Gender-Specific Prevalence and Risk Factors of Hypertension in a Chinese Rural Population: The Henan Rural Cohort Study.

Fayaz AHMAD; Tahir MEHMOOD; Xiao Tian LIU; Ying Hao YUCHI; Ning KANG; Wei LIAO; Rui Yu WU; Bota BAHETI; Xiao Kang DONG; Jian HOU; Sohail AKHTAR; Chong Jian WANG

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Gender-Specific Prevalence and Risk Factors of Hypertension in a Chinese Rural Population: The Henan Rural Cohort Study.

Author: Fayaz AHMAD ¹ ; Tahir MEHMOOD ² ; Xiao Tian LIU ¹ ; Ying Hao YUCHI ¹ ; Ning KANG ¹ ; Wei LIAO ¹ ; Rui Yu WU ¹ ; Bota BAHETI ¹ ; Xiao Kang DONG ³ ; Jian HOU ¹ ; Sohail AKHTAR ⁴ ; Chong Jian WANG ³
Author Information

1. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.
2. School of Natural Sciences (SNS), National University of Sciences and Technology (NUST), Islamabad 44000, Pakistan.
3. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China;Department of Neurology, The First Affiliated Hospital of Zhengzhou University; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou 450052, Henan, China.
4. Department of Mathematics and Statistics, The University of Haripur, Haripur 22620, Khyber Pakhtunkhwa, Pakistan.
Publication Type:Journal Article
Keywords: Cohort study; Gender disparities; Hypertension; Risk factors; Rural China
MeSH: Humans; Hypertension/etiology*; China/epidemiology*; Female; Male; Rural Population/statistics & numerical data*; Prevalence; Risk Factors; Middle Aged; Adult; Aged; Longitudinal Studies; Sex Factors; Cohort Studies; East Asian People
From: Biomedical and Environmental Sciences 2025;38(11):1417-1429
CountryChina
Language:English
Abstract: OBJECTIVE:To investigate hypertension (HTN) trends, key risk factors, and gender disparities in rural China, and to propose targeted strategies for improving HTN control in resource-limited settings.
METHODS:This longitudinal study used data from the Henan Rural Cohort Study, including baseline (2015-2017; n = 39,224) and follow-up (2018-2022; n = 28,621) participants. HTN was defined as systolic/diastolic blood pressure ≥ 140/90 mmHg, self-reported diagnosis, or use of antihypertensive medication. Severity was classified using a 7-tier blood pressure (BP) staging system (optimal, normal, high normal, and HTN stages 1-4). A generalized linear mixed-effects model (GLMM) identified associated risk factors.
RESULTS:HTN prevalence increased modestly from 32.7% (95% CI: 32.2-33.2) to 33.9% (95% CI: 33.3%-34.4%). Awareness and treatment improved from 20.1% to 25.3%, and from 18.8% to 24.4%, respectively, but control rates remained low (6.2% to 12.3%). After adjustment, women had a 1.53-fold higher HTN risk than men ( OR = 1.53, 95% CI: 1.43-1.63), revealing gender-specific trends. Key risk factors included alcohol use ( OR = 1.37, 95% CI: 1.27-1.47) and overweight status ( OR = 1.76, 95% CI: 1.66-1.86). BP staging showed an increase in optimal BP (42.3% to 45.8%), but stagnant management of advanced HTN stages.
CONCLUSION:Hypertension in rural China is shaped by behavioral risk factors and healthcare access gaps. Gender-sensitive, community-based interventions, including task-shifting models, are necessary to mitigate the growing burden of hypertension.