Zhengzhou Central Hospital, Affiliated to Zhengzhou University, Henan, China.
Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th St, 1617A, New York, NY, 10032, USA.
BMC Public Health. 2019 Apr 23;19(1):421. doi: 10.1186/s12889-019-6753-x.
There has been a limited recognition of hypertension and diabetes in China which has compromised optimal treatment. It is not clear if a screening program implemented by a national health survey has improved awareness and management of these conditions.
The China Health and Retirement Longitudinal Study (CHARLS) is an ongoing longitudinal health survey conducted since 2011 among Chinese people aged 45 years and older. Participants have been assessed every two years by interviews, physical examinations, and fasting glucose samples were taken in 2011. In 2013 and 2015, participants were asked about awareness and management of selected chronic diseases, and they first became aware of these conditions.
Of the 11,000+ participants screened in 2011, 4594 were identified with hypertension and 1703 with diabetes by medical examinations. Over 80% of the middle-aged and elderly Chinese diagnosed with hypertension and/or diabetes in 2011 reported in 2015 that they were unaware of the disease(s). Although some improvement was observed between 2011 and 2015, the main reason for the increase in awareness was a medical examination initiated by the study participant (over 75%), by their work unit or community (12-15%), and rarely (less than 3%) by the CHARLS examination. Participants with a rural household registration status and lower BMI were the most likely to be unaware and to remain unaware of their condition(s).
Disease screening in CHARLS did not lead to significant improvements in awareness of hypertension and diabetes. Improvements should be made by the systematic feedback of screening results to survey participants and the monitoring of disease awareness over time. This will be essential to improve disease recognition and facilitate optimal management.
中国对高血压和糖尿病的认识有限，这影响了这些疾病的最佳治疗效果。目前尚不清楚全国性健康调查实施的筛查项目是否提高了对这些疾病的认识和管理水平。
中国健康与养老追踪调查（CHARLS）是一项正在进行的纵向健康调查，自 2011 年以来对 45 岁及以上的中国人进行了调查。参与者每两年接受一次访谈、体检，并在 2011 年采集空腹血糖样本。在 2013 年和 2015 年，参与者被询问了一些慢性疾病的知晓和管理情况，以及他们首次知晓这些疾病的情况。
在 2011 年筛查的 11000 多名参与者中，有 4594 人通过体检被诊断为高血压，1703 人被诊断为糖尿病。在 2011 年被诊断患有高血压和/或糖尿病的中老年人中，超过 80%的人在 2015 年报告称他们不知道自己患有这种疾病。尽管在 2011 年至 2015 年期间有所改善，但认识提高的主要原因是研究参与者发起的体检（超过 75%）、工作单位或社区发起的体检（12-15%），很少（少于 3%）是由 CHARLS 调查发起的体检。具有农村户籍和较低 BMI 的参与者最有可能不知道自己的病情，也最不可能知道自己的病情。
CHARLS 的疾病筛查并没有显著提高对高血压和糖尿病的认识。应该通过将筛查结果系统地反馈给调查参与者，并监测疾病认识随时间的变化，来提高认识。这对于提高疾病识别能力和促进最佳管理至关重要。
