OBJECTIVETo analyze the prevalence states of hypertension and prehypertension and to explore relevant influencing factors among adult residents in Shandong province.

METHODS15 600 residents aged between 18 and 69 from 20 counties in Shandong province were selected by multiple stratified and clustered sampling method from July to September, in 2011, to acquire related information by questionnaire survey and physical measurement. The prevalence of hypertension and prehypertension was estimated by special statistic method used to deal with complex sampling data, and the relevant influencing factors were also analyzed.

RESULTSA total of 15 350 subjects were actually completed the survey, with age at (41.4 ± 14.1) years old. The average systolic blood pressure and diastolic blood pressure were 121.1(95%CI: 119.7-122.4) and 78.8(95%CI: 77.8-79.9) mmHg (1 mmHg = 0.133 kPa) respectively. And also 3776 hypertension patients and 5721 subjects with prehypertension were detected, and the weighting prevalence of hypertension and prehypertension were 23.4% (95%CI: 20.9%-26.0%) and 37.1% (95%CI: 34.7%-39.5%) with adjustive prevalence at 20.7% and 36.5% respectively. The multiple SURVEYLOGISTIC analysis showed that age above 40 years old (OR = 3.24, 95%CI: 2.56-4.10), overweight(OR = 2.22, 95%CI: 1.70-2.89) and obesity(OR = 5.84, 95%CI: 3.54-9.66), smoking history(OR = 1.82, 95%CI: 1.03-3.23), constantly drinking (OR = 1.71, 95%CI: 1.08-2.70), diabetes (OR = 1.99, 95%CI: 1.29-3.07), abnormal TC(OR = 1.64, 95%CI: 1.24-2.17), abnormal TG(OR = 1.75, 95%CI: 1.24-2.48) and high 24 h urine Na/K ratio (OR = 1.05, 95%CI: 1.02-1.08) were risk factors of hypertension, while education equal to or above junior middle school (OR = 0.68, 95%CI: 0.52-0.89) was protective factor of hypertension; age above 40 years old (OR = 1.49, 95%CI: 1.15-1.91), overweight(OR = 1.76, 95%CI: 1.25-2.48) and obesity (OR = 3.50, 95%CI: 2.05-5.97), abnormal TC (OR = 1.54, 95%CI: 1.10-2.14), abnormal TG (OR = 1.79, 95%CI:1.25-2.56) and high 24 h urine Na/K ratio (OR = 1.02, 95%CI: 1.01-1.04) were risk factors of prehypertension, while female (OR = 0.41, 95%CI: 0.31-0.56) and education level equal to or above junior middle school (OR = 0.67, 95%CI: 0.52-0.87) were protective factors.

CONCLUSIONThe hypertension, especially prehypertension tends to be at high prevalence states currently, which may be affected by many factors.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Middle Aged ; Prehypertension ; epidemiology ; Risk Factors ; Young Adult

Several lines of evidence indicate that prehypertension is more atherogenic than normal blood pressure. Serum gamma-glutamyltransferase (GGT) is known to be positively associated with prehypertensive status and the progression of hypertension. However, there have been no prospective studies of serum GGT level as a predictor of prehypertension. Apparently 13,435 healthy men (mean age 42.0 +/- 6.6 yr) with normal blood pressure were included in a prospective cohort study in 2005 and were followed up to 2010 with the endpoint being incident of prehypertension. During the follow up period (median 2.80 +/- 1.44 yr; actual follow-up 37,679.1 person-year), prehypertension was developed in 7,867 (58.6%) participants. Risk estimations for incident prehypertension were analyzed based on quartiles of serum GGT levels using multivariate adjusted Cox proportional hazards model. In unadjusted model, the hazard ratio for incident prehypertension for the highest 3 quartiles of baseline serum GGT level was 1.21 (1.13-1.29), 1.29 (1.21-1.38), and 1.57 (1.47-1.67) compared the lowest quartile of serum GGT level, respectively (P for trend < 0.001). These associations still remained statistically significant, even after adjusting for multiple covariates. These findings indicate that increased serum GGT level is independently associated with incident prehypertension in Korean men.
Adult ; Biological Markers/blood ; Blood Pressure ; Cohort Studies ; Humans ; Hypertension/blood ; Incidence ; Male ; Oxidative Stress ; Prehypertension/*blood/epidemiology ; Prospective Studies ; Republic of Korea/epidemiology ; gamma-Glutamyltransferase/*blood

OBJECTIVETo investigate the incidence and risk factors of prehypertension among adults in mainland China and identify the high-risk population.

METHODSSix databases including Chinese Biological Medical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), China National Knowledge Infrastructure (CNKI), Wanfang Database (WF), PubMed and Web of Knowledge were searched for publications documenting the incidence and risk factors of prehypertension among general population in Chinese adults. Eligible studies were selected according to the inclusion and exclusion criteria for meta-analysis using Stata software and RevMan software.

RESULTSTwenty-one published studies were finally included. The results showed that the incidence of prehypertension was 37% in Chinese adults. The pooled SMD (95% confidence interval [CI]) was 0.37 (0.29-0.46) for body mass index, 0.20 (0.12-0.27) for fasting blood glucose (FPG), 0.17 (0.15-0.19) for total cholesterol (TC), 0.22 (0.17-0.27) for triglyceride (TG), 0.13 (0.10-0.15) for low-density lipoprotein cholesterol (LDL-C), and -0.07 (-0.16-0.02) for high-density lipoprotein cholesterol (HDL-C). For smoking, drinking and family history of hypertension, the pooled OR (95% CI) were 1.44 (1.40-1.47), 1.60 (1.44-1.79), and 1.19 (1.04-1.35), respectively.

CONCLUSIONThe incidence of prehypertension among adults in mainland China is relatively high, especially in males. BMI, FBG, TC, TG, LDL-C, smoking, drinking and family history of hypertension are positively related to prehypertension, and early intervention is recommended to reverse these modifiable risk factors.

Adult ; Asian Continental Ancestry Group ; Body Mass Index ; China ; epidemiology ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hypertension ; Incidence ; Male ; Prehypertension ; epidemiology ; Risk Factors ; Smoking ; Triglycerides

Objective: To estimate the prevalence, awareness, treatment and control rate of hypertension among young and middle-aged population in China. Methods: The analysis was based on the results of 2012-2015 China Hypertension Survey, which was a cross-sectional stratified multistage random sampling survey. A total of 229 593 subjects were included in the final analysis. The data including sex, age, living in urban and rural areas, prevalence of hypertension, history of stroke, family history of coronary heart disease and drinking, physical examination, heart rate were collected. Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mmHg (1 mmHg=0.133 kPa), and (or) diastolic blood pressure (DBP) ≥90 mmHg, and (or) self-report a history of hypertension, and (or) use of antihypertensive medicine within 2 weeks before survey. Prehypertension was defined as SBP between 120-139 mmHg, and (or) DBP between 80-89 mmHg. Control of hypertension was considered for hypertensive individuals with SBP<140 mmHg and DBP<90 mmHg. The prevalence of prehypertension, hypertension, awareness, treatment, control rate were calculated, and the control rate among those with antihypertensive medication was also calculated. Results: The prevalence of prehypertension and hypertension was 43.8% (95%CI: 42.3%-45.4%), and 22.1% (95%CI: 20.8%-23.3%), respectively. The prevalence of prehypertension and hypertension was significantly higher among male than female across different age groups. The awareness, treatment, control rate of hypertension and control rate among treated hypertensive participants were 43.8%, 33.2%, 16.7%, and 40.2%, respectively. The prevalence was higher, and the control rate was lower among individuals with higher heart rate. Conclusion: The prevalence of prehypertension and hypertension among young and middle-aged population is high, the awareness, treatment and control rate need to be further improved in this population. The prevention and treatment of hypertension should be strengthened in the future to improve the control rate of hypertension in China.
Middle Aged ; Male ; Female ; Humans ; Antihypertensive Agents/therapeutic use* ; Prehypertension/epidemiology* ; Prevalence ; Cross-Sectional Studies ; Hypertension/drug therapy* ; Blood Pressure ; China/epidemiology*

Previous epidemiologic studies have shown the clinical association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD). However, there is only limited information about the effect of NAFLD on the development of hypertension. Accordingly, we investigated the clinical association between NAFLD and prehypertension. A prospective cohort study was conducted on the 11,350 Korean men without prehypertension for 5 yr. The incidences of prehypertension were evaluated, and Cox proportional hazard model was used to measure the hazard ratios (HRs) for the development of prehypertension according to the degree of NAFLD (normal, mild, moderate to severe). The incidence of prehypertension increased according to NAFLD states (normal: 55.5%, mild: 63.7%, moderate to severe: 70.3%, P<0.001). Even after adjusting for multiple covariates, the HRs (95% confidence interval) for prehypertension were higher in the mild group (1.18; 1.07-1.31) and moderate to severe group (1.62; 1.21-2.17), compared to normal group, respectively (P for trend <0.001). The development of prehypertension is more potentially associated with the more progressive NAFLD than normal and milder state. These findings suggest the clinical significance of NAFLD as one of risk factors for prehypertension.
Adult ; Blood Glucose ; Blood Pressure ; Cohort Studies ; Diabetes Mellitus, Type 2/complications/diagnosis ; Humans ; Incidence ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/complications/*diagnosis ; Prehypertension/diagnosis/*epidemiology/etiology ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Smoking