OBJECTIVETo analyze the trends in prevalence, awareness, treatment, control of hypertension among middle-aged Chinese.

METHODSThe study comprised two cross-sectional surveys including urban and rural residents, manual workers, farmers and fishermen in different southern and northern parts of China. There were 13 populations under research with comparable data. 18 746 (in 1992 - 1994) and 13 504 (in 1998) participants, aged 35 through 59 years, equal number of men and women, were examined in each of the surveys, on blood pressure measurement, in 1992 - 1994 and in 1998. Hypertension was defined as systolic pressure >/= 140 mm Hg, and/or diastolic pressure >/= 90 mm Hg, and/or reported treatment with antihypertensive medications. Awareness and treatment on hypertension were assessed with standardized questions. Hypertension control was defined as measured blood pressure of less than 140/90 mm Hg. Awareness, treatment and control of hypertension were standardized according to the WHO world standard population.

RESULTSIn 1998, 24.0% of participants had hypertension, an increase of 2.3% from 1992 - 1994. Prevalence of hypertension was higher in urban area (25.4%), increasing with age, and higher in men among the younger groups and lower in women among the older groups. Overall, in 1998, 42.6% were aware of their hypertensive status (increase of 5.3%), 31.3% were treated (increase of 3.8%), and the rate under control was 6.0% (increase of 2.6%). The rates of awareness, treatment and control, which tended to increase with age except those aged above 55 years, which were higher in urban areas and women compared with rural areas and men. For people with treated hypertension, the rates of those under control were ranged from 12.7% in 1992 - 1994, to 19.9% in 1998.

CONCLUSIONPrevalence of hypertension was increasing in China, while the rates of control, although improving, continued to be low. This implied that effective public measures needed to be developed to enhance the awareness and rates of treatment.