Zhongguo quanke yixue (Aug 2023)
Differences between the First and Another 3-day Blood Pressure Levels and Associated Factors in a Self-reported Non-hypertensive Population Aged 35-64 Years
Abstract
Background Previous studies have compared the first and another 3-day blood pressure levels in populations with no history of self-reported hypertension, but there have been few studies conducted in COVID-19 vaccine recipients. Objective To understand the blood pressure levels among 35-64-year-old COVID-19 vaccine recipients during regular COVID-19 containment, and to assess the differences between the first and another 3-day blood pressure levels and the factors affecting the fluctuation of blood pressure levels in the recipients with suspected hypertension, providing a reference and guidance for blood pressure measurement before COVID-19 vaccination. Methods In September 2021, 2 814 residents aged 35-64 with no history of self-reported hypertension were randomly selected for screening for hypertension before receiving COVID-19 vaccination at Qingling Community Health Service Center, Hongshan District, Wuhan City, Hubei Province. Blood pressure was measured and recorded as the first blood pressure measurement value, then based on this, those who were found with suspected hypertension〔systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg (1 mmHg=0.133 kPa) 〕standardizedly measured their clinic blood pressure for another three times on different days without the use of any antihypertensive drugs. Based on the 3-day blood pressure measurement results, the proportions of those with blood pressure in the ideal range (systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg), in the high normal range (systolic blood pressure: 120-139 mmHg and/or diastolic blood pressure: 80-89 mmHg), and in the hypertensive range (systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg) were calculated, and the rate of hypertension diagnosis was compared between them by sex, age group, and the first blood pressure measurement level. The factors affecting the fluctuation of blood pressure levels (changes in blood pressure analyzed based on comparing the first blood pressure level and the 3-day blood pressure levels) in suspected hypertensive patients were analyzed using univariate and multivariate ordered Logistic regression. Results Of the 2 814 cases, 36.67% (1 032/2 814) were suspected hypertensive patients. Analysis of the 3-day blood pressure levels indicated that the proportions of suspected hypertensive patients with a blood pressure level in the ideal range, high normal range and hypertensive range were 8.82% (91/1 032), 14.34% (148/1 032), and 76.84% (793/1 032), respectively. Among the cases with confirmed hypertension, the prevalence of stages 1, 2, and 3 hypertension was 63.68% (505/793), 26.48% (210/793) and 9.84% (78/793), respectively. The hypertension diagnosis rate was higher in females〔80.68% (380/471) 〕than that in males〔73.62% (413/561) 〕, with statistical significance (χ2=7.173, P=0.007). The hypertension diagnosis rate increased with the increase in the first blood pressure level in suspected hypertensive patients (χ2 trend =23.443, P<0.001). The factors affecting the fluctuation of blood pressure levels in suspected hypertensive patients were gender, age, time period for first blood pressure measurement, psychological factors and environmental noise≥40 dB during first blood pressure measurement (P<0.05) . Conclusion There are significant differences between the first blood pressure measurement results and 3-day blood pressure measurement results among suspected hypertensive patients. To improve the reliability of blood pressure measurement results to ensure the successful implementation of COVID-19 vaccination, it is suggested for community medical workers to ensure the vaccine recipients are in good mental state, and pre-vaccination blood pressure measurement for them is performed in a quiet environment, and to pay more attention to verify the reliability of pre-vaccination blood pressure level in males, the 55-64 age group, or individuals receiving blood pressure measurement at community health centers between 11: 01 in the morning and 14: 00 in the afternoon.
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