Objectives To investigate thestatus of theclustering of cardiovascular risk factors and hypertension control in hypertensive outpatients of China.

Methods A multi-centre cross-sectional study was carried out from June to December 2009. Study patients were consecutively recruited from out-patient clinics of hypertension in 46 hospitals of 22 provinces, autonomous regions, and municipalities of China according to the consistent inclusion criteria. About 100 consecutive patients were recruited in each hospital, and were examined by questionnaires, physical examinations, and biochemical analyses. Totally, 5206 hypertensive outpatients were included in the final analysis. Risk factors were defined according to the Guidelines on Hypertension Control in China (2010).

Results In the patients, dyslipidemia was the most prevalent risk factor (61.5%), followed by obesity (56.0%), and impaired glucose regulation (27.8%). The prevalence of smoking was 34.9% in men. In total, 88.9% of the hypertensive patients had at least one of the above-mentioned four risk factors and 17.4% had three or more. Only 4.1% of the hypertensive outpatients were classified as low cardiovascular risk, 72.5% of patients were in high or very high risk stratification. The control rate (<140/90 mmHg) was 44.3%, higher in the age group of ≥65 years than in those of <45 years (51.3% vs. 29.6%, p < 0.01); higher in low-risk patients than in high-risk patients (65.4% vs. 41.8%, p < 0.01); and higher in patients under regular therapy (≥ 9 months per year) than in those of irregular therapy (< 6 months per year) (50.7% vs. 30.0%, p < 0.01).

Conclusions Clustering of cardiovascular risk factors is common among hypertensive outpatients in China. Most of the hypertensive outpatients also had dyslipidemia and were at high or very high level of cardiovascular risk, and their blood pressure were poorly controlled. This analysis supports the urgent need for improving the control rate of hypertension.