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The Expanding Burden of Elevated Blood Pressure in China: Evidence From Jiangxi Province, 2007-2010
Gang Xu1, Junxiu Liu, Shiwei Liu
1From the Department of Preventive Medicine, School of Basic Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang, China (GX, JH); Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA (JL, OO); National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China (SL, YL); Department of Statistics, University of South Carolina, Columbia, South Carolina, USA (HZ); Division of Chronic Disease Control and Prevention, Jiangxi Province Center for Disease Control and Prevention, Nanchang, Jiangxi, China (JL); Chinese Preventive Medicine Association, Beijing, China (JT); and Department of Nosocomial Infectious Prevention and Control, Beijing Friendship Hospital, Capital Medical University, Beijing, China (CZ).
Abstract:
Elevated blood pressure (BP) as a risk factor accounts for the biggest burden of disease worldwide and in China. This study aimed to estimate attributed mortality and life expectancy (LE) to elevated BP in Jiangxi province between 2007 and 2010. BP and mortality data (2007 and 2010 inclusive) were obtained from the National Chronic Diseases and Risk Factors Surveillance Survey and Disease Surveillance Points system, respectively. Population-attributable fraction used in comparative risk assessment of the Global Burden of Disease study 2010 were followed to quantify the attributed mortality to elevated BP, subsequently life table methods were applied to estimate its effects on LE. Uncertainty analysis was conducted to get 95% uncertainty intervals (95% uncertainty interval [UI]) for each outcome. There are 35,482 (95% UI: 31,389-39,928) and 47,842 (42,323-53,837) deaths in Jiangxi province were caused by elevated BP in 2007 and 2010, respectively. 2.24 (1.87-2.65) years of LE would be gained if all the attributed deaths were eliminated in 2007, and increased to 3.04 (2.52-3.48) in 2010. If the mean value of elevated BP in 2010 was decreased by 5 and 10 mm Hg, 5324 (4710-5991) and 11,422 (10,104-12,853) deaths would be avoided, with 0.41 (0.37-0.48) and 0.85 (0.71-1.09) years of LE gained, respectively. The deaths attributable to elevated BP in Jiangxi province has increased by 35% from 2007 to 2010, with 0.8 years of LE loss, suggesting the necessity to take actions to control BP in Chinese population.
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.