World Health Matters – China: Most stroke patients have hypertension

by Gary Finnegan: Around three quarters of stoke patients in China have hypertension, according to data presented at the 26^th Great Wall International Congress of Cardiology.

The study by Dr Meilian Tang, Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, is based on data from 20,570 patients hospitalised for acute stroke at 41 hospitals in 25 provinces in China.

The hospital admissions occurred from January to May 2011 and the average age of patients was 63 years. Nearly two thirds (64% were male).

“Stroke is the leading cause of death in China and a significant source of disability,” said Dr Tang. “Our study investigated the levels of risk factors patients had before being hospitalised for stroke, whether patients knew about their risk factors, and whether the risk factors were under control.”

The investigators found that 75.5% of patients had hypertension, 53.5% had high low-density lipoprotein (LDL) cholesterol, 33.2% were smokers, 37.3% had diabetes and 6.5% had atrial fibrillation (irregular heartbeat).

The researchers found that 75.2% of stroke patients had two or more risk factors and 43.0% had three or more risk factors.

“Most stroke patients had multiple risk factors for stroke before they were admitted to hospital with a stroke,” said Dr Tang. “This shows that there are warning signs that people can address to avoid having a stroke.”

For 15,329 patients this was their first stroke. Of those who had hypertension, 70% were aware of it but only 20% receiving treatment had reached their target blood pressure. Just over half of the diabetics knew about it (54.4%) but only 9.1% of those with elevated LDL were aware of the fact.

Awareness of risk factors was higher in patients with recurrent stroke (83.0% for hypertension, 70.2% for diabetes and 16.1% for elevated LDL) but control rates were low.

“Chinese people often eat high salt diets and this is likely to be a big contributor to the high prevalence of hypertension in stroke patients,” continued Dr Tang. “Lack of exercise and low prescription of medications to control blood pressure, serum LDL cholesterol and blood glucose and may also contribute to the elevated levels of risk factors.”

Professor Dayi Hu, president of the China Heart Federation and president of the Chinese Association of Tobacco Control (CATC), said: “Smoking and salt consumption are out of control in China. We desperately need a ban on smoking in public plans and reduced salt levels in processed food. Prevention of cardiovascular disease has not been given enough priority and the Chinese population is paying the price through death and disability.”