Changes in average blood pressure and incidence of high blood pressure 1983-1984 to 1987-1988 in four population cohorts in the People's Republic of China

Objective. To assess comparative changes in systolic and diastolic blood pressure and incidence of high blood pressure over 4 years, and factors related to these changes, in northern and southern, urban and rural adults in the People's Republic of China. Setting. This is a prospective study of populations surveyed by standardized methods in 1983-1984 and 1987-1988 in north China, Beijing area steel mill workers and farmers, and south China, Guangzhou area shipyard workers and farmers. Subjects. The subjects were 8805 men and women aged 35-54 years at baseline (1983-1984), of whom 7338 were non-hypertensive (systolic blood pressure < 140, diastolic blood pressure < 90 mmHg, not being administered antihypertensive drugs). Main outcome measures. The main outcome measures were 4-year changes in systolic and diastolic blood pressures and the 4-year incidence of high blood pressure in persons not hypertensive at baseline. Results. At baseline, the average systolic and diastolic blood pressures were higher for Beijing than for Guangzhou cohorts. At resurvey the average systolic blood pressure had increased for seven of eight sex-city-setting cohorts (all but Guangzhou urban men). The Beijing urban cohorts had the greatest increases (men 6.2 mmHg, women 4.9 mmHg, slopes of 1.6 and 1.2 mmHg/year). The incidence of high blood pressure was higher for Beijing than for Guangzhou cohorts in all four comparisons (men and women, urban and rural), Beijing men, urban and rural, had the highest incidence rates (about 21%). In multiple logistic analyses by sex, variables significantly related to 4-year high blood pressure incidence were city, baseline systolic blood pressure and body mass index, change in weight, and, for men, baseline alcohol use and heart rate. Conclusion. Modifiable lifestyle traits, previously shown to be related to blood pressure and high blood pressure in cross-sectional studies, also relate to the incidence of hypertension.