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Longitudinal change in end-digit preference in blood pressure recordings of patients with hypertension in primary care clinics

Minhang study

Wang, Yana,b,*; Wang, Yajuanc,*; Qain, Yueshenga,b; Zhang, Jina,b; Tang, Xiaofenga,b; Sun, Junleic; Zhu, Dinglianga,b

doi: 10.1097/MBP.0000000000000092
Clinical Methods and Pathophysiology
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Background End-digit preference (EDP) of blood pressure (BP) has been reported in both general hospitals and primary clinics worldwide. We aimed to observe the longitudinal changes in EDP of BP recordings in hypertension patients and to estimate the impact of hypertension treatment target (140/90 mmHg) on the EDP of BP in Chinese primary care clinics.

Participants and methods A total of 318 898 BP readings from 16 433 hypertensive patients were obtained from the electronic health record of Xinzhuang town hospital in Shanghai from 1 January 2007, to 27 September 2011. The terminal digits of the recorded systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed. Zero preference was also analyzed according to the year and follow-ups, respectively.

Results In all, 62.5% of SBP readings and 63.5% of DBP readings ended in zero. The zero preference of SBP was reduced from the 75.2% in 2007 to 55.9% in 2011. In addition, the zero preference decreased from the 78.6% at the registration to 58.7% at the 25th follow-up. Moreover, compared with other BP levels, hypertension treatment target was associated with increased preference for the eight end-digit for both SBP and DBP (P<0.001).

Conclusion This study showed a decrease in zero EDP in hypertension patients managed in the Chinese community. The hypertension treatment target was associated with sub-target-EDP. Future efforts should focus on comprehensive education, coupled with the use of well-calibrated electronic BP monitors.

aShanghai Key Laboratory of Hypertension, Ruijin Hospital

bResearch Center for Hypertension Management and Prevention in Community, Shanghai Institute of Hypertension, Shanghai Jiaotong University School of Medicine

cXinzhuang Community Health Service Center, Shanghai, China

* Yan Wang and Yajuan Wang contributed equally to the writing of this article.

All supplementary data are available directly from the corresponding author.

Correspondence to Dingliang Zhu, PhD, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China Tel: +86 21 64313816; fax: +86 21 54654498; e-mail: zhudingliang@sibs.ac.cn

Received June 4, 2014

Received in revised form September 16, 2014

Accepted September 22, 2014

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