Underdiagnosis of hypertension reveals bigger health system gap in China, experts say

Xiao Mingying, 64, a retired worker in Shanghai, is among the 100 million old people on the mainland who have high blood pressure.

The condition afflicts more than one in two of this 60-plus-year-old population, but what’s more troubling is that 40 per cent don’t know it, according to findings from the landmark China Health and Retirement Longitudinal Study (CHARLS) released on Friday.

With a rapidly ageing population – and increasing age being one of the key risk factors for hypertension – China face a huge health burden. Hypertension is the most common risk factors for cardiovascular disease and contributes nearly 9.4 million deaths worldwide due to heart disease and stroke every year.

More importantly, this large-scale underdiagnosis of hypertension suggests a major health system gap in China, say the study researchers.

Yang Gonghuan, professor of epidemiology at the Chinese Academy of Medical Sciences and one of the study’s principal investigators, says the pattern of disease in China has changed. Non-communicable diseases such as hypertension and diabetes have overtaken infectious diseases as the major disease burden. “But China’s healthcare system lags behind,” she said.

Professor James P. Smith, the Distinguished Chair in Labour Markets and Demographic Studies at the Rand Corporation and another of the study’s researchers, said countries like the US and England had similar rates of undiagnosed hypertension 40 or 50 years ago.