Qinhua Wu, Huihui Bao, Xiaoshu Cheng, Yan Li.
This study aimed to describe the prevalence and risk factors of prehypertension and hypertension in Jiangxi Province, China. Individuals with prehypertension frequently progress into hypertension and are at high risk of developing cardiovascular disease and stroke.
A cross-sectional survey of 15,296 participants (15 years or older) was conducted in Jiangxi Province, China, in 2013, using questionnaire forms and physical measurements.
The prevalence of prehypertension and hypertension was 32.3% (39.2% in men and 27.6% in women) and 29.0% (30.1% in men and 28.2% in women), respectively. The awareness, treatment, and control rates among all hypertensive participants were 64.8%, 27.1%, and 12.6%, respectively. The prevalence of prehypertension in males declined with age, but the prevalence of hypertension increased in different genders. The prevalence of prehypertension and hypertension increased with increasing body mass index (BMI). The prevalence of prehypertension decreased, in parallel to an increase in the prevalence of hypertension, with increasing waist circumference (WC). A combination of WC and BMI was superior to individual indices in identifying hypertension. A multivariate logistic regression analysis indicated that increasing age, high BMI, high visceral adipose index, and high heart rate were risk factors for prehypertension and hypertension. The high body fat percentage was significantly associated with prehypertension. Living in an urban area, male sex, abdominal obesity, and menopause were correlated with hypertension.
Prehypertension and hypertension are epidemic in southern China. Further studies are needed to explore an indicator that can represent the visceral fat accurately and has a close relationship with cardiovascular disease.
Hypertension is not only a well-known risk factor for cardiovascular disease but also a public health challenge worldwide . More than 1.5 billion individuals are estimated to currently have hypertension [1–3]. Studies have indicated that blood pressure (BP) values of 120–139/80–89 mm Hg are associated with an increased risk of cardiovascular morbidity and mortality compared with BP levels below 120/80 mm Hg [4–6]. The concept of prehypertension has been defined for a detailed study of the risks of elevated BP. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) proposed high BP category, including 120–139 mm Hg systolic BP (SBP) or 80–89 mm Hg diastolic BP (DBP), designated as prehypertension . According to JNC-7, individuals with prehypertension have a higher risk of developing hypertension compared with those with ideal BP levels; also, they have an increased risk of cardiovascular morbidity and mortality [5–9]. Previous studies have shown that prehypertension is related to a 1.7-fold increase in coronary artery disease and a 3.5-fold increase in myocardial infarction . Moreover, prehypertension is often closely linked to target organ damage, such as early arteriosclerosis, small vascular damage, coronary artery calcification, vascular remodeling, and left ventricular hypertrophy [11–13].
As shown in S1 Table, a total of 15,296 participants from 15,364 eligible participants (6,279 males and 9,017 females; aged 15–97 years) were included in the statistical analysis. Of those, 7805 participants came from urban areas and 7491 from rural areas. Sixty-eight participants were excluded because of missing data including sex, age, BP, and so on. The majority of nonresponders were young people because of their busy work (Fig 1).
Many epidemiological studies have demonstrated that prehypertension and hypertension are the biggest contributors to the global burden of disease worldwide, and the prevalence of prehypertension and hypertension in different countries and districts differs significantly. The present findings showed that the prevalence of prehypertension was 32.3% among individuals 15 years or older in Jiangxi Province, which was consistent with the rate in the adult population of Zhejiang Province (32.1%)  and lower than the rate in northeastern China (36.0%) , Taiwanese adults (34.0%) , Brazilian adults (36.1%) , and southern Iran adults . Also, the overall prevalence of hypertension in this study was 29.0%, which was comparable to that in China (29.6%)  and developed countries such as the United States (29.3%) , higher than that in Zhejiang Province (24.59%)  and inner Mongolia (28.61%) , but significantly lower than that reported in previous studies [14,18,24].