A Nationwide Cross-Sectional Study of Chronic Urticaria in Chinese Adults with Cardiometabolic Diseases: Epidemiology, Risk Factors, and Effect on Disease Management.
Yang Z, Zhang X, et al. • Biomedical and environmental sciences : BES • 2026
CU is prevalent in patients with CMD and associated with distinct demographic and lifestyle risk factors, and although CU facilitates earlier detection of CMD, it does not improve disease control, indicating the need for integrated dermatology-cardiometabolic care.
Key Findings
Results
The weighted prevalence of chronic urticaria (CU) among Chinese adults with cardiometabolic diseases (CMDs) was 2.90%, peaking at 3.94% in 60-69-year-old individuals.
Analysis used data from the 2018-2019 China Chronic Disease and Risk Factor Surveillance, including 118,036 adults with CMDs.
CU prevalence was estimated using a complex survey design to account for the nationwide sampling structure.
Prevalence peaked in the 60-69 age group at 3.94%.
CU was more common in females (3.41%) than in males (2.56%).
Prevalence was noted to be higher in rural areas, particularly among females.
Results
Current smoking was a significant risk factor for CU in patients with cardiometabolic diseases.
Current smoking was associated with an odds ratio (OR) of 1.17 (95% CI: 1.06-1.29) for CU.
Risk factors were identified using multivariable logistic regression.
Smoking status was among key lifestyle-related risk factors identified in the analysis.
Results
Abnormal sleep duration was strongly associated with CU risk, with short sleep (<5 hours) showing the strongest association.
Sleep duration of less than 5 hours was associated with OR 1.79 (95% CI: 1.61-1.99) for CU.
Sleep duration of more than 10 hours was associated with OR 1.39 (95% CI: 1.19-1.61) for CU.
Both short and long sleep durations were independently associated with CU in multivariable logistic regression.
Abnormal sleep duration was identified as one of the key risk factors for CU in this population.
Results
Patients with CU had significantly higher CMD awareness rates compared to those without CU across hypertension, diabetes, and dyslipidemia.
Hypertension awareness: 50.71% in CU patients vs. 40.27% in non-CU patients.
Diabetes awareness: 47.14% in CU patients vs. 36.21% in non-CU patients.
Dyslipidemia awareness: 30.71% in CU patients vs. 17.12% in non-CU patients.
These findings suggest that CU may facilitate earlier detection or recognition of cardiometabolic conditions.
Results
Patients with CU had higher CMD treatment rates than non-CU patients, but CMD control rates were comparable between the two groups.
Hypertension treatment rates: 41.37% (CU) vs. 34.22% (non-CU).
Diabetes treatment rates: 41.31% (CU) vs. 32.52% (non-CU).
Dyslipidemia treatment rates: 18.29% (CU) vs. 9.94% (non-CU).
Despite higher awareness and treatment rates, CMD control rates were comparable between CU and non-CU patients.
Authors concluded this indicates that CU does not improve disease control despite facilitating earlier detection.
Discussion
The study identified a need for integrated dermatology-cardiometabolic care based on the observed gap between CMD awareness/treatment and control among CU patients.
CU patients showed higher CMD awareness and treatment rates but failed to achieve better control rates than non-CU patients.
Authors interpreted this pattern as indicating that CU facilitates earlier CMD detection but does not translate into improved disease control.
The findings support integrating dermatological and cardiometabolic clinical management.
This was a cross-sectional study, limiting causal inference between CU status and CMD management outcomes.
What This Means
This research suggests that chronic urticaria (CU), commonly known as chronic hives, affects about 2.9% of Chinese adults who also have cardiometabolic diseases such as hypertension, diabetes, or dyslipidemia. The condition was most common in people aged 60-69, in women, and in rural areas. Key lifestyle factors linked to having CU in this population included being a current smoker and having abnormal sleep patterns — particularly sleeping less than 5 hours or more than 10 hours per night — even after accounting for other factors.
Interestingly, patients who had both CU and a cardiometabolic disease were more likely to be aware of their cardiometabolic condition and to be receiving treatment for it compared to patients without CU. For example, among people with dyslipidemia (abnormal blood fat levels), awareness was nearly double in those with CU (30.71%) compared to those without (17.12%). This suggests that having a visible, bothersome skin condition like CU may lead people to seek medical care more often, during which their underlying heart or metabolic conditions are more likely to be identified and treated.
However, despite this improved awareness and treatment, patients with CU did not achieve better control of their cardiometabolic conditions compared to those without CU. This gap between treatment and control points to a practical challenge: being diagnosed and treated is not enough if the conditions are not being managed effectively. This research suggests that healthcare systems may benefit from better coordination between dermatology and cardiometabolic care, so that patients being treated for skin conditions like CU also receive comprehensive management of related cardiovascular and metabolic health issues.
Yang Z, Zhang X, Chen W, Zhao Z, Huang T, Wang L. (2026). A Nationwide Cross-Sectional Study of Chronic Urticaria in Chinese Adults with Cardiometabolic Diseases: Epidemiology, Risk Factors, and Effect on Disease Management.. Biomedical and environmental sciences : BES. https://doi.org/10.3967/bes2026.084