Prevalence and management of hypertension among adults aged 45 and older in mainland China: Insights from the 2020 CHARLS survey.

Hypertension is an escalating global public health challenge. This study aimed to assess the prevalence, awareness, treatment, and management of hypertension, particularly the role of primary healthcare facilities, in individuals aged ≥ 45 years in mainland China. Data were derived from the 2020 baseline survey of the China Health and Retirement Longitudinal Study, comprising 19,282 participants. Statistical analyses were performed using SPSS Statistics 25.0 (Chicago), to examine hypertension prevalence across different demographic subgroups, along with detection rates, treatment status, and utilization of medical and health services. The overall prevalence of hypertension in the study population was 37.73%, with rates increasing with age and peaking in the 85 to 94 age group. While no statistically significant differences were found by gender, region, or education level, prevalence was markedly higher among individuals of the Uygur, Tibetan, and Mongolian ethnicities. Divorced or widowed individuals exhibited significantly higher hypertension rates than those of other marital statuses. Notably, 27.25% of hypertensive individuals were diagnosed through routine physical examination. Regarding disease management, 78.9% of hypertensive patients reported using one or more antihypertensive medications, and 77.9% believed that their blood pressure was well controlled. On average, 72.6% of patients received blood pressure monitoring services at primary healthcare facilities approximately 11.91 ± 4.36 times per year. However, <50% of the patients reported receiving health education for the prevention of hypertension-related complications. Hypertension is highly prevalent among middle-aged and older adults in Mainland China. Enhancing the effectiveness of primary healthcare services is essential to improve the diagnosis and treatment of hypertension. Greater efforts are needed to strengthen health education, raise public awareness, and promote self-management among patients to reduce the burden of hypertension and its associated complications.