Please wait a minute...
 Home  About the Journal Editorial Board Aims & Scope Peer Review Policy Subscription Contact us
Early Edition  //  Current Issue  //  Open Special Issues  //  Archives  //  Most Read  //  Most Downloaded  //  Most Cited
Aging and Disease    2017, Vol. 8 Issue (5) : 558-569     DOI: 10.14336/AD.2016.1220
Original Article |
Uncontrolled Hypertension Increases with Age in an Older Community-Dwelling Chinese Population in Shanghai
Sheng Peng1,Ting Shen1,Jie Liu1,Brian Tomlinson2,Huimin Sun1,Xiaoli Chen1,Paul Chan3,YaShu Kuang1,Liang Zheng1,Hong Wu4,Xugang Ding4,Dingguang Qian4,Yixin Shen1,Pingjin Gao5,Huimin Fan1,Zhongmin Liu1,*,Yuzhen Zhang1,*
1Key Laboratory of Arrhythmias, Ministry of Education, Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
2Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
3Division of Cardiology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
4Gaohang Community Medical Center, Shanghai, 201208, China
5Shanghai Hypertension Institute, Rui Jin Hospital, JiaoTong Univeristy School of Medicine, Shanghai, 200120, China
Download: PDF(819 KB)   HTML
Export: BibTeX | EndNote | Reference Manager | ProCite | RefWorks    

We determined the prevalence of hypertension, medication usage and attainment of blood pressure goals in older (≥65 to <80 years and ≥80 years) urban community-dwelling Chinese subjects. Data were obtained in 3950 subjects (mean age 72.0 years, 1745 male) including 609 subjects aged ≥80 years in the Shanghai Elderly Cardiovascular Health Study (SHECHS). Established cardiovascular disease was present in 7.7% of participants. The prevalence of hypertension was 74.8% overall and it was more than 80% in individuals considered to be in moderate and higher cardiovascular disease risk categories. In hypertensive subjects, 67.1% were on treatment and treatment was more frequent in high and very high cardiovascular risk individuals. Attainment of the systolic blood pressure goal <150 mmHg was 62.9% and was greater in the ≥65 to <80 years group than in the ≥80 years group. The most commonly used antihypertensive treatments were calcium channel blockers (54.2%), followed by angiotensin receptor blockers (43.1%). Diuretics were used in 2.6%. Fixed-dose combination antihypertensive tablets were used in some of the ≥65 to <80 years group (12.4%) and more of the ≥80 years group (18.2%) and 70.9% of the ≥65 to <80 years group and 80.2% of the ≥80 years group were on monotherapy. There were high prevalence and high treatment rates of hypertension, but poor attainment of the systolic blood pressure goal of <150 mmHg, especially in the ≥80 years group of community-dwelling Chinese. Considering that more intensive treatment of hypertension in older subjects may be warranted after recent studies, this might be achieved by more frequent use of combinations of effective therapies and diuretics.

Keywords hypertension      prevalence      cardiovascular disease      older Chinese community population     
Corresponding Authors: Zhongmin Liu,Yuzhen Zhang   
Issue Date: 01 October 2017
E-mail this article
E-mail Alert
Articles by authors
Sheng Peng
Ting Shen
Jie Liu
Brian Tomlinson
Huimin Sun
Xiaoli Chen
Paul Chan
YaShu Kuang
Liang Zheng
Hong Wu
Xugang Ding
Dingguang Qian
Yixin Shen
Pingjin Gao
Huimin Fan
Zhongmin Liu
Yuzhen Zhang
Cite this article:   
Sheng Peng,Ting Shen,Jie Liu, et al. Uncontrolled Hypertension Increases with Age in an Older Community-Dwelling Chinese Population in Shanghai[J]. A&D, 2017, 8(5): 558-569.
URL:     OR
[1] Ezzati M, Riboli E (2013). Behavioral and dietary risk factors for noncommunicable diseases. N Engl J Med, 369: 954-964
[2] Miura K, Nagai M, Ohkubo T (2013). Epidemiology of hypertension in Japan: where are we now?. Circ J, 77: 2226-2231
[3] Liu LS, Writing Group of Chinese Guidelines for the Management of Hypertension (2011). [2010 Chinese guidelines for the management of hypertension]. Zhonghua Xin Xue Guan Bing Za Zhi, 39: 579-615
[4] Sheng CS, Liu M, Kang YY, Wei FF, Zhang L, Li GL, et al. (2013). Prevalence, awareness, treatment and control of hypertension in elderly Chinese. Hypertens Res, 36: 824-828
[5] Systolic Hypertension in the Elderly Program Cooperative Research Group (1991). Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA, 265: 3255-3264
[6] Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. (2008). Treatment of hypertension in patients 80 years of age or older. N Engl J Med, 358: 1887-1898
[7] Dahlof B, Lindholm LH, Hansson L, Schersten B, Ekbom T, Wester PO (1991). Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension). Lancet, 338: 1281-1285
[8] Staessen JA, Fagard R, Thijs L, Celis H, Arabidze GG, Birkenhager WH, et al. (1997). Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet, 350: 757-764
[9] Wang JG, Staessen JA, Gong L, Liu L (2000). Chinese trial on isolated systolic hypertension in the elderly. Systolic Hypertension in China (Syst-China) Collaborative Group. Arch Intern Med, 160: 211-220
[10] Wright JTJr., Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, et al. (2015). A Randomized Trial of Intensive versus Standard Blood-Pressure Control. N Engl J Med, 373: 2103-2116
[11] Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, et al. (2016). Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged >/=75 Years: A Randomized Clinical Trial. JAMA, 315: 2673-2682
[12] Fan H, Li X, Zheng L, Chen X, Lan Q, Wu H, et al. (2016). Abdominal obesity is strongly associated with Cardiovascular Disease and its Risk Factors in Elderly and very Elderly Community-dwelling Chinese. Sci Rep, 6: 21521
[13] Go AS, Bauman MA, Coleman King SM, Fonarow GC, Lawrence W, Williams KA, et al. (2014). An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. J Am Coll Cardiol, 63: 1230-1238
[14] Wu Y, Liu X, Li X, Li Y, Zhao L, Chen Z, et al. (2006). Estimation of 10-year risk of fatal and nonfatal ischemic cardiovascular diseases in Chinese adults. Circulation, 114: 2217-2225
[15] Rodriguez-Roca GC, Llisterri JL, Prieto-Diaz MA, Alonso-Moreno FJ, Escobar-Cervantes C, Pallares-Carratala V, et al. (2014). Blood pressure control and management of very elderly patients with hypertension in primary care settings in Spain. Hypertens Res, 37: 166-171
[16] Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. (2013). Heart disease and stroke statistics--2013 update: a report from the American Heart Association. Circulation, 127: e6-e245
[17] Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JLJr., et al. (2003). The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA, 289: 2560-2572
[18] Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, et al. (2014). Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens, 32: 3-15
[19] Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. (2013). 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J, 34: 2159-2219
[20] James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA, 311: 507-520
[21] Kario K (2016). PREFACE: "The Lower the Better" Association between White-coat Effect-excluded Blood Pressure and Cardiovascular Events in High-risk Hypertension: Insights from SPRINT. Curr Hypertens Rev, 12: 2-10
[22] Kjeldsen SE, Os I, Redon J (2016). Treatment of hypertension and the price to pay; adverse events and discontinuation from randomized treatment in clinical trials. J Hypertens, 34: 1489-1491
[23] Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, et al. (2011). ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents developed in collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension. J Am Soc Hypertens, 5: 259-352
[24] Krause T, Lovibond K, Caulfield M, McCormack T, Williams B (2011). Management of hypertension: summary of NICE guidance. BMJ, 343: d4891
[25] Tomlinson B, Young RP, Chan JC, Chan TY, Critchley JA (1997). Pharmacoepidemiology of ACE inhibitor--induced cough. Drug Saf, 16: 150-151
[1] Jiang Xue,Jiarui Li,Jiaming Liang,Shulin Chen. The Prevalence of Mild Cognitive Impairment in China: A Systematic Review[J]. A&D, 2018, 9(4): 706-715.
[2] Emma EF. Kleipool,Emiel O. Hoogendijk,Marijke C. Trappenburg,M. Louis Handoko,Martijn Huisman,Mike JL. Peters,Majon Muller. Frailty in Older Adults with Cardiovascular Disease: Cause, Effect or Both?[J]. A&D, 2018, 9(3): 489-497.
[3] Nathalie K Zgheib,Fatima Sleiman,Lara Nasreddine,Mona Nasrallah,Nancy Nakhoul,Hussain Isma’eel,Hani Tamim. Short Telomere Length is Associated with Aging, Central Obesity, Poor Sleep and Hypertension in Lebanese Individuals[J]. A&D, 2018, 9(1): 77-89.
[4] Chuan-Fang Dai, Xiang Xie, Yi-Tong Ma, Yi-Ning Yang, Xiao-Mei Li, Zhen-Yan Fu, Fen Liu, Bang-Dang Chen, Min-Tao Gai. Relationship between CYP17A1 Genetic Polymorphism and Essential Hypertension in a Chinese Population[J]. A&D, 2015, 6(6): 486-498.
[5] Karen L. Saban,Herbert L. Mathews,Holli A. DeVon,Linda W. Janusek. Epigenetics and Social Context: Implications for Disparity in Cardiovascular Disease[J]. Aging and Disease, 2014, 5(5): 346-355.
[6] Francisco J. Félix-Redondo,Maria Grau,Daniel Fernández-Bergés. Cholesterol and Cardiovascular Disease in the Elderly. Facts and Gaps[J]. Aging and Disease, 2013, 4(3): 154-169.
[7] João Luis Carvalho-de-Souza,Wamberto A. Varanda,Rita C. Tostes,Andreia Z. Chignalia. BK Channels in Cardiovascular Diseases and Aging[J]. Aging and Disease, 2013, 4(1): 38-49.
[8] Guarner Veronica,Rubio-Ruiz Maria Esther. Aging, Metabolic Syndrome and the Heart[J]. Aging and Disease, 2012, 3(3): 269-279.
Full text



Copyright © 2014 Aging and Disease, All Rights Reserved.
Address: Aging and Disease Editorial Office 3400 Camp Bowie Boulevard Fort Worth, TX76106 USA
Fax: (817) 735-0408 E-mail:
Powered by Beijing Magtech Co. Ltd