Impact of community based screening for hypertension on blood pressure after two years: Regression discontinuity analysis in a national cohort of older adults in China

BMJ Jul 17, 2019

Chen S, et al. - Through a regression discontinuity analysis that used data from a national cohort study of 3,899 older adults who had earlier undiagnosed hypertension, the researchers determined the causal influence of community-based blood pressure screening on subsequent blood pressure levels among older adults in China. The intervention lessened systolic blood pressure to −6.3 mm Hg and −8.3 mm Hg in the model without covariates and in the model that adjusts additionally for demographic, social, and behavioral covariates, respectively. In all models, the influence on diastolic blood pressure was less and non-significant. Similar outcomes were found when alternative functional forms were utilized to determine the influence and the bandwidths around the intervention threshold were altered. The outcomes did not fluctuate by demographic and social subgroups. Hence, on systolic blood pressure at the population level, community-based hypertension screening and encouraging people with raised blood pressure to seek care and utilize blood pressure lowering behavior changes could have significant long term influence. Moreover, in China and other countries with large unmet need for hypertension diagnosis and care, this strategy could discuss the high burden of cardiovascular diseases.
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