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, Xiaofeng Liang, Aiqiang Xu, Linghong Wang, Xiaoming Shi, Wenhua Zhao, Jixiang Ma, Xiaolei Guo, Xiaofei Zhang, Jiyu Zhang, Jie Ren, Liuxia Yan, Zilong Lu, Huicheng Wang, Junli Tang, Xiaoning Cai, Jing Dong, Juan Zhang, Jie Chu, Michael Engelgau, Quanhe Yang, Yuling Hong, Yu Wang, Zhenqiang Bi, Xiaofeng Liang, Aiqiang Xu, Linghong Wang, Xiaoming Shi, Wenhua Zhao, Jixiang Ma, Xiaolei Guo, Xiaofei Zhang, Jiyu Zhang, Jie Ren, Liuxia Yan, Zilong Lu, Huicheng Wang, Junli Tang, Xiaoning Cai, Jing Dong, Juan Zhang, Jie Chu, Michael Engelgau, Quanhe Yang, Yuling Hong, Yu Wang

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.

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.

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).

Conclusion: Hypertension and excessive sodium intake in adults are major public health problems in Shandong Province, China.

Figures

Figure 1
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.
Figure 2
Figure 2
Participant flow in the Shandong–Ministry of Health Action on Salt Reduction and Hypertension baseline survey in Shandong Province, China, 2011. In the list of reasons for nonresponse, “out” is defined as not residing in hometown for an extended period because of working or education purposes; “absent” is defined as not at home on the day the survey was conducted.
Figure 3
Figure 3
Age- and sex-specific daily dietary sodium intake of adults participating in the Shandong–Ministry of Health Action on Salt Reduction and Hypertension baseline survey in Shandong Province, China, 2011. [Table: see text]

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Source: PubMed

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