Temporal trends and geographic disparity in hypertension care in China

BACKGROUND: This study examines trends and geographic disparities in the diagnosis, treatment and control of hypertension in China, and investigates the association between regional factors and hypertension care. METHODS: Blood pressure data and data relating to health care for hypertension were used for this study. The data were sourced from baseline and follow-up surveys of the China Health and Retirement Longitudinal Study conducted in 2011, 2013 and 2015. To estimate the geographical disparities in diagnosis, treatment and control of hypertension, random effects models were also applied after controlling for sociodemographic characteristics. RESULTS: Among hypertensive individuals in China, the trends showed decreases in undiagnosed, untreated, uncontrolled hypertension, 44.1%, 51.6%, and 80.7% in 2011, 40.0%, 47.4%, and 77.8% in 2013, and 31.7%, 38.0%, and 71.4% in 2015, respectively. The number of undiagnosed, untreated, uncontrolled hypertensive residents living in urban areas in 2015 was more than 10% lower than the number in rural areas and among rural-to-urban immigrant individuals in China. The poorest socio-economic regions across China were 8.5 times more likely to leave their residents undiagnosed, 2.8 times more likely to leave them untreated, and 2.6 times more likely to leave hypertension uncontrolled. CONCLUSIONS: Although China has made impressive progress in addressing regional inequalities in hypertension care over time, it needs to increase its effort to reduce geographic disparities and to provide more effective treatments and higher quality care for patients with hypertension.