Low Concordance Between Blood Pressures Measured in Periodic Health Examinations and in a Workplace-Based Hypertension Management Program

查看全文 作　　者：Jun-Xiang [1]Chen;Yan-Feng [1]Zhou;Tingting [1]Geng;Simiao [2]Chen;Shuohua [3]Chen;Guodong [3]Wang;Yan-Bo [1]Zhang;Yi [1]Wang;Zhou-Zheng [1]Tu;Gang [4]Liu;Shouling [3]Wu;An [1]Pan 机构地区：[1]Department of Epidemiology and Biostatistics,Ministry of Education Key Laboratory of Environment and Health,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,13 Hangkong Road,Wuhan 430030,Hubei,China;[2]Heidelberg Institute of Global Health,Faculty of Medicine and University Hospital,Heidelberg University,44883 Heidelberg,Germany;[3]Department of Cardiology,Kailuan General Hospital,North China University of Science and Technology,57 Xinhua East Road,Tangshan 063000,Hebei,China;[4]Department of Nutrition and Food Hygiene,Hubei Key Laboratory of Food Nutrition and Safety,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430040,Hubei,China 出　　处：《Phenomics》索引2022年第2卷第6期,共11页 基　　金：supported by National Natural Science Foundation of China(81930124 and 82021005);Shanghai Municipal Science and Technology Major Project(Grant No.2017SHZDZX01). 摘　　要：Poor adherence to standard protocols of blood pressure(BP)measurement in routine clinical practice leads to higher readings than“research-quality”measurements.Whether this phenomenon exists in periodic health examinations was unknown.We aimed to explore the concordance between BP measurements in periodic health examinations and those measured following a standard measurement protocol.We used data from the Kailuan Study,an ongoing longitudinal cohort study in China,of which participants received biennial health examinations in health management centers.In addition,BPs were measured following standard protocols in a workplace-based hypertension management program nested in the Kailuan Study.We compared BP readings of the same person between the two settings using generalized linear mixed-effects models.A total of 3988 men(the mean age was 44.9 years)had at least two BP measurements both in health examinations and management program with a time interval between the two settings that less than 90 days.The mean systolic blood pressures(SBP)and diastolic blood pressures(DBP)in health examinations were 4.2(95%CI 3.9–4.5)mm Hg and 3.3(95%CI 3.1–3.5)mm Hg higher than those in the management program,respectively.Bland–Altman analyses showed the wide agreement inter-vals ranging from-27.7-to 36.5-mm Hg for SBP and-18.3-to 24.7-mm Hg for DBP.In conclusion,BP measurements in periodic health examinations were generally higher than BPs measured following a standard protocol.Our findings highlight the importance of standard BP measurement to avoid overestimation of hypertension prevalence and treatment initiation. 关 键 词：HYPERTENSION Physical examination Blood pressure determination Guideline adherence