ArticleBMJ open2022
Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine the impact of urbanisation on the prevalence, awareness and treatment of hypertension among elderly in China.
designThis cross-sectional study used data from the most recent nationally representative Chinese Longitudinal Healthy Longevity Survey, 2018.
settingPeople in urban and rural communities from 500 sample areas in 22 Chinese provinces.
participantsAfter exclusion, this study surveyed 9859 participants in the final analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: The main dependent variables were prevalence, awareness and treatment of hypertension defined as (1) systolic blood pressure (BP)≥140 mm Hg, diastolic BP≥90 mm Hg or (2) taking antihypertensive drugs. Hypertension awareness was defined as a previous diagnosis of hypertension by a health professional, and hypertension treatment was defined as undergoing BP treatment.
resultsThe prevalence of hypertension was lower among semiurbanised adults than among non-urbanised rural adults (OR=0.94, 95% CI=0.90 to 0.99; p<0.05). The probabilities of awareness (OR=1.10, 95% CI=1.01 to 1.20; p<0.05) and treatment (OR=1.17, 95% CI=1.08 to 1.26; p<0.001) of hypertension were significantly lower among non-urbanised adults than among urban-born adults. Urbanisation in eastern (OR=0.93, 95% CI=0.88 to 0.99; p<0.05) and western China (OR=1.11, 95% CI=1.01 to 1.23; p<0.05) was associated with the prevalence of hypertension. The urbanisation level was also associated with hypertension awareness and treatment in eastern (OR=1.17, 95% CI=1.04 to 1.32; p<0.01; OR=1.26, 95% CI=1.14 to 1.40; p<0.001), central (OR=1.31, 95% CI=1.05 to 1.63; p<0.05; OR=1.29, 95% CI=1.08 to 1.55; p<0.01) and western China (OR=1.28, 95% CI=1.07 to 1.53; p<0.01; OR=1.34, 95% CI=1.15 to 1.57; p<0.001). The Blinder-Oaxaca decomposition suggested that approximately 42% and 39% of the urban-rural gap in hypertension awareness and treatment, respectively, could be attributed to coefficient difference.
conclusionsPublic health programmes and policies for chronic diseases should adjust with urbanisation and combine individual-centred strategies.
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