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

Jun-Xiang Chen; Yan-Feng Zhou; Tingting Geng; Simiao Chen; Shuohua Chen; Guodong Wang; Yan-Bo Zhang; Yi Wang; Zhou-Zheng Tu; Gang Liu; Shouling Wu; An Pan

doi:10.1007/s43657-022-00067-w

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

Phenomics. 2022 Aug 18;2(6):419-429. doi: 10.1007/s43657-022-00067-w. eCollection 2022 Dec.

Authors

Jun-Xiang Chen^#¹, Yan-Feng Zhou^#¹, Tingting Geng¹, Simiao Chen², Shuohua Chen³, Guodong Wang³, Yan-Bo Zhang¹, Yi Wang¹, Zhou-Zheng Tu¹, Gang Liu⁴, Shouling Wu³, An Pan¹

Affiliations

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.

^# Contributed equally.

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.

Supplementary information: The online version contains supplementary material available at 10.1007/s43657-022-00067-w.

Keywords: Blood pressure determination; Guideline adherence; Hypertension; Physical examination.

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