Abstract
In China, the prevalence of hypertension is currently 18.8 %, and a major risk factor for hypertension is unbalanced dietary sodium and potassium intakes. High dietary sodium intake may change the circadian rhythm of 24-h blood pressure, which is characterized by a higher nighttime blood pressure. The prevalence of isolated nighttime hypertension, defined as a nighttime blood pressure of at least 120 mm Hg systolic or 70 mm Hg diastolic and a daytime systolic/diastolic blood pressure less than 135/85 mm Hg, is higher in Chinese than in Europeans. The complications of hypertension are also different across ethnicities, being mainly stroke instead of myocardial infarction in Chinese. Lowering of blood pressure provides more protection against stroke than against myocardial infarction, and calcium channel blockers provide more protection against stroke than do other classes of antihypertensive drugs. Current Chinese hypertension guidelines recommend calcium channel blockers as the most suitable class of drugs of the five classes of antihypertensive drugs.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs11906-012-0288-1/MediaObjects/11906_2012_288_Fig1_HTML.gif)
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Staessen JA, Wang JG, Bianchi G, Birkenhäger WH. Essential hypertension. Lancet. 2003;361:1629–41.
Wu X, Duan X, Gu D, Hao J, Tao S, Fan D. Prevalence of hypertension and its trends in Chinese populations. Int J Cardiol. 1995;52:39–44.
Li LM, Rao KQ, Kong LZ, Yao CH, Xiang HD, Zhai FY, Ma GS, Yang XG, the Technical Working Group of China National Nutrition and Health Survey. A description on the Chinese national nutrition and health survey in 2002. Chin J Epidemiol. 2005;26:478–84. Chinese.
Li Y, Staessen JA, Li LH, Gao PJ, Thijs L, Zhu DL, Wang JG. Blood pressure and urinary sodium excretion in relation to the A-1984 G adrenomedullin polymorphism in a Chinese population. Kidney Int. 2006;69:1153–8.
Wang JG, Liu LF, Zagato L, Xie JX, Fagard R, Jin KG, Wang JX, Li Y, Bianchi G, Staessen JA, Liu LS. Blood pressure in relation to three candidate genes in a Chinese population. J Hypertens. 2004;22:937–44.
Zhou BF, Stamler J, Dennis B, Moag-Stahlberg A, Okuda N, Robertson C, Zhao L, Chan Q, Elliott P, INTERMAP Research Group. Nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s: the INTERMAP study. J Hum Hypertens. 2003;17:623–30.
• Liu L, Wang JG, Ma SP, Wang W, Lu FH, Zhang LQ, Banya W, Peters R, Beckett N, Fletcher A, Bulpitt CJ. Chinese subjects entered in the Hypertension in the Very Elderly Trial (HYVET). Chin Med J. 2008;121:1509–12. In hypertensive patients over 80 years of age, Chinese had significantly lower serum potassium concentration than other patient populations. This phenomenon might reflect lower dietary intakes of potassium in Chinese.
Savage PJ, Pressel SL, Curb JD, Schron EB, Applegate WB, Black HR, Cohen J, Davis BR, Frost P, Smith W, Gonzalez N, Guthrie GP, Oberman A, Rutan G, Probstfield JL, Stamler J. Influence of long-term, low-dose, diuretic-based, antihypertensive therapy on glucose, lipid, uric acid, and potassium levels in older men and women with isolated systolic hypertension: the Systolic Hypertension in the Elderly Program. SHEP Cooperative Research Group. Arch Intern Med. 1998;158:741–51.
Franse LV, Pahor M, Di Bari M, Somes GW, Cushman WC, Applegate WB. Hypokalemia associated with diuretic use and cardiovascular events in the Systolic Hypertension in the Elderly Program. Hypertension. 2000;35:1025–30.
ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981–97.
Guyton AC. Blood pressure control–special role of the kidneys and body fluids. Science. 1991;252:1813–6.
Li Y, Wang JG, Gao PJ, Guo HF, Nawrot T, Wang GL, Qian YS, Staessen JA, Zhu DL. Are published characteristics of the ambulatory blood pressure generalizable to rural Chinese? The JingNing population study. Blood Press Monit. 2005;10:125–34.
Li Y, Staessen JA, Lu L, Li LH, Wang GL, Wang JG. Is isolated nocturnal hypertension a novel clinical entity? Findings from a Chinese population study. Hypertension. 2007;50:333–9.
Li LH, Li Y, Huang QF, Sheng CS, Staessen JA, Wang JG. Isolated nocturnal hypertension and arterial stiffness in a Chinese population. Blood Press Monit. 2008;13:157–9.
•• Fan HQ, Li Y, Thijs L, Hansen TW, Boggia J, Kikuya M, Björklund-Bodegård K, Richart T, Ohkubo T, Jeppesen J, Torp-Pedersen C, Dolan E, Kuznetsova T, Stolarz-Skrzypek K, Tikhonoff V, Malyutina S, Casiglia E, Nikitin Y, Lind L, Sandoya E, Kawecka-Jaszcz K, Imai Y, Ibsen H, O’Brien E, Wang J, Staessen JA, on behalf of the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) Investigators. Prognostic value of isolated nocturnal hypertension in 8711 subjects from 10 populations. J Hypertens. 2010;28:2036–45. In an international collaboration of prospective population studies on ambulatory blood pressure monitoring, the prevalence of isolated nocturnal hypertension was higher in East Asians than in eastern and western Europeans. Isolated nocturnal hypertension was associated with unfavorable cardiovascular health outcomes.
Asia Pacific Cohort Studies Collaboration. Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens. 2003;21:707–16.
He J, Ogden LG, Vupputuri S, Bazzano LA, Loria C, Whelton PK. Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults. JAMA. 1999;282:2027–34.
Boggia J, Li Y, Thijs L, Hansen TW, Kikuya M, Björklund-Bodegård K, Richart T, Ohkubo T, Kuznetsova T, Torp-Pedersen C, Lind L, Ibsen H, Imai Y, Wang JG, Sandoya E, O’Brien E, Staessen JA, on behalf of the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes (IDACO) Investigators. Prognostic accuracy of the day versus night ambulatory blood pressure revisited in 7458 randomly recruited subjects. Lancet. 2007;370:1219–29.
Kario K, Matsuo T, Kobayashi H, Imiya M, Matsuo M, Shimada K. Nocturnal fall of blood pressure and silent cerebrovascular damage in elderly hypertensive patients. Advanced silent cerebrovascular damage in extreme dippers. Hypertension. 1996;27:130–5.
Kario K, Pickering TG, Matsuo T, Hoshide S, Schwartz JE, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertension. 2001;38:852–7.
Liu L, Wang JG, Gong L, Liu G, Staessen JA, for the Systolic Hypertension in China (Syst-China) Collaborative Group. Comparison of active treatment and placebo for older Chinese patients with isolated systolic hypertension. J Hypertens. 1998;16:1823–9.
Wang JG, Staessen JA, Gong L, Liu L, for the Systolic Hypertension in China (Syst-China) Collaborative Group. Chinese trial on isolated systolic hypertension in the elderly. Arch Intern Med. 2000;160:211–20.
Gong L, Zhang W, Zhu Y, Zhu J, Kong D, Pagé V, Ghadirian P, LeLorier J, Hamet P. Shanghai trial of nifedipine in the elderly (STONE). J Hypertens. 1996;14:1237–45.
Liu L, Zhang Y, Liu G, Li W, Zhang X, Zanchetti A, FEVER Study Group. The Felodipine Event Reduction (FEVER) Study: a randomized long-term placebo-controlled trial in Chinese hypertensive patients. J Hypertens. 2005;23:2157–72.
•• Wang JG, Kario K, Lau T, Wei YK, Park CG, Kim CH, Huang J, Zhang WZ, Li Y, Yan P, Hu D. Use of the dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: a scientific statement of the Asian Pacific Heart Association. Hypertens Res. 2011;34:423–30. In this scientific statement, clinical studies on the management of hypertension in East Asians were comprehensively reviewed and discussed with the focus on dihydropyridine calcium channel blockers. In East Asians, calcium channel blockers are more efficacious than other classes of antihypertensive drugs in lowering blood pressure.
Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a meta-analysis. Lancet. 2001;358:1305–15.
Wang JG, Li Y, Franklin S, Safar M. Prevention of stroke and myocardial infarction by amlodipine and angiotensin receptor blockers: a quantitative overview. Hypertension. 2007;50:181–8.
Pristipino C, Beltrame JF, Finocchiaro ML, Hattori R, Fujita M, Mongiardo R, Cianflone D, Sanna T, Sasayama S, Maseri A. Major racial differences in coronary constrictor response between Japanese and Caucasians with recent myocardial infarction. Circulation. 2000;101:1102–8.
Sueda S, Kohno H, Fukuda H, Uraoka T. Did the widespread use of long-acting calcium antagonists decrease the occurrence of variant angina ? Chest. 2003;124:2074–8.
Wang JG, Liu M. Utilization of genetic information for the dissection of complex diseases or traits. Hypertens Res. 2011;34:1255–6.
Acknowledgments
The authors were financially supported by grants from the National Natural Science Foundation of China (grants 30871360, 30871081, and 81170245), the Ministry of Science and Technology [2006BAI01A03 and a grant for China–European Union collaborations (1012)], the Ministry of Education, Beijing, China (NCET-09-0544), the Shanghai Commission of Science and Technology (grant 07JC14047, the “Rising Star” program 06QA14043, and 11QH1402000), the Shanghai Commission of Education (grant 07ZZ32 and the “Dawn” project 08SG20), the Shanghai Bureau of Health (XBR2011004), Shanghai Jiaotong University School of Medicine (a Distinguished Young Investigators grant to Yan Li), and the European Union (grants LSHM-CT-2006-037093 and HEALTH-F4-2007-201550).
Disclosure
J.-G. Wang received compensation for consulting and lectures from A&D, AstraZeneca, Bayer, Boehringer Ingelheim, GlaxoSmithKline, MSD, Novartis, Omron, Pfizer, Sankyo, Sanofi, Servier, and Takeda; Y. Li: none.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wang, JG., Li, Y. Characteristics of Hypertension in the Chinese Population. Curr Hypertens Rep 14, 410–415 (2012). https://doi.org/10.1007/s11906-012-0288-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11906-012-0288-1