The prevalence of monotherapy and combination therapy in hypertension in China from 2019 to 2021: A nationwide population-based cross-sectional study

Temporal trends and relevant factors of hypertension in China: a cross-sectional study based on national surveys from 2002 to 2019

PURPOSE

This study examined temporal trends in hypertension prevalence across China (2002-2019), analyzing age-, sex-, and region-specific disparities and identifying key risk factors.

MATERIALS AND METHODS

A retrospective analysis was conducted using data from the China Chronic Disease and Risk Factor Surveillance (CCDRFS) program, involving 120,000 adults aged ≥18 years. Descriptive statistics were used to calculate prevalence rates, and multivariable logistic regression analyzed associations with age, sex, BMI, smoking, alcohol consumption, and physical inactivity.

RESULTS

Hypertension prevalence increased significantly from 18.9% (2002) to 29.6% (2019) (P<0.001). The sharpest rise occurred among adults aged 18-44 years, tripling from 5.3% to 12.8%. By 2019, prevalence was higher in men (34.2%) than women (25.4%), with the western regions showing the highest rates (32.9%). Key risk factors included aging (OR=1.72), elevated BMI (OR=1.85), smoking (OR=1.32), alcohol use (OR=1.28), and physical inactivity (OR=1.18) (P<0.05 for all).

CONCLUSIONS

Hypertension prevalence in China has surged over two decades, disproportionately affecting younger adults and men. Regional disparities and modifiable lifestyle factors underscore the urgency for tailored prevention strategies targeting high-risk populations. Future research should explore mechanisms driving these trends and optimize integrated interventions to curb this public health burden.

Incidence and Risk of Heart Failure in Patients With Coronary Heart Disease and Stroke: A Population-Based Cohort Study

Heart failure (HF) is a major global health issue, with coronary heart disease (CHD) and stroke being risk factors with different mechanisms. The risk of HF in stroke patients remain poorly characterized despite the potential contributions of "stroke-heart syndrome." This study aimed to evaluate HF incidence and risk factors across different cardiovascular disease (CVD) subtypes in a large population-based Chinese cohort. This study included 13,258 CVD patients, i.e. 3,470 patients with CHD (including 610 with myocardial infarction [MI]) and 10,048 with total stroke (comprising 8,631 ischemic and 1,515 hemorrhagic stroke), and 66,290 age- and sex-matched controls without CVD (1:5 ratio). The primary outcome was new-onset HF. Cumulative incidence functions were estimated with non-HF death as a competing event, stratified by CVD subtypes. Cox proportional hazard models were used to assess the risk factors of HF and compare relative hazard ratio (HR) between CHD and stroke patients. The 10-year cumulative incidence of HF was 25.3% in patients with CHD (24.6% in MI patients), 13.5% in stroke patients (14.7% and 7.3% for ischemic and hemorrhagic stroke, respectively), and 6.9% in controls. Hypertension (81.8% in CHD, 81.0% in stroke) significantly increased HF risk compared to those without it (incidence rate ratio: 1.74, 95% CI: 1.41 to 2.12 for stroke; 1.42, 95% CI: 1.12 to 1.78 for CHD). Obesity showed a stronger association with HF in stroke patients than in CHD patients (HR: 1.43, 95%CI: 1.15 to 1.78 vs 0.94, 95%CI: 0.69 to 1.28, ratio of HRs: 1.67, 95% CI: 1.14 to 2.42). Other significant risk factors in both CHD and stroke patients include older age, male sex, former smoking, diabetes, chronic kidney disease, and chronic obstructive pulmonary disease. In conclusion, heart failure incidence varies by CVD subtypes, with the highest risk rates in CHD and MI patients, followed by stroke. Hypertension and obesity notably increase HF risk for stroke patients. Tailored risk management strategies are needed, considering the differential impact of risk factors across CVD subtypes.