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Published on: May 3, 2018
[Analysis of blood pressure measurement among Chinese adults in 2018]
Y S Zhang1, M Zhang2, Z J Huang2
1Division of Chronic Disease and Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China Department of Health Statistics, School of Public Health, China Medical University, Shenyang 110122, China.
Insights
Regular blood pressure measurement in China needs improvement, particularly for men and rural populations. Targeted interventions are crucial for hypertension control, especially in high-risk groups.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Disease Research
Background:
- Hypertension is a major public health concern in China.
- Understanding blood pressure measurement behaviors is vital for early detection and intervention.
- Previous surveillance data on blood pressure monitoring practices in Chinese adults is limited.
Purpose of the Study:
- To analyze blood pressure measurement status among Chinese adult residents in 2018.
- To identify disparities in blood pressure testing rates based on demographics and socioeconomic factors.
- To provide evidence for improving hypertension management strategies in China.
Main Methods:
- A multi-stage stratified cluster random sampling method was employed in the 2018 China Chronic Disease and Risk Factor Surveillance.
- Data from 170,551 adult residents were analyzed, including demographic information, chronic diseases, and blood pressure measurements.
- Statistical analyses, including chi-squared and trend tests, were performed using SAS 9.4 software.
Main Results:
- Only 44.4% of adults with normal blood pressure, 50.4% with 'high' blood pressure, and 52.6% with newly detected hypertension were tested within three months.
- Blood pressure testing rates were higher in women, urban residents, and older age groups.
- Individuals with diagnosed hypertension showed higher testing rates in urban areas and with increased education, income, and BMI.
Conclusions:
- Regular blood pressure self-monitoring requires significant improvement among Chinese adults, especially men and rural residents.
- Health promotion and targeted policies are needed to enhance blood pressure measurement behaviors.
- Interventions should focus on high-risk groups, including those with elevated blood pressure, to effectively control hypertension.
Abstract:
Objective: To analyze the blood pressure measurement of Chinese adult residents in 2018 and provide a scientific basis for early detection and intervention of hypertension. Methods: In 2018, China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties (districts) of 31 provinces (autonomous regions, municipalities) across the country, using a multi-stage stratified cluster random sampling method to survey permanent residents aged 18 years and above. We selected 184 509 people and carried out a face-to-face questionnaire survey and body measurement method to collect demographic data, major chronic diseases, and blood pressure measurement information of the survey subjects. Blood glucose and blood lipid-related indicators were obtained by laboratory testing. There were 170 551 adult residents included in the study after excluding abnormal and missing data for key variables. After complex weighting, blood pressure detection rates and detection times in people with different blood pressure levels and other diseases were analyzed. SAS 9.4 software was used to perform the χ2-test and trend test. Results: Among adult residents in China, the proportions of those with normal blood pressure, commonly recognized 'high' blood pressure, and newly detected hypertension who had their blood pressure tested within three months were 44.4%, 50.4%, and 52.6%, respectively. The proportions all appeared higher in women than in men (all P<0.05), in urban than in rural areas (all P<0.05), and showed an increasing trend with age (all P<0.001); The proportion of these three populations who had never had their blood pressure measured was 27.6%, 24.2%, and 23.5% respectively. The proportion of people with diagnosed hypertension who had their blood pressure tested within seven days was 44.0%, 51.4% in urban areas, higher than 37.7% in rural areas (P<0.001), and the proportion of people who had their blood pressure tested increased with education, per capita annual income and BMI (all P<0.001). Conclusions: The behavior of regular self-monitoring of blood pressure among adult residents in China still needs to be improved, especially among men and rural areas. Relevant health promotion and education should be strengthened. More targeted policies and measures should be developed to improve blood pressure measurement behavior in people with normal high blood pressure and other high-risk groups to control elevated blood pressure effectively.
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
Measurement of Blood Pressure
Assessment of blood pressure in brachial artery(two-step method)
Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Pre-Procedural Guidelines for Assessing Blood Pressure

