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March 3, 2026Journal of Human Hypertension0 citations

Predictors of blood pressure improvement in untreated hypertensive adults in china: a longitudinal analysis of urban-rural differences using CHARLS Data (2015–2020)

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CSChen SunJQJianyu QuTLTaotao Liu

Key Result

Never smoking (OR 1.82) and non-drinking (OR 1.66) significantly increased the odds of blood pressure improvement, while rural residence was associated with lower odds of improvement (OR 0.63).

Key Points

  • Blood pressure improvement was reported by 41.6% of untreated hypertensive individuals by 2018, showing significant outcomes linked to demographic factors.
  • Urban residents had lower odds of blood pressure improvement (OR = 0.63), compared to rural residents, indicating persistent disparities in healthcare.
  • Generalized estimating equations highlighted that lifestyle changes, like not smoking or drinking, enhanced the likelihood of blood pressure improvement in participants over time. While fewer deaths occurred in the improved blood pressure group (1.9%), this was not statistically significant, suggesting further investigation is needed.

Study Design

Type

Cohort (n=502)

Multicenter

Yes

Structured PICO

Do demographic and lifestyle factors predict self-reported blood pressure improvement in untreated middle-aged and elderly hypertensive patients?

P
Population
502 untreated middle-aged and elderly hypertensive patients from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2015-2020
I
Intervention
Lifestyle modifications (never smoking, non-drinking) and urban residence
C
Comparator
Current smoking, heavy drinking, and rural residence
O
Outcome
Self-reported blood pressure improvement by the 2018 follow-uppatient reported

Abstaining from smoking and alcohol significantly improves self-reported blood pressure in untreated hypertensive adults, though rural residents face disparities in hypertension control.

Main Result

Effect estimate: OR 1.82 (95% CI 1.05-3.13)

p-value: p=0.032

Abstract

While non-pharmacological interventions are fundamental to hypertension management, real-world evidence regarding their effectiveness and the specific populations most likely to benefit remains limited in China. This study investigates the demographic and lifestyle factors associated with self-reported blood pressure improvement among untreated middle-aged and elderly hypertensive patients, utilizing longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2015-2020. Among 502 eligible participants not receiving pharmacological treatment, 41.6% reported blood pressure improvement by the 2018 follow-up. Generalized Estimating Equations (GEE) analysis revealed that residential and lifestyle factors were significantly associated with hypertension management outcomes. Specifically, rural residents had significantly lower odds of improvement compared to their urban counterparts (OR = 0.63, 95% CI: 0.40-0.99, p = 0.047). In contrast, lifestyle modifications showed a clear protective effect: never smokers (OR = 1.82, 95% CI: 1.05-3.13, p = 0.032) and non-drinkers (OR = 1.66, 95% CI: 1.09-2.53, p = 0.017) demonstrated significantly higher odds of blood pressure improvement compared to current smokers and heavy drinkers, respectively. While the 2020 follow-up indicated a lower mortality rate in the improved group (1.9%) compared to the ineffective group (4.1%), this difference did not reach statistical significance. These findings highlight that abstaining from smoking and alcohol remains a cornerstone of non-pharmacological blood pressure management. Furthermore, the observed urban-rural disparity suggests a critical need for targeted public health interventions and enhanced resource allocation to support hypertension control in China's rural communities.

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Cite This Study

Sun et al. (2026) conducted a cohort in Untreated hypertension (n=502). Never smoking vs. Current smoking was evaluated on Self-reported blood pressure improvement (OR 1.82, 95% CI 1.05-3.13, p=0.032). Never smoking (OR 1.82) and non-drinking (OR 1.66) significantly increased the odds of blood pressure improvement, while rural residence was associated with lower odds of improvement (OR 0.63).

synapsesocial.com/papers/69a75f78c6e9836116a2addchttps://doi.org/10.1038/s41371-026-01117-w
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