Abstract
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 intervals 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.
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Data Availability
The datasets generated during the current study are not publicly available due to data confidentiality but are available from the corresponding author on reasonable request.
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Acknowledgements
The authors thank all the survey teams of the Kailuan study group for their contribution and the study participants who contributed their information.
Funding
AP was supported by National Natural Science Foundation of China (81930124 and 82021005) and Shanghai Municipal Science and Technology Major Project (Grant No. 2017SHZDZX01).
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J-XC and Y-FZ contributed equally. Conceptualization: J-XC, Y-FZ, SW and AP; methodology: J-XC and Y-FZ; formal analysis: J-XC; investigation: SC and GW; writing—original draft preparation: J-XC; writing—review and editing: all authors; resources: SW; supervision: SW and AP.
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Chen, JX., Zhou, YF., Geng, T. et al. Low Concordance Between Blood Pressures Measured in Periodic Health Examinations and in a Workplace-Based Hypertension Management Program. Phenomics 2, 419–429 (2022). https://doi.org/10.1007/s43657-022-00067-w
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DOI: https://doi.org/10.1007/s43657-022-00067-w