Hypertension in China: epidemiology and treatment initiatives

The past two to three decades have seen a steady increase in the prevalence of hypertension in China, mainly owing to increased life expectancy and lifestyle changes. Data from the China hypertension survey conducted in 2012–2015 revealed a high prevalence of grade 3 hypertension in the general population, which increased with age to up to 5% among individuals aged ≥65 years. The risk profile of patients with hypertension in China has also been the subject of intense study in the past 30 years. Dietary sodium and potassium intake have remained the same in China over the past three decades. Salt substitution strategies effectively reduce blood pressure levels and the risk of cardiovascular events and death. However, the number of individuals with risk factors for hypertension and cardiovascular disease in general, such as physical inactivity and obesity, has increased dramatically in the same period. Moreover, even in patients diagnosed with hypertension, their disease is often poorly managed due to a lack of patient education and poor treatment compliance. This Review summarizes the latest epidemiological data on hypertension in China, discusses the risk factors for hypertension specific to this population, and describes several ongoing nationwide hypertension control initiatives targeting these risk factors, especially in the low-resource rural setting.