Skip to main content
Top
Published in: Cardiovascular Diabetology 1/2015

Open Access 01-12-2015 | Original investigation

Awareness, treatment and control of cardiometabolic disorders in Chinese adults with diabetes: a national representative population study

Authors: Tiange Wang, Yu Xu, Min Xu, Weiqing Wang, Yufang Bi, Jieli Lu, Meng Dai, Di Zhang, Lin Ding, Baihui Xu, Jichao Sun, Wenhua Zhao, Yong Jiang, Limin Wang, Yichong Li, Mei Zhang, Shenghan Lai, Linhong Wang, Guang Ning

Published in: Cardiovascular Diabetology | Issue 1/2015

Login to get access

Abstract

Background

The diagnosis of diabetes has important clinic implications for the prevention and management of cardiometabolic disorders. We aimed to investigate the awareness, treatment and control of hypertension and dyslipidemia in previously-diagnosed and newly-diagnosed diabetes in Chinese adult population.

Methods

We conducted a cross-sectional survey in a nationally representative sample of 98658 Chinese adults aged 18 years or older in 2010, using a complex, multistage, probability sampling design. Glycemic status were defined according to the 2010 American Diabetes Association criteria. Hypertension was diagnosed by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Dyslipidemia was diagnosed by the 2004 National Cholesterol Education Program Adult Treatment Panel III.

Results

The weighted prevalence of hypertension and dyslipidemia gradually increased in adults with normal glucose regulation, prediabetes, newly-diagnosed diabetes and previously-diagnosed diabetes. Compared to newly-diagnosed diabetes patients, previously-diagnosed diabetes patients were more likely to be aware of hypertension (weighted percentage [95% confidence interval]: 55.2% [52.9%-57.5%] vs 37.6% [35.9%-39.3%]) and dyslipidemia (33.9% [31.8%-36.1%] vs 12.8% [11.7%-13.9%]), to receive blood pressure-lowing (43.7% [41.5%-46.0%] vs 27.5% [26.0%-29.0%]) and lipid-lowering (18.9% [17.2%-20.7%] vs 5.4% [4.6%-6.2%]) therapies, and to have controlled blood pressure (4.7% [3.5%-6.2%] vs 3.5% [2.6%-4.8%]) and lipid (15.9% [12.3%-20.3%] vs 9.5% [6.4%-13.8%]) levels.

Conclusions

Detection and control of hypertension and dyslipidemia is far from optimal in Chinese adults, especially in newly-diagnosed diabetes. Improved screening for diabetes is required to promote a better prevention, treatment and control of hypertension and dyslipidemia in China.
Appendix
Available only for authorised users
Literature
1.
go back to reference Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, et al. Heart disease and stroke statistics–2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115(5):e69–171.CrossRefPubMed Rosamond W, Flegal K, Friday G, Furie K, Go A, Greenlund K, et al. Heart disease and stroke statistics–2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115(5):e69–171.CrossRefPubMed
2.
go back to reference Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371(9623):1513–8.CrossRefPubMed Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371(9623):1513–8.CrossRefPubMed
3.
go back to reference Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007;370(9602):1829–39.CrossRefPubMed Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet. 2007;370(9602):1829–39.CrossRefPubMed
4.
go back to reference Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, et al. Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol. 2003;32(4):563–72.CrossRefPubMed Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, et al. Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. Int J Epidemiol. 2003;32(4):563–72.CrossRefPubMed
5.
go back to reference Erqou S, Kaptoge S, Perry PL, Di Angelantonio E, Thompson A, White IR, et al. Lipoprotein (a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. Jama. 2009;302(4):412–23.CrossRefPubMed Erqou S, Kaptoge S, Perry PL, Di Angelantonio E, Thompson A, White IR, et al. Lipoprotein (a) concentration and the risk of coronary heart disease, stroke, and nonvascular mortality. Jama. 2009;302(4):412–23.CrossRefPubMed
6.
go back to reference Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet. 2011;377((9765):578–86.CrossRef Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet. 2011;377((9765):578–86.CrossRef
7.
go back to reference Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. Jama. 2013;310(9):959–68.CrossRefPubMed Chow CK, Teo KK, Rangarajan S, Islam S, Gupta R, Avezum A, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. Jama. 2013;310(9):959–68.CrossRefPubMed
8.
go back to reference Tolonen H, Keil U, Ferrario M, Evans A. Prevalence, awareness and treatment of hypercholesterolaemia in 32 populations: results from the WHO MONICA Project. Int J Epidemiol. 2005;34(1):181–92.CrossRefPubMed Tolonen H, Keil U, Ferrario M, Evans A. Prevalence, awareness and treatment of hypercholesterolaemia in 32 populations: results from the WHO MONICA Project. Int J Epidemiol. 2005;34(1):181–92.CrossRefPubMed
9.
go back to reference Goff Jr DC, Bertoni AG, Kramer H, Bonds D, Blumenthal RS, Tsai MY, et al. Dyslipidemia prevalence, treatment, and control in the Multi-Ethnic Study of Atherosclerosis (MESA): gender, ethnicity, and coronary artery calcium. Circulation. 2006;113(5):647–56.CrossRefPubMed Goff Jr DC, Bertoni AG, Kramer H, Bonds D, Blumenthal RS, Tsai MY, et al. Dyslipidemia prevalence, treatment, and control in the Multi-Ethnic Study of Atherosclerosis (MESA): gender, ethnicity, and coronary artery calcium. Circulation. 2006;113(5):647–56.CrossRefPubMed
10.
go back to reference Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open. 2013;3(8):e003423.CrossRefPubMedCentralPubMed Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ Open. 2013;3(8):e003423.CrossRefPubMedCentralPubMed
11.
go back to reference Hogan P, Dall T, Nikolov P. Economic costs of diabetes in the US in 2002. Diabetes Care. 2003;26(3):917–32.CrossRefPubMed Hogan P, Dall T, Nikolov P. Economic costs of diabetes in the US in 2002. Diabetes Care. 2003;26(3):917–32.CrossRefPubMed
12.
go back to reference Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310(9):948–59.CrossRefPubMed Xu Y, Wang L, He J, Bi Y, Li M, Wang T, et al. Prevalence and control of diabetes in Chinese adults. JAMA. 2013;310(9):948–59.CrossRefPubMed
13.
go back to reference van Hoeven KH, Factor SM. A comparison of the pathological spectrum of hypertensive, diabetic, and hypertensive-diabetic heart disease. Circulation. 1990;82(3):848–55.CrossRefPubMed van Hoeven KH, Factor SM. A comparison of the pathological spectrum of hypertensive, diabetic, and hypertensive-diabetic heart disease. Circulation. 1990;82(3):848–55.CrossRefPubMed
14.
go back to reference Querton L, Buysschaert M, Hermans MP. Hypertriglyceridemia and residual dyslipidemia in statin-treated, patients with diabetes at the highest risk for cardiovascular disease and achieving very-low low-density lipoprotein-cholesterol levels. J Clin Lipidol. 2012;6(5):434–42.CrossRefPubMed Querton L, Buysschaert M, Hermans MP. Hypertriglyceridemia and residual dyslipidemia in statin-treated, patients with diabetes at the highest risk for cardiovascular disease and achieving very-low low-density lipoprotein-cholesterol levels. J Clin Lipidol. 2012;6(5):434–42.CrossRefPubMed
15.
go back to reference Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease: an update. Hypertension. 2001;37(4):1053–9.CrossRefPubMed Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease: an update. Hypertension. 2001;37(4):1053–9.CrossRefPubMed
16.
go back to reference Hunt KJ, Gebregziabher M, Egede LE. Racial and ethnic differences in cardio-metabolic risk in individuals with undiagnosed diabetes: National Health and Nutrition Examination Survey 1999–2008. J Gen Intern Med. 2012;27(8):893–900.CrossRefPubMedCentralPubMed Hunt KJ, Gebregziabher M, Egede LE. Racial and ethnic differences in cardio-metabolic risk in individuals with undiagnosed diabetes: National Health and Nutrition Examination Survey 1999–2008. J Gen Intern Med. 2012;27(8):893–900.CrossRefPubMedCentralPubMed
17.
go back to reference Brown TM, Tanner RM, Carson AP, Yun H, Rosenson RS, Farkouh ME, et al. Awareness, treatment, and control of LDL cholesterol are lower among U.S. adults with undiagnosed diabetes versus diagnosed diabetes. Diabetes Care. 2013;36(9):2734–40.CrossRefPubMedCentralPubMed Brown TM, Tanner RM, Carson AP, Yun H, Rosenson RS, Farkouh ME, et al. Awareness, treatment, and control of LDL cholesterol are lower among U.S. adults with undiagnosed diabetes versus diagnosed diabetes. Diabetes Care. 2013;36(9):2734–40.CrossRefPubMedCentralPubMed
18.
go back to reference Yang G, Hu J, Rao KQ, Ma J, Rao C, Lopez AD. Mortality registration and surveillance in China: History, current situation and challenges. Popul Health Metrics. 2005;3(1):3.CrossRef Yang G, Hu J, Rao KQ, Ma J, Rao C, Lopez AD. Mortality registration and surveillance in China: History, current situation and challenges. Popul Health Metrics. 2005;3(1):3.CrossRef
19.
go back to reference Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6(6):790–804.PubMed Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6(6):790–804.PubMed
20.
go back to reference American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62–9.CrossRef American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33 Suppl 1:S62–9.CrossRef
21.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama. 2003;289(19):2560–72.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama. 2003;289(19):2560–72.CrossRefPubMed
22.
go back to reference Grundy SM, Cleeman JI, Merz CN, Brewer Jr HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110(2):227–39.CrossRefPubMed Grundy SM, Cleeman JI, Merz CN, Brewer Jr HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110(2):227–39.CrossRefPubMed
23.
go back to reference Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–47.CrossRefPubMed Wilson PW, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97(18):1837–47.CrossRefPubMed
24.
go back to reference National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Circulation. 2002;106(25):3143–421. National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Circulation. 2002;106(25):3143–421.
25.
go back to reference Ford ES, Li C, Sniderman A. Temporal changes in concentrations of lipids and apolipoprotein B among adults with diagnosed and undiagnosed diabetes, prediabetes, and normoglycemia: findings from the National Health and Nutrition Examination Survey 1988–1991 to 2005–2008. Cardiovasc Diabetol. 2013;12:26.CrossRefPubMedCentralPubMed Ford ES, Li C, Sniderman A. Temporal changes in concentrations of lipids and apolipoprotein B among adults with diagnosed and undiagnosed diabetes, prediabetes, and normoglycemia: findings from the National Health and Nutrition Examination Survey 1988–1991 to 2005–2008. Cardiovasc Diabetol. 2013;12:26.CrossRefPubMedCentralPubMed
26.
go back to reference Sacks FM, Hermans MP, Fioretto P, Valensi P, Davis T, Horton E, et al. Association between plasma triglycerides and high-density lipoprotein cholesterol and microvascular kidney disease and retinopathy in type 2 diabetes mellitus: a global case–control study in 13 countries. Circulation. 2014;129(9):999–1008.CrossRefPubMed Sacks FM, Hermans MP, Fioretto P, Valensi P, Davis T, Horton E, et al. Association between plasma triglycerides and high-density lipoprotein cholesterol and microvascular kidney disease and retinopathy in type 2 diabetes mellitus: a global case–control study in 13 countries. Circulation. 2014;129(9):999–1008.CrossRefPubMed
27.
go back to reference Wasem J, Bramlage P, Gitt AK, Binz C, Krekler M, Deeg E, et al. Co-morbidity but not dysglycaemia reduces quality of life in patients with type-2 diabetes treated with oral mono- or dual combination therapy–an analysis of the DiaRegis registry. Cardiovasc Diabetol. 2013;12:47.CrossRefPubMedCentralPubMed Wasem J, Bramlage P, Gitt AK, Binz C, Krekler M, Deeg E, et al. Co-morbidity but not dysglycaemia reduces quality of life in patients with type-2 diabetes treated with oral mono- or dual combination therapy–an analysis of the DiaRegis registry. Cardiovasc Diabetol. 2013;12:47.CrossRefPubMedCentralPubMed
28.
go back to reference Taubert G, Winkelmann BR, Schleiffer T, Marz W, Winkler R, Gok R, et al. Prevalence, predictors, and consequences of unrecognized diabetes mellitus in 3266 patients scheduled for coronary angiography. Am Heart J. 2003;145(2):285–91.CrossRefPubMed Taubert G, Winkelmann BR, Schleiffer T, Marz W, Winkler R, Gok R, et al. Prevalence, predictors, and consequences of unrecognized diabetes mellitus in 3266 patients scheduled for coronary angiography. Am Heart J. 2003;145(2):285–91.CrossRefPubMed
29.
go back to reference Giraldez RR, Clare RM, Lopes RD, Dalby AJ, Prabhakaran D, Brogan Jr GX, et al. Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-ST-segment elevation acute coronary syndrome. Am Heart J. 2013;165(6):918–25. e912.CrossRefPubMed Giraldez RR, Clare RM, Lopes RD, Dalby AJ, Prabhakaran D, Brogan Jr GX, et al. Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-ST-segment elevation acute coronary syndrome. Am Heart J. 2013;165(6):918–25. e912.CrossRefPubMed
30.
go back to reference Lauruschkat AH, Arnrich B, Albert AA, Walter JA, Amann B, Rosendahl UP, et al. Prevalence and risks of undiagnosed diabetes mellitus in patients undergoing coronary artery bypass grafting. Circulation. 2005;112(16):2397–402.CrossRefPubMed Lauruschkat AH, Arnrich B, Albert AA, Walter JA, Amann B, Rosendahl UP, et al. Prevalence and risks of undiagnosed diabetes mellitus in patients undergoing coronary artery bypass grafting. Circulation. 2005;112(16):2397–402.CrossRefPubMed
31.
go back to reference Anderson RJ, Bahn GD, Moritz TE, Kaufman D, Abraira C, Duckworth W. Blood pressure and cardiovascular disease risk in the Veterans Affairs Diabetes Trial. Diabetes Care. 2011;34(1):34–8.CrossRefPubMedCentralPubMed Anderson RJ, Bahn GD, Moritz TE, Kaufman D, Abraira C, Duckworth W. Blood pressure and cardiovascular disease risk in the Veterans Affairs Diabetes Trial. Diabetes Care. 2011;34(1):34–8.CrossRefPubMedCentralPubMed
32.
go back to reference Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91.CrossRefPubMed Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91.CrossRefPubMed
33.
go back to reference Nagao H, Kashine S, Nishizawa H, Okada T, Kimura T, Hirata A, et al. Vascular complications and changes in body mass index in Japanese type 2 diabetic patients with abdominal obesity. Cardiovasc Diabetol. 2013;12:88.CrossRefPubMedCentralPubMed Nagao H, Kashine S, Nishizawa H, Okada T, Kimura T, Hirata A, et al. Vascular complications and changes in body mass index in Japanese type 2 diabetic patients with abdominal obesity. Cardiovasc Diabetol. 2013;12:88.CrossRefPubMedCentralPubMed
34.
go back to reference Saydah S, Bullard KM, Cheng Y, Ali MK, Gregg EW, Geiss L, et al. Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999–2010. Obesity (Silver Spring). 2014;22:1888–95.CrossRef Saydah S, Bullard KM, Cheng Y, Ali MK, Gregg EW, Geiss L, et al. Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999–2010. Obesity (Silver Spring). 2014;22:1888–95.CrossRef
35.
go back to reference Kones R, Rumana U. Prevention of cardiovascular disease: updating the immensity of the challenge and the role of risk factors. Hosp Pract (1995). 2014;42(1):92–100.CrossRef Kones R, Rumana U. Prevention of cardiovascular disease: updating the immensity of the challenge and the role of risk factors. Hosp Pract (1995). 2014;42(1):92–100.CrossRef
Metadata
Title
Awareness, treatment and control of cardiometabolic disorders in Chinese adults with diabetes: a national representative population study
Authors
Tiange Wang
Yu Xu
Min Xu
Weiqing Wang
Yufang Bi
Jieli Lu
Meng Dai
Di Zhang
Lin Ding
Baihui Xu
Jichao Sun
Wenhua Zhao
Yong Jiang
Limin Wang
Yichong Li
Mei Zhang
Shenghan Lai
Linhong Wang
Guang Ning
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2015
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-015-0191-6

Other articles of this Issue 1/2015

Cardiovascular Diabetology 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine