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Impact of intensive hypertension criteria on multimorbidity prevalence and patterns in a multi-ethnic Chinese
Yezhou Liu1, Baibing Mi1, Leilei Pei1
1Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
Insights
Intensive hypertension criteria (130/80 mmHg) increase multimorbidity prevalence but do not change patterns. Hypertension clusters with cardiometabolic conditions, suggesting targeted management strategies are needed for this multimorbidity pattern.
Area of Science:
- Public Health
- Epidemiology
- Cardiology
Background:
- The impact of intensive hypertension criteria on multimorbidity prevalence and patterns is understudied.
- This study investigates multimorbidity using current (140/90 mmHg) and intensive (130/80 mmHg) hypertension criteria in a Chinese population.
Purpose of the Study:
- To determine the effect of intensive hypertension criteria on multimorbidity prevalence and patterns.
- To identify hypertension-related multimorbidity patterns and their characteristics.
Main Methods:
- Utilized data from the Regional Ethnic Cohort Study in Northwest China (n=114,299).
- Defined multimorbidity as at least two chronic conditions from 26 possibilities.
- Employed agglomerative hierarchical cluster analysis to identify multimorbidity patterns, stratified by sex, age, and ethnicity.
Main Results:
- Intensive criteria (130/80 mmHg) increased multimorbidity prevalence from 17.6% to 21.7%.
- Four consistent multimorbidity patterns were identified: cardiometabolic, digestive-bone-kidney, respiratory, and mental-cancer.
- Hypertension consistently clustered within the cardiometabolic pattern with diabetes, heart attack, angina, and stroke/TIA.
Conclusions:
- Revised hypertension criteria significantly expand identified multimorbidity prevalence without altering underlying patterns.
- Hypertension commonly co-occurs within the cardiometabolic multimorbidity cluster.
- Findings emphasize the need for targeted treatment and management strategies for cardiometabolic multimorbidity.
Background:
The impact of intensive hypertension criteria on multimorbidity prevalence and patterns remains understudied. We investigated the prevalence and patterns of multimorbidity using both the current (140/90 mmHg) and intensive (130/80 mmHg) hypertension criteria within a multi-ethnic Chinese population.
Methods:
Data were obtained from the baseline survey of the Regional Ethnic Cohort Study in Northwest China, conducted from June 2018 to May 2019, which enrolled adults aged 35-74 years from five provinces. A total of 114,299 participants were included in this study. Multimorbidity was defined as the presence of at least two chronic diseases or conditions from a list of 26, ascertained through self-report and physical examination. Agglomerative hierarchical cluster analysis was employed to identify multimorbidity patterns. A hypertension-related multimorbidity pattern was identified and further analyzed. The prevalence of multimorbidity and hypertension-related pattern were analyzed in different subgroups, and subgroup cluster analyses were conducted stratified by sex, age, and ethnicity.
Results:
Applying the intensive 130/80 mmHg hypertension criteria resulted in an increase in multimorbidity prevalence from 17.6% (20,128 participants) to 21.7% (24,805 participants) compared to the 140/90 mmHg criteria. Four distinct multimorbidity patterns were consistently identified: cardiometabolic, digestive-bone-kidney, respiratory, and mental-cancer. Hypertension consistently clustered within the cardiometabolic pattern alongside diabetes, acute myocardial infarction, angina, and stroke/TIA, with relatively stable proportions observed even under the 130/80 mmHg threshold.
Conclusion:
The revision of hypertension criteria significantly expands the population identified as having multimorbidity, without altering the identified multimorbidity patterns. Hypertension commonly co-occurs within the cardiometabolic cluster. These findings highlight the need for improved treatment and management strategies specifically targeting cardiometabolic multimorbidity.
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