Potential epidemiological impact of the 2017 American College of Cardiology/American Heart Association high blood pressure guideline on the Chinese population: a cross-sectional study in rural areas of Liaoning Province

OBJECTIVES: The present study estimated the percentage of rural Chinese adults with hypertension and recommended pharmacological antihypertensive treatment according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline compared with the 2010 Chinese Guideline for the Management of Hypertension. DESIGN: Cross-sectional study. SETTING: Three counties in rural areas of northeastern China. PARTICIPANTS: A total of 11 747 eligible individuals aged ≥35 years from rural areas of northeastern China were selected for the present analysis. MAIN OUTCOME MEASURES: The percentage of rural Chinese adults with hypertension and recommended pharmacological antihypertensive treatment according to the 2017 ACC/AHA guideline and the 2010 Chinese Guideline for the Management of Hypertension, and the proportion of rural Chinese adults taking antihypertensive medication with blood pressure (BP) above the 2017 ACC/AHA guideline and the 2010 Chinese guideline treatment goal. RESULTS: The mean age of the study population was 53.9±10.8 years and 53.7% of the participants were women. According to the 2017 ACC/AHA guideline and the 2010 Chinese guideline, the crude prevalence of hypertension was 72.2% and 49.8%, respectively, and the percentage of recommended antihypertensive medications for rural Chinese adults was 56.4% and 51.4%, respectively. Among these rural Chinese adults taking antihypertensive medications, 96.7% had above goal BP according to the 2017 ACC/AHA guideline compared with 86.1% with above goal BP according to the 2010 Chinese guideline. CONCLUSION: The present analysis demonstrated that compared with the 2010 Chinese guideline, the 2017 ACC/AHA hypertension guideline will result in a substantial increase in the percentage of rural Chinese adults defined as having hypertension and a small increase in the percentage of adults who are recommended antihypertensive medications. More intensive management is suggested to improve the control rate of hypertension among rural Chinese adults.