Chinese Physicians’ Perspectives on the 2017 American College of Cardiology/American Heart Association Hypertension Guideline: A Mobile App-Based Survey
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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.
KeywordsChinese Physicians Guideline Hypertension
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
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.
- 5.Whelton PK, et al. “2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertens. Dallas Tex 1979. 2017.Google Scholar
- 6.New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension. American College of Cardiology. http://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017. Accessed 24 Nov 2018.
- 8.Crawford C. AAFP Decides to Not Endorse AHA/ACC Hypertension Guideline. https://www.aafp.org/news/health-of-the-public/20171212notendorseaha-accgdlne.html. Accessed: 07 May 2018.
- 10.Chobanian AV, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertens Dallas Tex 1979. 2003;42(6):1206–52.Google Scholar
- 15.WeChat: number of users 2018. Statista. https://www.statista.com/statistics/255778/number-of-active-wechat-messenger-accounts/. Accessed 14 Jan 2019.
- 16.Tarrant C, Angell E, Baker R, et al. Developing and piloting the questionnaires (pilots 1 and 2). In: Responsiveness of primary care services: development of a patient-report measure – qualitative study and initial quantitative pilot testing. Health Services and Delivery Research, No. 2.46. Southampton, UK: NIHR Journals Library; 2014.Google Scholar
- 17.Babbie E. The logic of sampling. In: Howard E, editor. The practice of social research, Chap 7. 10th ed. Belmont: Wadsworth/Thomson; 2004.Google Scholar
- 19.Saldana J. The coding manual for qualitative researchers. Thousand Oats: SAGE; 2015.Google Scholar