Chen Jun-Xiang, Zhou Yan-Feng, Geng Tingting, Chen Simiao, Chen Shuohua, Wang Guodong, Zhang Yan-Bo, Wang Yi, Tu Zhou-Zheng, Liu Gang, Wu Shouling, Pan An
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.
Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, 44883 Heidelberg, Germany.
Phenomics. 2022 Aug 18;2(6):419-429. doi: 10.1007/s43657-022-00067-w. eCollection 2022 Dec.
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.
The online version contains supplementary material available at 10.1007/s43657-022-00067-w.
在常规临床实践中，对血压（BP）测量标准方案的依从性差会导致测量值高于“研究质量”测量值。这种现象在定期健康检查中是否存在尚不清楚。我们旨在探讨定期健康检查中的血压测量值与按照标准测量方案测量的血压值之间的一致性。我们使用了开滦研究的数据，这是一项在中国正在进行的纵向队列研究，参与者在健康管理中心接受两年一次的健康检查。此外，在开滦研究中嵌套的一个基于工作场所的高血压管理项目中，按照标准方案测量血压。我们使用广义线性混合效应模型比较了同一人在两种情况下的血压读数。共有3988名男性（平均年龄为44.9岁）在健康检查和管理项目中至少进行了两次血压测量，两次测量的时间间隔小于90天。健康检查中的平均收缩压（SBP）和舒张压（DBP）分别比管理项目中的高4.2（95%CI 3.9 - 4.5）mmHg和3.3（95%CI 3.1 - 3.5）mmHg。Bland - Altman分析显示，SBP的一致性区间较宽，为 - 27.7至36.5 mmHg，DBP为 - 18.3至24.7 mmHg。总之，定期健康检查中的血压测量值通常高于按照标准方案测量的血压值。我们的研究结果强调了标准血压测量对于避免高估高血压患病率和启动治疗的重要性。
在线版本包含可在10.1007/s43657 - 022 - 00067 - w获取的补充材料。
