International Journal of Public Health

, Volume 64, Issue 9, pp 1375–1387 | Cite as

Generational differences in longitudinal blood pressure trajectories by geographic region during socioeconomic transitions in China

  • Jinjing Wu
  • Peter A. Muennig
  • Katherine Keyes
  • Jilei WuEmail author
Original article



To examine generational differences in longitudinal blood pressure trajectories by region following socioeconomic transitions, which is important for establishing the population risk of cardiovascular diseases (CVDs).


With data from the China Health and Nutrition Survey (1991–2011), we used multilevel growth-curve models to estimate systolic/diastolic blood pressure (SBP/DBP) levels at the mean age and rates of change by cohort (born between 1931 and 1980), region, and sex.


Younger cohorts generally had higher SBP/DBP levels at 44.5 years but lower growth rates in SBP/DBP than older cohorts. They became prehypertensive (SBP ≥ 120 mm Hg or DBP ≥ 80 mm Hg) at an earlier age. The upward shift of SBP/DBP trajectories across cohorts was more pronounced in the Coastal and Southern Mountainous Regions than the Northeastern and Inland Regions, and for males versus females.


Younger cohorts have a longer lifetime duration of being susceptible to CVDs, posing warnings for an increased burden of CVDs. Generational differences in BP trajectories and geographic and sex variations in the cohort trends highlight the need for tailored interventions to tackle the generation, region, and sex-based risk of CVDs.


Systolic/diastolic blood pressure trajectories Socioeconomic transitions Life course perspective Generational differences Geographic variations China 



This research used data from China Health and Nutrition Survey (CHNS). We are grateful to the National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, the Carolina Population Center, the University of North Carolina at Chapel Hill, and all the people involved in the program of China Health and Nutrition Survey.


This work was supported by National Social Science Foundation (No. 17ZDA124) and China Postdoctoral Science Foundation (No. 2019M650083). The funders had no role in study design, in the analysis and interpretation of data, in the writing of the paper, or in the decision to submit the paper for publication.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was exempt from ethical approval because it was limited to the publicly available China Health and Nutrition Survey dataset that contained no personally identifiable information beyond birthdates.

Informed consent

All participants provided informed consent before being enrolled in the China Health and Nutrition Survey.

Supplementary material

38_2019_1276_MOESM1_ESM.docx (289 kb)
Supplementary material 1 (DOCX 289 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2019

Authors and Affiliations

  • Jinjing Wu
    • 1
  • Peter A. Muennig
    • 2
  • Katherine Keyes
    • 3
  • Jilei Wu
    • 4
    Email author
  1. 1.Asian Demographic Research InstituteShanghai UniversityShanghaiChina
  2. 2.Department of Health Policy and Management, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  3. 3.Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  4. 4.Institute of Population ResearchPeking UniversityBeijingChina

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