Preventing Chronic Disease | Hypertension Prevalence, Awareness, Treatment, and Control and Sodium Intake in Shandong Province, China: Baseline Results From Shandong–Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011 - CDC
Hypertension Prevalence, Awareness, Treatment, and Control and Sodium Intake in Shandong Province, China: Baseline Results From Shandong–Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011
Zhenqiang Bi, PhD; Xiaofeng Liang, MS; Aiqiang Xu, PhD; Linghong Wang, MS; Xiaoming Shi, PhD; Wenhua Zhao, PhD; Jixiang Ma, PhD; Xiaolei Guo, MS; Xiaofei Zhang, PhD; Jiyu Zhang, MS; Jie Ren, MS; Liuxia Yan, MS; Zilong Lu, MS; Huicheng Wang, MS; Junli Tang, MS; Xiaoning Cai, MS; Jing Dong, MS; Juan Zhang, PhD; Jie Chu, PhD; Michael Engelgau, MD; Quanhe Yang, PhD; Yuling Hong, MD, PhD; Yu Wang, PhD
Suggested citation for this article: Bi Z, Liang X, Xu A, Wang L, Shi X, Zhao W, et al. Hypertension Prevalence, Awareness, Treatment, and Control and Sodium Intake in Shandong Province, China: Baseline Results From Shandong–Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011. Prev Chronic Dis 2014;11:130423. DOI: http://dx.doi.org/10.5888/pcd11.130423
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Abstract
Introduction
In China, population-based blood pressure levels and prevalence of hypertension are increasing. Meanwhile, sodium intake, a major risk factor for hypertension, is high. In 2011, to develop intervention priorities for a salt reduction and hypertension control project in Shandong Province (population 96 million), a cross-sectional survey was conducted to collect information on sodium intake and hypertension prevalence, awareness, treatment, and control.
In China, population-based blood pressure levels and prevalence of hypertension are increasing. Meanwhile, sodium intake, a major risk factor for hypertension, is high. In 2011, to develop intervention priorities for a salt reduction and hypertension control project in Shandong Province (population 96 million), a cross-sectional survey was conducted to collect information on sodium intake and hypertension prevalence, awareness, treatment, and control.
Methods
Complex, multistage sampling methods were used to select a provincial-representative adult sample. Blood pressure was measured and a survey conducted among all participants; condiments were weighed in the household, a 24-hour dietary recall was conducted, and urine was collected. Hypertension was determined by blood pressure measured on a single occasion and self-reported use of antihypertension medications.
Complex, multistage sampling methods were used to select a provincial-representative adult sample. Blood pressure was measured and a survey conducted among all participants; condiments were weighed in the household, a 24-hour dietary recall was conducted, and urine was collected. Hypertension was determined by blood pressure measured on a single occasion and self-reported use of antihypertension medications.
Results
Overall, 23.4% (95% confidence interval [CI], 20.9%–26.0%) of adults in Shandong were estimated to have hypertension. Among those classified as having hypertension, approximately one-third (34.5%) reported having hypertension, approximately one-fourth (27.5%) reported taking medications, and one-seventh (14.9%) had their blood pressure controlled (<140/<90 mm Hg). Estimated total average daily dietary sodium intake was 5,745 mg (95% CI, 5,428 mg–6,063 mg). Most dietary sodium (80.8%) came from salt and high-salt condiments added during cooking: a sodium intake of 4,640 mg (95% CI, 4,360 mg–4,920 mg). The average daily urinary sodium excretion was 5,398 mg (95% CI, 5,112 mg–5,683 mg).
Overall, 23.4% (95% confidence interval [CI], 20.9%–26.0%) of adults in Shandong were estimated to have hypertension. Among those classified as having hypertension, approximately one-third (34.5%) reported having hypertension, approximately one-fourth (27.5%) reported taking medications, and one-seventh (14.9%) had their blood pressure controlled (<140/<90 mm Hg). Estimated total average daily dietary sodium intake was 5,745 mg (95% CI, 5,428 mg–6,063 mg). Most dietary sodium (80.8%) came from salt and high-salt condiments added during cooking: a sodium intake of 4,640 mg (95% CI, 4,360 mg–4,920 mg). The average daily urinary sodium excretion was 5,398 mg (95% CI, 5,112 mg–5,683 mg).
Conclusion
Hypertension and excessive sodium intake in adults are major public health problems in Shandong Province, China.
Hypertension and excessive sodium intake in adults are major public health problems in Shandong Province, China.
Figure 1. Location of the sampled countries/districts in Shandong Province, China, Shandong–Ministry of Health Action on Salt Reduction and Hypertension baseline survey, 2011. [A text description of this figure is also available.]
Author Information
Corresponding Author: Yu Wang, PhD, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, 102206, People’s Republic of China. Telephone: 86-10-58900301. E-mail: wangyu@chinacdc.cn.
Author Affiliations: Zhenqiang Bi, Aiqiang Xu, Xiaolei Guo, Jiyu Zhang, Jie Ren, Zilong Lu, Junli Tang, Jing Dong, Jie Chu, Academy of Preventive Medicine, Shandong University, Jinan, China, and Shandong Center for Disease Control and Prevention, Jinan, China; Xiaofeng Liang, Xiaoming Shi, Wenhua Zhao, Huicheng Wang, Juan Zhang, Chinese Center for Disease Control and Prevention, Beijing, China; Linghong Wang, Jixiang Ma, Liuxia Yan, Xiaoning Cai, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Xiaofei Zhang, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China; Michael Engelgau, Quanhe Yang, Yuling Hong, Centers for Disease Control and Prevention, Atlanta, Georgia.
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