Global Health, Project HOPE, Shanghai, China.
Division of Non-communicable Diseases and Injury Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Glob Heart. 2024 Aug 21;19(1):67. doi: 10.5334/gh.1344. eCollection 2024.
An intelligent office blood pressure measurement (IOBPM) model for community-based hypertension management was piloted in Shanghai, China, to overcome the conventional blood pressure management (CBPM) model's deficiencies.
We selected adults aged 35-89 years who were being treated and managed for hypertension in two community health centers for the IOBPM and CBPM models. The IOBPM model consisted of two or three consecutive blood pressure (BP) measurements using a pre-programmed and validated automatic device. The BP data for the CBPM model were obtained from the routine follow-up records of hypertensive patients and derived from the Shanghai Non-communicable Diseases Management Information System. Subjects in the IOBPM model were selected by a simple random sampling method, and propensity score matching was used to select a comparable control population from the CBPM model based on important covariables. The BP levels, end-digit preferences, frequency distribution, and BP control were compared between the two models.
We selected 2,909 patients for the IOBPM model and 5,744 for the CBPM model. The systolic BP in the CBPM model was 12.3 mmHg lower than in the IOBPM model. In the CBPM model, there were statistically significant end-digit preferences ( < 0.001), with zero being the most reported end-digit (23.3% for systolic BP and 27.7% for diastolic BP). There was no significant end-digit preference in the IOBPM model. Certain BP values below 140/90 mmHg in the CBPM model were more frequent, while the IOBPM model showed a normal distribution. The BP control in the CBPM model was significantly higher than the IOBPM model ( < 0.001).
The IOBPM model appears to overcome the deficiencies of the CBPM model, leading to more accurate and reliable BP measurements.
为克服传统血压管理(conventional blood pressure management,CBPM)模型的缺陷,中国上海对社区高血压管理的智能办公血压测量(intelligent office blood pressure measurement,IOBPM)模型进行了试点。
我们选择正在接受治疗和管理的 35-89 岁社区卫生中心的高血压患者,进行 IOBPM 和 CBPM 模型。IOBPM 模型包括使用预编程和验证的自动设备进行两次或三次连续血压(blood pressure,BP)测量。CBPM 模型的 BP 数据来自高血压患者的常规随访记录,并源自上海非传染性疾病管理信息系统。IOBPM 模型中的受试者通过简单随机抽样法选择,根据重要协变量,使用倾向评分匹配从 CBPM 模型中选择可比的对照人群。比较了两种模型的 BP 水平、末位数字偏好、频率分布和 BP 控制情况。
我们选择了 2909 名患者进行 IOBPM 模型,5744 名患者进行 CBPM 模型。CBPM 模型中的收缩压比 IOBPM 模型低 12.3mmHg。在 CBPM 模型中,末位数字偏好具有统计学意义(<0.001),零是最常报告的末位数字(收缩压为 23.3%,舒张压为 27.7%)。IOBPM 模型中没有显著的末位数字偏好。CBPM 模型中某些低于 140/90mmHg 的 BP 值更为常见,而 IOBPM 模型呈正态分布。CBPM 模型中的 BP 控制明显高于 IOBPM 模型(<0.001)。
IOBPM 模型似乎克服了 CBPM 模型的缺陷,导致更准确和可靠的 BP 测量。