Chinese Physicians’ Perspectives on the 2017 American College of Cardiology/American Heart Association Hypertension Guideline: A Mobile App-Based Survey

  • Zhao NiEmail author
  • Juan He
  • Ji-Guang Wang
  • Jiepin Cao
  • Qing Yang
  • Bei Wu
  • Ryan Jeffrey Shaw
Original article



Hypertension is a leading global risk factor for death and disability. Seeking new ways to prevent and treat hypertension is a priority for scientists and healthcare professionals worldwide. In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) issued a new hypertension guideline shifting the definition of hypertension from 140/90 mm Hg to 130/80 mm Hg for systolic/diastolic blood pressure. This new diagnostic threshold of hypertension has sparked a lively discussion worldwide over whether it should be applied in clinical settings to diagnose and treat hypertension. China, the world’s most populous country, is facing a hypertension crisis. According to the 140/90 mm Hg guideline, China has an estimated 244.5 million population aged ≥ 18 years with hypertension, and another 435.3 million with pre-hypertension. If the new guideline is adopted, the prevalence of hypertension in China would double. This change would significantly impact patients, healthcare professionals, scientists, and policy makers in terms of the delivery of care and needed resources.


This study aims to investigate whether Chinese physicians will use the 130/80 mm Hg threshold to diagnose hypertension in clinical practice.


In March 2018, we launched a mobile app-based survey to study 253 Chinese physicians’ perspectives on the ACC/AHA Guideline.


A total of 253 physicians from 21 Chinese provinces completed the survey. Nearly 80% of the participants had already noticed the ACC/AHA guideline change. The proportion of participants who said they would use the new threshold to diagnoses hypertension was 41%, while 59% said they would not use the new threshold. The primary reason for those who said “yes” was that they believed early diagnosis of hypertension can trigger early actions to prevent the increasing blood pressure. For those who said “no”, they argued that their decision was based on the fact that the Chinese Hypertension Prevention Guideline had not yet changed the diagnostic threshold from 140/90 to 130/80 mm Hg.


Different understanding of hypertension prevention and treatment exists among Chinese physicians. It is an emergent need to form an evidence-based authoritative answer to guide Chinese physicians’ future clinical practice.


Chinese Physicians Guideline Hypertension 


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Italian Society of Hypertension 2019

Authors and Affiliations

  1. 1.School of NursingDuke UniversityDurhamUSA
  2. 2.West China Hospital, Sichuan UniversityChengduChina
  3. 3.The Shanghai Institute of HypertensionShanghaiChina
  4. 4.Rory Meyers College of NursingNew York UniversityNew YorkUSA
  5. 5.Duke Mobile App GatewayDuke UniversityDurhamUSA
  6. 6.School of Nursing, Health Innovation LabDuke UniversityDurhamUSA
  7. 7.School of Medicine, Center for Applied Genomics and Precision MedicineDuke UniversityDurhamUSA

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