More than a third of adults in China suffer from high blood pressure, but only one in 20 are able effectively to manage their condition, according to research published Thursday.

Strokes are the leading cause of death in China, accounting for one in five deaths annually, researchers said, with uncontrolled high blood pressure a significant risk factor.

But fewer than a quarter of people with hypertension in China take medication and treatment among those who receive it was found to be ineffective or unsuitable.

The availability of medication for high blood pressure is patchy across the country and one in 12 primary health-care pharmacies do not stock any anti-hypertensive drugs at all, according to two studies published jointly in The Lancet, a leading medical journal.

In addition to problems of access, researchers noted that "despite the availability of low-cost antihypertensive medications, higher-cost medications were more often prescribed".

Only a third of sites stocked "high-value" medication, referring to drugs that are both recommended and low-cost.

Blood pressure levels in China are increasing "likely because of an ageing population, urbanisation, dietary changes and obesity", Professor Lixin Jiang, from Fuwai Hospital in Beijing, said in response to the study.

Some 1.7 million people aged 35-75 were screened in all 31 provinces in mainland China as part of the research, an initiative to improve cardiovascular disease risk factors in China.

Prescriptions of anti-hypertensive medications at more than 3,300 primary health care sites were also analysed as part of the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project.

"It is simple deficiencies in the country's health system that make a large contribution to the disease burden," said Therese Hesketh of the UCL Institute for Global Health and Xudong Zhou of Zhejiang University School of Public Health, Hangzhou, in a joint commentary for the study.

"This situation is worrying, not least because prevention and control of hypertension have been a high priority in China for more than two decades."

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