2011 年至 2015 年中国中老年人群高血压患病率、知晓率、治疗率和控制率的城乡差异：一项重复横断面研究。
Urban-rural disparities in hypertension prevalence, awareness, treatment, and control among Chinese middle-aged and older adults from 2011 to 2015: a repeated cross-sectional study.
机构信息
School of Public Health, Peking University, Beijing, 100191, China.
Division of Environmental Health Science, School of Public Health, University of California, Berkeley, Berkeley, CA, 94720, USA.
出版信息
BMC Cardiovasc Disord. 2022 Jul 17;22(1):319. doi: 10.1186/s12872-022-02769-5.
BACKGROUND
China has experienced a continuing increase in hypertension prevalence over the past few decades, especially in rural areas. The paper aims to examine the variation of urban-rural disparities in hypertension prevalence, awareness, treatment, and control among Chinese middle-aged and older adults between 2011 and 2015.
METHODS
Our team extracted data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey of residents aged 45 years and older. In this study, we used the 2011 wave and the 2015 wave of CHARLS. We calculated crude rates and age-adjusted rates of hypertension prevalence, awareness, treatment, and control for the general, urban, and rural populations in each wave and performed chi-square tests to examine urban-rural disparities. We used logistic regression to further confirm these disparities by controlling confounding factors in each wave. We then used generalized estimating equation (GEE) to further examine whether urban-rural disparities changed between 2011 and 2015.
RESULTS
We included 11,129 records in the 2011 wave and 8916 records in the 2015 wave in this study. The mean age was 59.0 years and 5359 (48.2%) participants were male in the 2011 wave. Age-adjusted hypertension prevalence, awareness, treatment, control, and control among treated in the total population were 38.5%, 70.6%, 59.2%, 27.4%, and 46.4% in 2015. Urban-rural disparities in the indicators mentioned above were 5.7%, 13.4%, 15.3%, 9.4% and 5.6% in 2011; which decreased to 4.8%, 2.7%, 5.2%, 4.9% and 3.8% in 2015. Urban-rural disparities in prevalence, awareness and treatment were statistically significant in 2011 but not significant in 2015 adjusted for confounding factors, yet control disparities were statistically significant in both waves. Finally, urban-rural disparities in awareness and treatment had narrowed from 2011 to 2015.
CONCLUSIONS
Awareness, treatment, and control rates were sub-optimal among both urban and rural adults. Prevention and management of hypertension among both urban and rural adults should be further strengthened. Awareness and treatment increased more rapidly among rural adults, indicating some achievement had been made in enhancing the healthcare system in rural areas. More efforts are needed in attaining urban-rural equity of healthcare services.
背景
过去几十年，中国的高血压患病率持续上升，尤其是在农村地区。本文旨在探讨 2011 年至 2015 年中国中老年人群城乡高血压患病率、知晓率、治疗率和控制率的变化情况。
方法
我们从中国健康与养老追踪调查（CHARLS）中提取数据，这是一项对 45 岁及以上居民进行的全国代表性调查。在本研究中，我们使用了 CHARLS 的 2011 年波和 2015 年波的数据。我们计算了每个波城乡总体、城市和农村人群的高血压患病率、知晓率、治疗率和控制率的粗率和年龄调整率，并进行了卡方检验以检验城乡差异。我们使用逻辑回归在每个波中控制混杂因素进一步证实了这些差异。然后，我们使用广义估计方程（GEE）进一步检验 2011 年至 2015 年期间城乡差异是否发生了变化。
结果
本研究共纳入 2011 年波的 11129 条记录和 2015 年波的 8916 条记录。2011 年波的平均年龄为 59.0 岁，5359 名（48.2%）参与者为男性。2015 年，总人口中高血压的年龄调整患病率、知晓率、治疗率、控制率和治疗控制率分别为 38.5%、70.6%、59.2%、27.4%和 46.4%。城乡之间在上述指标上的差异在 2011 年为 5.7%、13.4%、15.3%、9.4%和 5.6%，而在 2015 年则降至 4.8%、2.7%、5.2%、4.9%和 3.8%。城乡之间的患病率、知晓率和治疗率在 2011 年调整混杂因素后具有统计学意义，但在 2015 年则不具有统计学意义，而控制率的城乡差异在两个波次中均具有统计学意义。最后，城乡之间的知晓率和治疗率差距从 2011 年到 2015 年有所缩小。
结论
城乡成年人的知晓率、治疗率和控制率都不理想。应进一步加强城乡成年人的高血压预防和管理。农村成年人的知晓率和治疗率增长较快，表明农村地区的医疗保健系统取得了一些成就。需要进一步努力实现城乡医疗服务公平。
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