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Hypertension in China: a large and increasing public health challenge.

H ypertension is the leading preventable risk factor for cardiovascular disease and premature death in China [1,2]. The prevalence of hypertension is high and increasing in China in recent years [3–5]. For example, the 2002 China National Nutrition and Health Survey, conducted in a nationally representative sample of 141 892 Chinese adults aged not less than 18 years, reported 18% (20% in men and 17% in women) or 153 million Chinese adults had hypertension [3]. In 2010, the prevalence of hypertension increased to 33.6% (35.3% in men and 32.0% in women) or 335.8 million Chinese adults based on the China Noncommunicable Disease Surveillance 2010, which was conducted in a nationally representative sample of 98 658 Chinese adults aged at least 18 years [4,5]. Both surveys used the same sampling method to select a nationally representative sample covering major geographic areas of all 31 provinces, autonomous regions, and municipalities in mainland China. Recently, several other national surveys in China also reported the prevalence of hypertension in the Chinese general population (Table 1) [6,7]. The China National Diabetes and Metabolic Disorders Study reported an agestandardized prevalence of hypertension of 26.6% in a nationally representative sample of 46 239 adults aged not less than 20 years in 2007–2008 [6]. Likewise, the China National Survey of Chronic Kidney Disease reported an age-standardized prevalence of hypertension of 29.6% in a nationally representative sample of 50 171 adults aged at least 18 years in 2009–2010 [7]. The differences in the prevalence of hypertension among these studies might be partially due to measurement methods. Whereas the China National Diabetes and Metabolic Disorders Study and the China National Survey of Chronic Kidney Disease used a standardized mercury sphygmomanometer, the China