Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study

Objectives To examine the impact of urbanisation on the prevalence, awareness and treatment of hypertension among elderly in China.Design This cross-sectional study used data from the most recent nationally representative Chinese Longitudinal Healthy Longevity Survey, 2018.Setting People in urban an...

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Main Authors: Qiutong Yu, Genyong Zuo
Format: Article
Language:English
Published: BMJ Publishing Group 2022-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/6/e057065.full
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author Qiutong Yu
Genyong Zuo
author_facet Qiutong Yu
Genyong Zuo
author_sort Qiutong Yu
collection DOAJ
description Objectives To examine the impact of urbanisation on the prevalence, awareness and treatment of hypertension among elderly in China.Design This cross-sectional study used data from the most recent nationally representative Chinese Longitudinal Healthy Longevity Survey, 2018.Setting People in urban and rural communities from 500 sample areas in 22 Chinese provinces.Participants After 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.Results The 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.Conclusions Public health programmes and policies for chronic diseases should adjust with urbanisation and combine individual-centred strategies.
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spelling doaj-art-eca658900c8a47a89f6ba02596adb3df2025-01-27T13:55:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-057065Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional studyQiutong Yu0Genyong Zuo1Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, ChinaObjectives To examine the impact of urbanisation on the prevalence, awareness and treatment of hypertension among elderly in China.Design This cross-sectional study used data from the most recent nationally representative Chinese Longitudinal Healthy Longevity Survey, 2018.Setting People in urban and rural communities from 500 sample areas in 22 Chinese provinces.Participants After 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.Results The 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.Conclusions Public health programmes and policies for chronic diseases should adjust with urbanisation and combine individual-centred strategies.https://bmjopen.bmj.com/content/12/6/e057065.full
spellingShingle Qiutong Yu
Genyong Zuo
Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study
BMJ Open
title Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study
title_full Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study
title_fullStr Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study
title_full_unstemmed Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study
title_short Impact of urbanisation on the gaps of hypertension prevalence, awareness and treatment among older age in China: a cross-sectional study
title_sort impact of urbanisation on the gaps of hypertension prevalence awareness and treatment among older age in china a cross sectional study
url https://bmjopen.bmj.com/content/12/6/e057065.full
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