Prevalence and factors associated with hypertension among individuals undergoing premarital examination in Guangxi, China: a large cross-sectional study, 2022-2024.
Chen B, Xia S, et al. • Frontiers in public health • 2026
Hypertension imposes a non-negligible health burden among premarital adults in Guangxi, with a markedly higher prevalence in males, and overweight, obesity, elevated liver enzymes, low education, advancing age, and abnormal fasting glucose (in women) are key correlates.
Key Findings
Results
The overall prevalence of hypertension among premarital examinees in Guangxi was 7.68%, and it was significantly higher in men than in women.
The study enrolled 11,283 consecutive premarital participants aged 20-50 years (5,641 males, 5,642 females) at the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from 2022 to 2024.
Prevalence was 10.28% in men versus 5.09% in women.
Hypertension was defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg, or self-reported physician-diagnosed hypertension.
Results
In univariate analysis, several demographic, anthropometric, and biochemical variables were associated with hypertension in the total population.
Significant variables were age, BMI, fasting blood glucose (FBG), ALT, sex, BMI classification, alcohol drinking, education level, abnormal FBG, and abnormal ALT (all p < 0.05).
Methods included univariate tests, multivariate logistic regression and restricted cubic spline (RCS) models.
Fasting blood glucose was measured only in female participants because of local premarital health policy.
Results
Overweight and obesity were independently associated with higher odds of hypertension, with a larger effect for obesity.
Overweight: OR = 1.88, 95% CI 1.27-2.77, p = 0.002.
Obesity: OR = 3.90, 95% CI 2.29-6.64, p < 0.001.
Results
Underweight was associated with lower odds of hypertension in multivariate analysis.
Underweight: OR = 0.42, 95% CI 0.19-0.93, p = 0.033.
Results
Lower education level, abnormal ALT, and increasing age were independently associated with higher odds of hypertension.
Lower education level: OR = 1.64, 95% CI 1.13-2.38, p = 0.009.
Abnormal ALT: OR = 1.69, 95% CI 1.12-2.56, p = 0.013.
Each annual increment in age: OR = 1.04, 95% CI 1.01-1.08, p = 0.011.
Results
In sex-stratified analyses, abnormal fasting blood glucose was independently associated with higher odds of hypertension in women.
Abnormal FBG in women: OR = 1.96, 95% CI 1.21-3.16, p = 0.006.
FBG was measured only in females, so this could not be assessed in men.
Results
Restricted cubic spline analyses showed positive dose-response relationships between BMI, ALT, and age and the odds of hypertension.
P for overall was < 0.05 for all three variables.
This supports the multivariate findings that higher BMI, ALT and age correspond to higher odds of hypertension.
Conclusions
The authors conclude that premarital health services should integrate cardiovascular risk screening including blood pressure measurement and BMI assessment, with targeted health education.
Premarital examinations are described as an underutilized platform for population-based cardiovascular screening.
Early detection in young adults is framed as critical for primordial and primary prevention.
What This Means
This study looked at blood pressure among more than 11,000 people aged 20-50 who came for a premarital health check at a hospital in Guangxi, China, between 2022 and 2024. About 7.7% had hypertension (high blood pressure), and it was about twice as common in men (10.3%) as in women (5.1%).
People who were overweight or obese, older, had lower education, or had abnormal liver enzyme (ALT) levels were more likely to have high blood pressure. Obesity showed the strongest link, with almost four times the odds compared with normal weight. In women, abnormal fasting blood sugar was also linked to higher odds (blood sugar was only measured in women). Underweight people had lower odds. Higher BMI, ALT and age were each linked to gradually rising odds of hypertension.
This research suggests that premarital examinations could be a useful opportunity to spot high blood pressure and related risk factors in young adults. Because this was a cross-sectional study at a single hospital, it shows associations at one point in time and cannot prove that these factors cause hypertension, and the findings may not apply to all populations.
Chen B, Xia S, Deng Y, Huang J, Zhang M. (2026). Prevalence and factors associated with hypertension among individuals undergoing premarital examination in Guangxi, China: a large cross-sectional study, 2022-2024.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1948319