Dataset Information

Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project.

ABSTRACT: Background Characterizing and assessing the prevalence, awareness, and treatment patterns of patients with isolated diastolic hypertension (IDH) can generate new knowledge and highlight opportunities to improve their care. Methods and Results We used data from the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) Million Persons Project, which screened 2 351 035 participants aged 35 to 75 years between 2014 and 2018. IDH was defined as systolic and diastolic blood pressure of <140 and ?90 mm Hg; awareness as self-reported diagnosis of hypertension; and treatment as current use of antihypertensive medications. Of the 2 310 184 participants included (mean age 55.7 years; 59.5% women); 73 279 (3.2%) had IDH, of whom 63 112 (86.1%) were untreated, and only 6512 (10.3%) of the untreated were aware of having hypertension. When compared with normotensives, participants who were <60 years, men, at least college educated, had body mass index of >28 kg/m², consumed alcohol, had diabetes mellitus, and prior cardiovascular events were more likely to have IDH (all P<0.01). Among those with IDH, higher likelihood of awareness was associated with increased age, women, college education, body mass index of >28 kg/m², higher income, diabetes mellitus, prior cardiovascular events, and Central or Eastern region (all P<0.05). Most treated participants with IDH reported taking only 1 class of antihypertensive medication. Conclusions IDH affects a substantial number of people in China, however, few are aware of having hypertension and most treated participants are poorly managed, which suggests the need to improve the diagnosis and treatment of people with IDH.

SUBMITTER: Mahajan S

PROVIDER: S-EPMC6806046 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project.

Mahajan Shiwani S Zhang Danwei D He Siyun S Lu Yuan Y Gupta Aakriti A Spatz Erica S ES Lu Jiapeng J Huang Chenxi C Herrin Jeph J Liu Shuling S Yang Jingwei J Wu Chaoqun C Cui Jianlan J Zhang Qiuli Q Li Xi X Nasir Khurram K Zheng Xin X Krumholz Harlan M HM Li Jing J

Journal of the American Heart Association 20190928 19

Background Characterizing and assessing the prevalence, awareness, and treatment patterns of patients with isolated diastolic hypertension (IDH) can generate new knowledge and highlight opportunities to improve their care. Methods and Results We used data from the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) Million Persons Project, which screened 2 351 035 participants aged 35 to 75 years between 2014 and 2018. IDH was defined as systolic and diastolic blood pressure o ...[more]

PMID: 31566101

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Project description:INTRODUCTION:Collection of high-quality data from large populations is considered essential to generate knowledge that is critical to an era of precision medicine. Cardiovascular disease (CVD) is a leading cause of mortality in China and is a suitable focus of an initiative to discover factors that would improve our ability to assess and modify individual risk. METHODS AND ANALYSIS:The pilot phase of China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) Million Persons Project is being conducted during 2014-2015 in four provinces across China to demonstrate the feasibility of a population-based assessment. It is designed to screen 0.4 million community-dwelling residents aged 40-75 years with measurements of blood pressure, height and weight, a lipid blood test, and a questionnaire on cardiovascular-related health status. Participants identified at high risk of CVD receive further health assessments, including ECG, ultrasound scan, blood and urine analysis, and a questionnaire on lifestyle and medical history. Collection of blood and urine samples is used to establish a biobank. High-risk subjects are also counselled with suggestions regarding potential lifestyle changes. In addition, high-risk subjects are followed-up either in a return clinic visit or by telephone interview, with measurement of blood pressure, weight, ECG, and a questionnaire on survival status, hospitalisations and lifestyle. The first 0.1 million participants screened were used to conduct a preliminary analysis, with information on baseline characteristics, health-related behaviours, anthropometric variables, medical history, and prevalence of high-risk subjects. ETHICS AND DISSEMINATION:The central ethics committee at the China National Center for Cardiovascular Disease (NCCD) approved the pilot. Written informed consent is obtained from all participants on entry into the project. Findings will be disseminated in future peer-reviewed papers and will inform strategies aimed at developing precise methods of assessing and modifying risk. TRIAL REGISTRATION NUMBER:NCT02536456.

Project description:ImportanceIsolated systolic hypertension (ISH) is increasing in prevalence among young and middle-aged adults. However, most studies of ISH are limited to older individuals, and a substantial knowledge gap exists regarding younger adults with ISH.ObjectiveTo assess the prevalence, awareness, and characteristics of ISH among younger and middle-aged adults in China.Design, setting, and participantsThis cross-sectional study was performed as part of the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, which enrolled 3.1 million community residents aged 35 to 75 years from all of the 31 provinces in China between December 15, 2014, and May 15, 2019. The present analysis included only participants younger than 50 years. Data were analyzed from May to November 2019.Main outcomes and measuresPrevalence and awareness of ISH (defined as systolic blood pressure of 140 mm Hg or higher and diastolic blood pressure of less than 90 mm Hg) and individual characteristics of participants with ISH.ResultsAmong 898 929 participants aged 35 to 49 years, the mean (SD) age was 43.8 (3.9) years; 548 657 participants (61.0%) were women, and 235 138 participants (26.2%) had hypertension. Of those with hypertension, 62 819 participants (26.7%; 95% CI, 26.5%-26.9%) had ISH (mean [SD] age, 45.0 [3.5] years; 41 417 women [65.9%]), and 54 463 of those with ISH (86.7%; 95% CI, 86.4%-87.0%) had not received treatment. The prevalence of ISH was higher among individuals who were older, were female, were farmers, resided in the eastern region of China, and had an educational level of primary school or lower. Women and older individuals were more likely to have ISH than to be normotensive or to have other hypertension subtypes. Participants who were obese, currently used alcohol, had diabetes, and experienced previous cardiovascular events were more likely to have other types of hypertension and less likely to have normotension than to have ISH. Among the 54 463 participants with ISH who had not received treatment, only 3682 individuals (6.8%; 95% CI, 6.6%-7.0%) were aware of having hypertension, and awareness rates remained low even among those with systolic blood pressure of 160 mm Hg or higher (7135 individuals [13.1%; 95% CI, 12.4%-13.9%]).Conclusions and relevanceIn this study, ISH was identified in 1 of 4 young and middle-aged adults with hypertension in China, most of whom remained unaware of having hypertension. These results highlight the increasing need for better guidance regarding the management of ISH in this population.

Dataset Information

Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project.

Publications

Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project.

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