Role of office standardized blood pressure measurement model on hypertension screening in Shanghai community

Abstract Objectives To evaluate the effect of office standardized blood pressure measurement (SBPM) model on hypertension screening in the Shanghai community. Methods From January 1, 2019, to April 30, 2023, people aged 35 to 79 years old who underwent hypertension screening in the communities of Shanghai were selected. According to the blood pressure measurement method at the screening, the subjects were divided into the SBPM group and the conventional blood pressure assessment (CBPA) group, and the diagnosis within 1 year was followed up. The inverse probability of treatment weighting (IPTW) was used to balance confounding factors between the 2 groups. The difference in the distribution of the end digit of blood pressure value, the detection rate of elevated blood pressure, and the diagnosis rate within 1 year after screening between the 2 groups was analyzed after IPTW analysis. Weighted logistic regression was used to evaluate the effect of hypertension screening using SBPM compared with CBPA. Results A total of 3,151,155 subjects were included in this study, including 110,487 subjects in the SBPM group and 3,040,668 subjects in the CBPA group. After IPTW analysis, the baseline characteristics were balanced in 2 groups (standardized mean difference [SMD] <0.1). The proportion of the end digit of systolic and diastolic blood pressure value in the SBPM group was 9.75% to 10.26% and 9.80% to 10.22%, respectively, with balanced distribution. However, those in the CBPA group ranged from 0.91% to 44.13% and from 1.27% to 42.71%, respectively, which showed an uneven distribution and an obvious preference of “0.” The detection rate of elevated blood pressure in the SBPM (27.36%) was significantly higher than that in the CBPA group (2.84%, χ2 = 178 641.000, P < .001; after adjusting confounding factors, OR = 13.40, 95% CI, 13.17 to 13.63). The association between blood pressure measurement methods and the detection rate of elevated blood pressure was more pronounced among men, subjects aged 35 to 44 years old, urban residents, those measured in winter, and during the medium-term promotion stage (Pint < .001). Similarly, the diagnosis rate within 1 year after screening in the SBPM group (13.20%) was significantly higher than that in the CBPA group (9.29%, χ2 = 1894.000, P < .001; after adjusting confounding factors, OR = 1.46, 95% CI, 1.43 to 1.49). Stratified analysis revealed that the most pronounced increase was observed in subjects aged 35 to 44 years old (OR = 2.01, 95%CI, 1.87 to 2.16). Conclusions The quality of data, the detection rate of elevated blood pressure, and the diagnosis rate of hypertension within 1 year using SBPM for hypertension screening are significantly superior to CBPA. This approach enhances early detection and diagnosis among the general population and should be promoted in community-based hypertension screening.