Predictors of progression from prehypertension to hypertension among rural Chinese adults: results from Liaoning Province

Background Individuals with prehypertension are at a high risk of developing hypertension. Little is known about the predictors of progression from prehypertesion to hypertension in rural Chinese adults.

Methods A population-based sample of 15 061 rural Chinese aged ≥ 35 years with prehypertension free cardiovascular diseases at baseline were followed-up from 2004–2006 to 2008. Incident hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or current use of antihypertensive medications.

Results During the 28-month follow-up period, 4917 individuals (32.6%) with prehypertension developed hypertension, in which only 1.5% (n = 73) of incident cases reached BP control target. After Cox stepwise regression analysis, baseline age (per 5 years) [hazard ratio (HR): 1.111; 95% confidence interval (CI): 1.095–1.126], Mongolian (HR: 1.079; 95% CI: 1.010–1.152), alcohol drinking, overweight and obese (HR: 1.349; 95% CI: 1.261–1.444), salt intake everyday, inappropriate physical activity, and family history of hypertension were associated with incident hypertension independent of initial systolic and diastolic BP. Among these predictors, current alcohol drinking (odds ratio: 1.126; 95% CI: 1.049–1.209), salt intake, and overweight and obese were associated only with increased systolic BP, whereas inappropriate physical activity contributed only to increase diastolic BP.

Conclusion These data suggest a high incidence of hypertension in individuals with prehypertension. Lifestyle modifications such as cessation of drinking, healthy diet, and moderate physical activity are advised to prevent or delay the progression of prehypertension to hypertension in rural areas of China.