Scaling up hypertension diagnosis, treatment, and control to target rates was estimated to avert up to 5.91 million CVD cases nationally, with the greatest benefits in rural localities.
Does scaling up hypertension diagnosis, treatment, and control rates reduce CVD burden and advance health equity in China?
Scaling up hypertension diagnosis, treatment, and control rates in China could avert up to 5.91 million CVD cases over 10 years, particularly benefiting rural and upper-middle HDI regions.
Objective: In this study, we developed a microsimulation model to comprehensively estimate how scaling up the performance of hypertension care cascade could prevent CVD cases and advance health equity across urban-rural locality in China.Design and method: Using an individual-level data from a nationally and provincially representative survey in China, we simulated four scenarios for the hypertension care cascades based on a microsimulation model. 80% diagnosis rate, 65% treatment rate, and 50% control rate were considered as the main target for diagnosis scenario, treatment scenario, and control intervention scenario. The impacts of intervention scenarios on CVD risk and the number of CVD cases averted were estimated across urban and rural locality in 31 provinces of mainland China. Results: The total number of individual respondents included in the simulated population was 86,071 adults aged 20-85 years with hypertension. Transitioning from baseline scenario to diagnosis, treatment and control scenario substantially reduced mean 10-year CVD risk in most provinces, with the most pronounced improvements observed in rural locality. Compared to baseline scenario, narrowed urban-rural CVD risk disparities were seen in most provinces, particularly under control scenario. When stratified by human development index (HDI), rural areas in upper-middle HDI regions achieved the greatest CVD averted under the control scenario (22.3 cases averted per 1,000 individuals with hypertension), exceeding urban counterparts (17.1 per 1,000). Provincial-level analyses revealed that rural Liaoning demonstrated the greatest impact under the control scenario, averting 31.8 CVD cases per 1,000 individuals with hypertension, followed by rural Shandong with 27.6 cased averted per 1,000 and rural Shaanxi with 26.9 cases averted per 1,000. Nationally, the estimated number of CVD cases averted for diagnosis, treatment, and control scenario were 1.68 million,1.38 million and 5.91 million, respectively. Conclusions: Strengthening hypertension diagnosis, treatment, and control rates across China would substantially reduce CVD burden, particularly in rural locality and upper-middle HDI regions. Prioritizing these targeted interventions could both reduce CVD burden and advance health equity nationwide, and there should also be a similar effect for the countries or territories with similar conditions.
Cao X (Fri,) conducted a other in Hypertension (n=86,071). Hypertension care cascade scale-up vs. Baseline scenario was evaluated on CVD cases averted and 10-year CVD risk. Scaling up hypertension diagnosis, treatment, and control to target rates was estimated to avert up to 5.91 million CVD cases nationally, with the greatest benefits in rural localities.