Hypertension prevalence, awareness, treatment, and control and sodium intake in Shandong Province, China: baseline results from Shandong-Ministry of Health Action on Salt Reduction and Hypertension (SMASH), 2011

Prev Chronic Dis. 2014 May 22;11:E88. doi: 10.5888/pcd11.130423.


Introduction: In China, population-based blood pressure levels and prevalence of hypertension are increasing. Meanwhile, sodium intake, a major risk factor for hypertension, is high. In 2011, to develop intervention priorities for a salt reduction and hypertension control project in Shandong Province (population 96 million), a cross-sectional survey was conducted to collect information on sodium intake and hypertension prevalence, awareness, treatment, and control.

Methods: Complex, multistage sampling methods were used to select a provincial-representative adult sample. Blood pressure was measured and a survey conducted among all participants; condiments were weighed in the household, a 24-hour dietary recall was conducted, and urine was collected. Hypertension was determined by blood pressure measured on a single occasion and self-reported use of antihypertension medications.

Results: Overall, 23.4% (95% confidence interval [CI], 20.9%-26.0%) of adults in Shandong were estimated to have hypertension. Among those classified as having hypertension, approximately one-third (34.5%) reported having hypertension, approximately one-fourth (27.5%) reported taking medications, and one-seventh (14.9%) had their blood pressure controlled (<140/<90 mm Hg). Estimated total average daily dietary sodium intake was 5,745 mg (95% CI, 5,428 mg-6,063 mg). Most dietary sodium (80.8%) came from salt and high-salt condiments added during cooking: a sodium intake of 4,640 mg (95% CI, 4,360 mg-4,920 mg). The average daily urinary sodium excretion was 5,398 mg (95% CI, 5,112 mg-5,683 mg).

Conclusion: Hypertension and excessive sodium intake in adults are major public health problems in Shandong Province, China.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Awareness
  • China / epidemiology
  • Cluster Analysis
  • Cross-Sectional Studies
  • Diet Records
  • Diet, Sodium-Restricted / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hypertension / epidemiology*
  • Hypertension / etiology
  • Hypertension / prevention & control
  • Hypertension / psychology
  • Male
  • Mental Recall
  • Middle Aged
  • Prevalence
  • Rural Population / statistics & numerical data
  • Sampling Studies
  • Sodium / urine
  • Sodium, Dietary / administration & dosage*
  • Sodium, Dietary / adverse effects
  • Sodium, Dietary / analysis
  • Surveys and Questionnaires
  • Taste Perception
  • Urban Population / statistics & numerical data
  • Young Adult


  • Antihypertensive Agents
  • Sodium, Dietary
  • Sodium