Objective To evaluate the effect of office standardized blood pressure measurement (SBPM) model on hypertension screening in 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 of hypertension within 1 year were followed up. The inverse probability of treatment weighting (IPTW) was used to balance confounding factors between two groups. The difference of the distribution of the end digit of blood pressure value, the detection rate of elevated blood pressure and the diagnosis rate of hypertension within 1 year after screening between two groups were 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 3151155 subjects were included in this study, including 110487 subjects in the SBPM group and 3040668 subjects in the CBPA group. After IPTW analysis, the baseline characteristics were balanced in two groups (standardized mean difference SMD ＜0.1). The terminal digit frequencies of 0 to 9 for systolic and diastolic blood pressure value in the SBPM group ranged from 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 group (27.36%) was significantly higher than that in the CBPA group (2.85%, χ² = 178 641.000, P＜0.001; 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 (P for interation ＜0.001). Similarly, the diagnosis rate of hypertension within 1 year after screening in the SBPM group (13.20%) was significantly higher than that in the CBPA group (9.29%, χ² = 1 894.000, P＜0.001; 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 can enhance the early detection and diagnosis among general people, and should be promoted in community-based hypertension screening.