Prevalence of hypertension in Chinese cities: a meta-analysis of published studies.

BACKGROUND: Hypertension has been recognized as a health concern for developing countries. However, there are no current nationwide surveys on the prevalence of hypertension in China (the latest nationwide survey was ten years ago). The goal of this study was to estimate the pooled prevalence of hypertension in Chinese cities. METHODS: We systematically reviewed published epidemiologic studies on the prevalence of hypertension in Chinese cities through meta-analysis. We searched for studies published between January 2002 and June 2012 using PubMed and two Chinese electronic publication libraries. The keywords 'hypertension' and 'prevalence' were used. Before pooling prevalence of hypertension, all raw prevalence data was age adjusted to the 2010 China standard population. Prevalence estimates were stratified by sex and geographic area. RESULTS: 27 studies were identified with of a total of 195,027 study participants. The overall pooled prevalence of hypertension was 21.5% (19.4%, 23.6%). Subgroup analyses showed the following results north 25.8% (21.6%, 30.0%), south 20.4% (18.6%, 22.2%); male 22.2% (19.3%, 25.1%), female 19.9% (17.6%, 22.1%); large cities 18.9% (15.7%, 22.1%), medium-sized cities 24.6% (19.9%, 29.4%), small cities 20.6% (17.5%, 23.7%); study years in 2002-2006, 21.9% (18.9%, 24.8%), and study year in 2007-2011, 20.6% (17.3%, 23.9%). CONCLUSIONS: Comparing data from several previous national hypertension surveys, the prevalence of hypertension is higher in cities than the Chinese national average. Subgroup studies also found a higher prevalence of hypertension in northern cities and among males. Also, the prevalence of hypertension in medium-sized and small cities is likely to increase faster than in large cities

Flow diagram of the study selection process.

<p>As shown, our initial searches yielded 8,289 citations: 6,494 from CNKI, 831 from TONGFANG, and 964 from PubMed/MEDLINE. After screening titles and abstracts, 125 studies were considered potentially eligible and retrieved in full text. Of these, 97 studies were subsequently excluded because they did not satisfy the inclusion criteria. Thus, 27 fully eligible studies were identified.</p

Forest plot of all selected studies.

<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0058302#pone-0058302-g002" target="_blank">Figure 2</a> shows unadjusted prevalence estimates (boxes) with 95% confidence limits (bars) for each study selected; pooled prevalence estimates are represented as diamonds in this plot.</p

Summarized information of the studies included in meta-analysis.

a<p>According to the universally agreed standard(population size, GDP, et al.), china cities is divided into three categories, including level A cities (large cities), level B cities (medium-sized cities) and level C cities (small cities).</p>b<p>geographic areas refers to geographic location of china cities, including southern (S: southern) cities and northern (N: northern) cities.</p>c<p>GP: General population; PP: Permanent population.</p>d<p>NR: not reported in original paper; NA: not available.</p