Associations between Communities’ Urbanization Levels and Onset of Hypertension in China

Jinjing Wu , Asian Demographic Research Institute
Jia Chen, Department of Social Work
Zhen Li, Shanghai University

Background: Although urbanization was considered as an underlying force of a nutrition transition towards “Western” diets and sedentary lifestyles and a subsequent increase in the burden of hypertension (HTN), empirical studies produced mixed results. Methods: With data from the China Health and Nutrition Survey (1991-2015), we performed multilevel discrete-time event history analyses to examine the association between communities' urbanization levels and HTN onset by region (the Northeast, Coastal East, Central, and West) and period. We stratified analyses by sex. Results: We found that 1) among women, the medium-to-high urbanization level was significantly positively associated with incident HTN in 1991 except that the positive association was insignificant in the Coastal East. From 1991 to 2015, the positive association became negative except for the West. 2) The high urbanization level was significantly negatively associated with incident HTN among the Coastal East’s women in 1991. The negative association in the Northeast and Central became statistically significant across the period. In the West, the association was still positive and insignificant in 2015. 3) Among men, the urbanization levels were not significantly related to incident HTN except for the Coastal East in which we found that the negative association between the high urbanization level and HTN occurrence became significant across the period. Conclusions: The regional differences in the association observed in the female, together with the changing association between 1991 and 2015, implied that a higher urbanization level might prevent HTN when a region becomes more economically developed.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality