High blood pressure can cause damages of target organs such as the heart, brain, kidneys and retina, while diabetes can cause a series of metabolic disorders, resulting in a variety of complications. Both are major risk factors for cardiovascular and cerebrovascular diseases. Eating a healthy diet may significantly contribute to the prevention and control of hypertension and diabetes.

To investigate the effects of a Chinese-style DASH diet in improving the nutritional status of community-living patients with type 2 diabetes and hypertension.

Sixty-one hypertensive patients with type 2 diabetes with medical records created in Chongqing Sihai Community Health Center were selected to undergo an eight-week Chinese-style DASH diet intervention, including dietary guidance (at 1 and 2 weeks) , eating the Chinese-style DASH diet provided using a group-based approach (at 3 and 4 weeks) , and home-based medical care (at 5 to 8 weeks) . Food frequency survey and 24-hour dietary recall were used to investigate the dietary structure and nutritional intake at baseline and after intervention. Anthropometric indicators (BMI and waist-to-hip ratio) , blood lipids (triacylglycerol, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol) , glycemic control and hypertension control status at baseline and after intervention were compared.

A total of 59 cases were included in the study. Regarding dietary structure after intervention, the average daily intake of soy, nuts, pickled products, fried foods and salt significantly decreased in subjects, while that of fresh fruit, milk and dairy products increased significantly (P<0.05) . Regarding nutritional status, the daily average intake of fat and sodium was significantly reduced, while that of dietary fiber, calcium, potassium and magnesium was significantly increased (P<0.05) . The number of participants eating a diet with a recommended ratio of fat increased significantly (P<0.05) . Health monitoring showed that total cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and 2-hour postprandial glucose were partially improved after intervention (P<0.05) . From the 4th week of the intervention, the control rate of 2-hour postprandial glucose at follow-up was significantly higher than the baseline level (P<0.05) , and it reached 69.5% at the end of the intervention. Except for the 2nd week of the intervention, the blood pressure control rate at follow-up was notably higher than the baseline level (P<0.05) , and it reached 67.8% at the end of the intervention.

Eating the Chinese-style DASH diet helps to promote the health in community-living hypertension patients with type 2 diabetes via effectively adjusting the inappropriate diet structure and improving the nutritional status.

Hypertension and mild cognitive impairment (MCI) are ordinary health problems in the elderly. The research on the status and risk factors of hypertension complicated with MCI in elderly population in the community is insufficient.

To inquire into the prevalence of hypertension combined with MCI in urban communities and analyze the possible influencing factors of its comorbidities.

Five communities with a relatively high proportion of elderly population were selected in Yinchuan City and Wuzhong City of Ningxia Hui Autonomous Region by typical sampling from September to November 2011. A health survey was conducted among all community residents aged≥55 years in the communities. 509 patients with hypertension were included, and multivariate Logistic regression was used to analyze the influencing factors of hypertension patients with MCI. The regression coefficient of each influencing factor was used as the weight to calculate individual predictive risk value, and receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of individual predictive risk value for hypertensive patients with MCI.

The patients were divided into hypertension with MCI group (n=97) and hypertension without MCI group (n=412) according to whether they were combined with MCI. There were statistically significant differences in age distribution, gender, smoking, hypertension grade, depression score, uric acid and albumin between the two groups (P<0.05) . Age≥75 years old〔OR=2.63, 95%CI (1.31, 5.27) 〕, gender〔OR=0.46, 95%CI (0.22, 0.94) 〕, albumin〔OR=0.96, 95%CI (0.91, 0.99) 〕, depression score〔OR=1.06, 95%CI (1.01, 1.10) 〕, hypertension grade 2〔OR=2.12, 95%CI (1.16, 3.89) 〕, hypertension grade 3〔OR=2.38, 95%CI (1.22, 4.66) 〕were the influential factors for hypertensive patients with MCI (P<0.05) . ROC curve analysis results showed that the area under ROC curve of individual predictive risk value predicting hypertensive patients with MCI was 0.72〔95%CI (0.65, 0.78) , P<0.001〕. The optimal cut-off value was 0.18, the sensitivity was 0.69, and the specificity was 0.63.

Community hypertension patients aged 75 years or older, with grade 2 or higher hypertension, with depressive symptoms, and female patients had an increased risk of MCI, screening programs and treatment of hypertension and depression symptoms can be helpful on maintaining cognitive function.

Many factors are associated with hypertension, the most prevalent chronic disease, among which, the association of sleep disturbance and hypertension has received wide attention as sleep medicine advances rapidly in recent years. However, relevant studies on sleep disturbance and hypertension have some limitations, and there is no bibliometric analysis of hotspots about sleep disturbance and hypertension.

To review and summarize the research hotspots and trends of literature related to sleep disturbances and hypertension.

Studies about sleep disturbance and hypertension were searched in Web of Science Core Collection from inception to June 30, 2021 using "hypertension" and "sleep disturbance" "insomnia" "sleep deprivation" "sleep fragmentation" and "short-term sleep" as subject headings. CiteSpace 5.7.R5W was used for visual analysis.

In total, 4 589 studies were included for analysis. The number of studies generally showed an increasing trend, with a peak in 2018, and a rapider growth rate between 2011 and 2021. The top 10 most frequently used keywords in the studies published between 2011 and 2021 were hypertension, blood pressure, prevalence, obstructive sleep apnea, risk factor, sleep, cardiovascular disease, positive airway pressure, obesity and insomnia. The tag clusters were sleep time, sleep quality, sleep-disordered breathing, obstructive sleep apnea, sleep apnea, insomnia, stress, sleep, epidemiology, heart failure and symptoms. Keyword clustering analysis revealed that major directions in the studies published between 2011 and 2021 were: (1) the association of sleep-disordered breathing, especially obstructive sleep apnea, and hypertension; (2) the association of sleep time and blood pressure; (3) the association of sleep quality and blood pressure. The most frequently cited studies were mainly about sleep apnea, obstructive sleep apnea and short-term sleep. REDLINE was the most prolific author, and the largest group of authors was formed with her as the core. The US was the most prolific country, and the most prolific institution was the University of Pittsburgh.

The research on sleep disturbance and hypertension had become increasingly popular. The research hotspots of this field had changed greatly in 2011 and 2018. The effects of obstructive sleep apnea and sleep duration on hypertension were the mostly focused hotspots.

The prevalence of sarcopenia is rising along with global population aging, and it is estimated that there will be about 200 million sarcopenia patients worldwide by the mid-21st century. Both essential hypertension and sarcopenia are common in the elderly, but the correlation between them has been rarely studied in China.

To examine the prevalence and risk factors of sarcopenia in middle-aged and elderly patients with essential hypertension, providing a reference for secondary prevention and early delivery of intervention of sarcopenia in this group.

A total of 107 patients with essential hypertension aged ≥50 years who were hospitalized in Geriatric Department, the First People's Hospital of Yunnan Province from December 2020 to December 2021 were enrolled. Sarcopenia was diagnosed by the recommendation from Asian Working Group for Sarcopenia in 2019. Nutrition status was assessed using the Mini-Nutritional Assessment Scale-Short Form (MNA-SF) . The general demographics, sarcopenia diagnostic indicators, laboratory indicators and MNA-SF assessment results were collected. Binary Logistic regression analysis was used to explore the influencing factors of sarcopenia in essential hypertension. The receiver operating characteristic (ROC) analysis was performed to explore the predictive value of body mass index (BMI) for sarcopenia in essential hypertension.

Among the 107 patients, 53 (49.5%) were diagnosed with sarcopenia, and other 54 (50.5%) cases had no sarcopenia. The prevalence of sarcopenia in slightly underweight, normal weight, overweight or obesity patients was 83.3% (5/6) , 64.2% (34/53) , 30.0% (12/40) , 25.0% (2/8) , respectively. The prevalence rate of sarcopenia decreased with the increase of BMI (χ²_trend=15.027, P=0.001) . Logistic regression analysis showed that female〔OR=0.175, 95%CI (0.059, 0.518) 〕, overweight〔OR=0.039, 95%CI (0.003, 0.513) 〕, obesity〔OR=0.019, 95%CI (0.001, 0.459) 〕, higher 25- (OH) D〔OR=0.914, 95%CI (0.843, 0.991) 〕, and higher MNA-SF score〔OR=0.832, 95%CI (0.697, 0.992) 〕 were associated with decreased risk of sarcopenia (P<0.05) , while older age〔OR=1.139, 95%CI (1.073, 1.209) 〕, increased systolic blood pressure〔OR=1.038, 95%CI (1.001, 1.076) 〕 and increased diastolic blood pressure〔OR=1.095, 95%CI (1.035, 1.159) 〕 were associated with increased risk of sarcopenia (P<0.05) . The area under the ROC curve of BMI in predicting sarcopenia was 0.749〔95%CI (0.656, 0.843) 〕, with 52.8% sensitivity and 88.9% specificity when 22.0 kg/m² was determined as the optimal cut-off value.

The prevalence of sarcopenia was high in middle-aged and elderly patients with essential hypertension, the risk of which was increased with advanced age, higher systolic blood pressure and diastolic blood pressure, and declined with being female, overweight, obesity, higher vitamin D and good nutrition. BMI may be a good predictor of sarcopenia in essential hypertension.

In recent years, due to the increase of life stress, there is an increasing number of the men and women of childbearing age suffering from hypertension in China. Therefore, the standardized management of hypertension during the preparation for pregnancy has become a current focus. The standardized management of blood pressure of males and females of childbearing age during pregnancy preparation was discussed in this paper in terms of both monitoring and evaluating of hypertension during the preparation for pregnancy and application of antihypertensive drugs, emphasizing that the management of hypertension during pregnancy preparation in women should consider both maternal and fetal safety, choose relatively safe antihypertensive drugs such as methyldopa, labetalol, nifedipine, etc; the management of hypertension during pregnancy preparation in men should consider the efficacy of antihypertensive drugs and the effects on sexual function and sperm, Nebivolol, ACEI/ARB and CCB drugs are recommended, in order to provide guidance for the management of hypertension during the preparation for pregnancy reference direction for future research.

Long-term high level of mental tension induced by nursing work may be associated with increased blood pressure in nurses. The factors influencing hypertension may differ by sex, since there are sex-specific differences in the regulation of blood pressure in molecules, cells and tissues. So exploring influencing factors for hypertension in male and female nurses is significant for formulating targeted prevention and control strategies.

To examine the prevalence and influencing factors of hypertension among male and female nurses in Hebei Province, providing a basis for developing sex-based hypertension prevention and control measures for nurses.

A census survey method was used. The prevalence and influencing factors of hypertension were investigated among 128 009 nurses in all hospitals in 11 cities of Hebei Province from November 2016 to July 2018. The recognized factors influencing hypertension were matched between male and female nurses by propensity score matching. Based on the matched data, multivariate Logistic regression was used to explore the factors influencing hypertension among male and female nurses.

The prevalence of hypertension was higher in male nurses than in female nurses〔20.36% (1 115/5 476) vs 6.26% (669/122 533) , P<0.001〕. After propensity score matching, age〔>25-35 years old (OR=2.182) , >35-45 years old (OR=3.560) , >45-55 years old (OR=7.406) , >55-65 years old (OR=13.339) 〕, BMI〔24.0-<28.0 kg/m² (OR=1.591) , ≥28.0 kg/m² (OR=2.739) 〕, location of hospital〔Cangzhou (OR=1.431) , Hengshui (OR=1.834) , Tangshan (OR=1.408) 〕, years of hyperlipidemia〔>0-5 years (OR=3.399) , >5-10 years (OR=4.451) 〕, family history of hypertension (OR=1.225) were influencing factors of hypertension for male nurses (P<0.05) . Age〔>25-35 years old (OR=1.382) , >35-45 years old (OR=4.125) , >45-55 years old (OR=6.510) , >55-65 years old (OR=5.616) 〕, BMI〔24.0-<28.0 kg/m² (OR=1.749) , ≥28.0 kg/m² (OR=3.111) 〕, department〔paediatrics (OR=1.570) , medical technology department (OR=1.779) 〕, years of hyperlipidemia〔>0-5 years (OR=2.863) , >5-10 years (OR=3.713) 〕, years of diabetes〔>0-5 years (OR=3.126) , >5-10 years (OR=2.947) , >10 years (OR=9.743) 〕, family history of hypertension (OR=1.243) , menstrual condition〔irregular (OR=1.358) , menopause (OR=1.689) 〕, pregnancy hypertension〔no (OR=0.486) , no history of pregnancy (OR=0.507) 〕were influencing factors of hypertension for female nurses (P<0.05) .

The prevalence of hypertension was higher in male nurses than in female nurses. Age, BMI, years of hyperlipidemia, and a family history of hypertension are influencing factors of hypertension for both male and female nurses. Working at the pediatric or medical technology department, irregular menstruation, menopause, or gestational hypertension only affected the risk of hypertension in female nurses. These factors associated with hypertension can inform targeted prevention and control measures. In addition, the location of hospital was influencing factors of hypertension only for male nurses.

Epidemiological studies have demonstrated that the prevalence of hypertension is higher in postmenopausal women than in elderly men. Increasing attention has been paid to postmenopausal hypertension recently, involving its clinical manifestations, pathological features, pathogenesisand treatment. However, due to disparities in study design, sample size and population characteristics, as well as insufficient resources, the research results of risk factors for postmenopausal hypertension are inconsistent and incomprehensive.

To perform a systematic review of risk factors for postmenopausal hypertension, so as to provide evidence-based basis for better prevention and management of the disease.

From January to May 2022, the databases of CNKI, WanfangData, SinoMed, PubMed, EmBase, the Cochrane Library, and Web of Science were searched for cohort and case-control studies related to risk factors for postmenopausal hypertension from the establishment of the databases to May 20, 2022. Studies were identified using the inclusion and exclusion criteria, then assessed in terms of quality using the Newcastle-Ottawa Scale (NOS) , and those with NOS score≥6 (high quality) were included. RevMan 5.3 was used for meta-analysis.

Ten high-quality studies were included, 5 of which were cohort studies, and the other 5 were case-control studies. Overall, 16 potential risk factors for postmenopausal hypertension were identified in a total sample size of 34 864. Meta-analysis showed that the risk factors for postmenopausal hypertension included elevated hs-CRP〔RR (95%CI) =1.38 (1.04, 1.83) 〕, older age〔OR (95%CI) =1.39 (1.11, 1.74) 〕, elevated BMI〔OR (95%CI) =1.61 (1.19, 2.18) 〕, elevated total cholesterol〔OR (95%CI) =1.35 (1.14, 1.59) 〕, elevated triglyceride〔OR (95%CI) =2.17 (1.03, 4.59) 〕, history of diabetes〔OR (95%CI) =1.70 (1.27, 2.27) 〕. The risk-reducing factors included high adiponectin〔RR (95%CI) =0.83 (0.70, 0.99) 〕and advanced menopausal age〔OR (95%CI) =0.90 (0.82, 0.98) 〕.

Older age, high levels of hs-CRP, BMI, total cholesterol, and triglyceride, and diabetes are independent risk factors for postmenopausal hypertension. Thus, controlling some of the above controllable factors may effectively decrease the risk of postmenopausal hypertension.

Drinking sugary drinks are common in China, but inadequate intake of which can induce a variety of diseases. Many studies have reported the relationship between intake of sugary drinks and the risk of hypertension, however, there are still disputes over the specific dose-response relationship between them.

To assess the dose-response relationship between the intake of sugary drinks and the risk of hypertension.

We searched for cross-sectional and prospective studies about the intake of sugary drinks and risk of hypertension in databases of CNKI, CQVIP, SinoMed, Wanfang Data, PubMed, EMBase, Cochrane Library, and Web of Science from inception to November 2021. Two reviewers independently extracted data, and evaluated the quality of included studies. Stata 16.0 was used for meta-analysis.

Sixteen studies with 316 205 subjects were included. Meta-analysis results showed that the intake of sugary drinks increased the risk of hypertension〔OR=1.12, 95%CI (1.10, 1.15) , P<0.05 〕. Subgroup analyses revealed that by the intake of sugary drinks, the risk of hypertension increased by 34% in Asian population〔OR=1.34, 95%CI (1.20, 1.51) , P<0.05〕, and increased by 11% in North American population〔OR=1.11, 95%CI (1.09, 1.14) , P<0.05〕, and rose by 82% in Oceanian population〔OR=1.82, 95%CI (1.04, 3.21) , P<0.05〕, and grew by 18% in European population〔OR=1.18, 95%CI (1.02, 1.36) , P<0.05〕. Furthermore, the intake of sugary drinks was associated with a 43% higher risk of hypertension in minors〔OR=1.43, 95%CI (1.21, 1.69) , P<0.05〕, and a 12% higher risk of hypertension in adults〔OR=1.12, 95%CI (1.09, 1.15) , P<0.05〕 . In addition, the intake of sugary drinks was associated with a 12% higher risk of hypertension in people with normal BMI〔OR=1.12, 95%CI (1.09, 1.15) , P<0.05〕, a 17% higher risk of hypertension in overweight people〔OR=1.17, 95%CI (1.00, 1.38) , P<0.05〕, and a 19% higher risk of hypertension in obese people〔OR=1.19, 95%CI (1.06, 1.34) , P<0.05〕. Dose-response analysis results showed that for every additional sugary drink (i.e. 12 ounces, about 340 g or 355 ml) per day, the risk of hypertension increases by 16%〔OR=1.16, 95%CI (1.13, 1.18) , P<0.05〕. The basically symmetrical funnel plot and the Begg's test (Z=0.23, P>0.05) and Egger's test (t=1.46, P>0.05) showed no published bias.

The intake of sugary drinks may be associated with increased risk of hypertension, and for every increased intake of a sugary drink (i.e. 12 ounces, about 340 g or 355 ml) per day, the risk of hypertension increased by 16%. So controlling the intake of sugar is important for preventing hypertension.

Sleep duration is strongly associated with hypertension, but its effect on H-type hypertension in female population is not well characterized.

The examine the effect of sleep duration on the prevalence of H-type hypertension in female population.

A cross-sectional study design was used. One thousand seven hundred and nine female hypertensive inpatients were selected from Department of General Medicine and Geriatric Department of Hunan Provincial People's Hospital from July 2018 to December 2020, among whom those who with serum Hcy≥10 μmol/L and the others were assigned into H-type hypertension and non-H-type hypertension groups, respectively. Binary Logistic regression was used to assess the correlation of between sleep duration and H-type hypertension across three groups with different self-reported mean daily sleep durations in the past month (<7 h, 7-8 h, and >8 h) , and to further assess the correlation between the two across by age (≤60 and >60) .

The distribution of age, education level and marital status differed across three groups with different daily sleep durations (P<0.05) . 901 (52.72%) with daily sleep duration of <7 h, 697 (40.78%) with daily sleep duration of 7-8 h, and 111 (6.50%) with daily sleep duration of >8 h. The distribution of age, education level, living area (urban or rural) , marital status, BMI, exercise status, and daily sleep duration, as well as prevalence of drinking between H-type hypertension group〔973 (56.93%) 〕 and non-H-type hypertension group〔736 (43.07%) 〕 (P<0.05) . The risk of H-type hypertension in those with <7 h of daily sleep duration was 1.291 times higher than that in those with 7-8 h of daily sleep duration〔95%CI (1.032, 1.615) , P<0.05〕after adjusting for confounding factors such as age, education level, living area, marital status, BMI and exercise status. Further analysis revealed that <7 h of daily sleep duration was associated with increased risk of H-type hypertension only in those aged greater than 60 years〔OR (95%CI) =1.421 (1.021, 1.978) , P<0.05〕.

Less than 7 h of daily sleep duration was a risk factor for H-type hypertension in female over 60 years old. In view of this, it is suggested to put more attention to sleep health to improve blood pressure in this group.

Older people are a group susceptible to hypertension, and among whom hypertension prevalence is increasing as population aging aggravates. Early prevention, diagnosis and treatment of hypertension in the elderly are very important, which can be enhanced by an important way, namely developing high-quality clinical practice guidelines.

To perform an analysis of the guidelines regarding the diagnosis and management of hypertension in the elderly, and to assess their methodological quality.

In December 2021, we searched for clinical guidelines for hypertension in the elderly in databases of CNKI, CQVIP, WanFang Data, SinoMed, PubMed, EmBase and Medlive, as well as in the official websites of the National Guideline Clearing house, the Guidelines International Network and the National Institute for Health and Care Excellence from inception to December 2021. Two reviewers independently conducted literature screening and data extraction. Four reviewers independently evaluated the methodological quality of included guidelines using the AGREEⅡ. Recommendations from each guideline were retrieved.

A total of 11 guidelines were included: seven are Chinese guidelines, two are US guidelines and the other two are European guidelines. The mean standardized domains scores of the AGREEⅡinstrument in assessing the overall guideline quality were as follows: 50.13% for scope and purpose, 24.24% for stakeholder involvement, 18.51% for rigour of development, 54.03% for clarity of presentation, 11.36% for applicability and 30.30% for editorial independence. The recommendation level was B for five guidelines, and was C for the remaining six guidelines. The main recommendations involve three aspects: pharmacological intervention, non-pharmacological intervention, and continuing health management.

The overall methodological quality of included guidelines is unsatisfactory. To improve the quality of such guidelines developed in the future to better guide clinical practice, it is suggested to give more attention and priority to domains of stakeholder involvement, rigour of development, and applicability.

Mild cognitive impairment (MCI) is highly prevalent in hypertensive patients, but the current studies on MCI in hypertension mostly focus on the elderly group, while scarcely involve young and middle-aged patients.

To investigate the prevalence and associated factors of MCI in young and middle-aged hospitalized patients with hypertension.

A convenience sample of 213 young and middle-aged hypertensive inpatients were recruited from a tertiary grade A hospital in Harbin from May to December 2021. The General Demographic Questionnaire, Montreal Cognitive Assessment (MoCA) , and the Type-D Scale-14 (DS14) were used for understanding patients' demographics, cognitive impairment status, and D-type personality prevalence, respectively. Multiple Logistic regression was used to analyze associated factors of MCI.

The prevalence of MCI was 37.56% (80/213) . Multiple Logistic regression analysis showed that age〔OR=1.073, 95%CI (1.033, 1.115) 〕, education level〔junior college education level: OR=0.278, 95%CI (0.084, 0.920) , smoking history〔OR=2.494, 95%CI (1.146, 5.426) 〕, stage of hypertension〔stage 2: OR=3.442, 95%CI (1.252, 9.468) ; stage 3: OR=3.934, 95%CI (1.518, 10.193) 〕, D-type personality〔OR=2.160, 95%CI (1.015, 4.598) , TG〔OR=1.596, 95%CI (1.125, 2.265) 〕, and HDL-C〔OR=0.185, 95%CI (0.049, 0.707) 〕were influential factors of MCI in hypertension (P<0.05) .

Young and middle-aged hospitalized patients with hypertension had a high prevalence of MCI. Older age, lower level of education, D-type personality, higher level of TG and lower level of HDL-C were related to increased risk of MCI in hypertension. In view of this, medical workers should screen MCI in these patients to identify those at high risk of MCI as early as possible, and deliver interventions to them timely.

The new electrocardiogram (ECG) criteria have higher accuracy in the diagnosis of left ventricular hypertrophy (LVH) in general population with hypertension than traditional ECG voltage criteria. However, the diagnostic efficacy of new ECG criteria for LVH in overweight and obese patients with hypertension has been rarely reported.

To explore the diagnostic value of new ECG indicators for LVH in overweight and obese patients with hypertension.

A retrospective design was used. A total of 368 overweight and obese patients with hypertension were recruited from the First Affiliated Hospital of Wannan Medical College from December 2017 to December 2020, and divided into LVH (+) group (including males with LVH>115 g/m² and females with LVH >95 g/m²) and LVH (-) group (including males with LVH≤115 g/m² and females with LVH≤95 g/m²) . General data were collected and compared between two groups. Intergroup comparison was also performed in terms of ultrasonic cardiography (UCG) indicators〔diastolic interventricular septal thickness (IVST) , left ventricular posterior wall thickness (LVPWT) , left ventricular mass (LVM) , left ventricular mass index (LVMI) , left ventricular ejection fraction (LVEF) 〕and ECG indicators〔QRS duration (QRSd) , corrected QT interval (QTc) , Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria, Cornell product〕with the accuracy of UCG indicators as the gold standard. Binary Logistic regression model was used to analyze the influencing factors of LVH in hypertension with overweight or obesity. ROC analysis was used to evaluate the diagnostic efficacy of new ECG indicators (Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria, Cornell product) for LVH in hypertension with overweight or obesity.

There were statistically significant differences in sex ratio, mean age, body surface area (BSA) , SBP, DBP, β-blocker utilization rate and blood pressure control between LVH (+) and LVH (-) groups (P<0.05) . The mean values of IVST, LVPWT, LVM, LVMI, QRSd, QTc, Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria and Cornell product in LVH (+) group were higher than those in LVH (-) group (P<0.05) . The mean LVEF value in LVH (+) group was lower than that in LVH (-) group (P<0.05) . Age 〔OR=1.046, 95%CI (1.024, 1.069) 〕 and Sokolow-Lyon voltage criteria〔OR=1.793, 95%CI (1.305, 2.463) 〕 were influential factors for LVH risk in hypertension with overweight or obesity (P<0.05) . The AUC of Sokolow-Lyon voltage criteria, Cornell voltage criteria Peguero Lo-Presti voltage criteria and Cornell product for LVH diagnosis in hypertension with overweight or obesity was 0.674, 0.695, 0.662 and 0.722, respectively. The AUC of the combined diagnostic model with age, BSA, SBP, DBP, time of the duration of hypertension, QRSd, QTc, Sokolow-Lyon voltage criteria, Cornell voltage criteria, Peguero Lo-Presti voltage criteria, and Cornell product incorporated was 0.846.

In overweight and obese people with hypertension, the Sokolow-Lyon voltage criteria was associated with LVH. Moreover, the new ECG indicator Peguero Lo-Presti voltage criteria was less effective than Cornell product and other traditional ECG indicators in diagnosing LVH. The combined diagnostic model has proven to be with better diagnostic performance for LVH, which is recommended to be used and promoted in primary care settings with relatively unsatisfactory examination conditions.

Population aging has become a prominent problem in recent years. At present, there are many studies on hypertension and mild cognitive impairment (MCI) , but few studies on the relationship between masked hypertension (MH) and MCI in elderly patients.

To investigate the relationship of carotid intima-media thickness (CIMT) and epicardial fat thickness (EAT) with cognitive dysfunction in elderly patients with MH, to provide a theoretical basis for early detection of mild changes in cognitive function in this group.

A total of 255 cases were selected from Municipal Hospital of Traditional Chinese Medicine of Jiayuguan from January 2019 to February 2022, including 173 elderly inpatients and outpatients diagnosed with MH (MH group) , and 82 elderly healthy people with normal blood pressure (control group) . Ambulatory blood pressure monitoring, CIMT and EAT measurement were performed in both groups, and relevant indicators were recorded. The Montreal Cognitive Assessment (MoCA) scale was used to assess the cognitive function. Binary Logistic regression analysis was used to explore the factors associated with MCI in MH.

Compared with control group, MH group had greater average age, and higher levels of average clinic systolic blood pressure (SBP) , clinic diastolic blood pressure (DBP) , 24 h ambulatory SBP, 24 h ambulatory DBP, 24 h SBP coefficient of variation, 24 h DBP coefficient of variation, CIMT and EAT, as well as less average years of education (P<0.05) . The average scores of executive function/visuospatial ability, animal naming, attention, language, abstraction, delayed recall and average total MoCA score in MH group were significantly lower than those in control group (P<0.05) . Correlation analysis showed that the total score of MoCA was negatively correlated with age, 24 h DBP coefficient of variation, CIMT, and EAT (P<0.001) . Binary Logistic regression analysis indicated that CIMT〔OR=48.282, 95%CI (10.734, 217.168) 〕, EAT〔OR=2.124, 95%CI (1.057, 4.269) 〕 were associated with MCI in MH (P<0.05) .

Increased age, lower education level, increased 24 h SBP coefficient of variation, and increased CIMT and EAT values are risk factors for cognitive dysfunction in elderly patients with MH.

The prevalence of hypertension and cognitive dysfunction in the elderly in China is not optimistic, and hypertension has been associated with an increased risk of developing cognitive dysfunction. It is of great significance to explore and promote the methods for prevention and control of cognitive dysfunction in elderly patients with hypertension in community.

To explore the effect of leisure physical activities on cognitive function in elderly patients with hypertension in community.

From August 2020 to December 2020, a total of 770 patients with hypertension aged ≥65 years who underwent chronic disease management were selected from community health service centers in Wuhan using the stratified random sampling method. A questionnaire was administered to obtain the general information of the subjects, leisure physical activity (including 6 cognitive activities and 11 physical activities) and cognitive function (using the Mini-Mental State Examination Scale). Multivariate Logistic regression was used to analyze the influencing factors of cognitive dysfunction in elderly patients with hypertension. Multiple linear regression was used to analyze the influence of leisure physical activity on cognitive function in elderly patients with hypertension. Multiple Logistic regression was used to analyze the influence of the weekly participation frequency of 17 leisure physical activity on cognitive dysfunction in elderly patients with hypertension.

The incidence of cognitive dysfunction in elderly hypertensive patients in community was 39.4% (303/770). There were significant differences in gender, age, education, duration of hypertension, leisure physical activity scores between patients with and without cognitive impairment (P<0.05). Multivariate Logistic regression analysis showed that duration of hypertension〔OR (95%CI) =1.02 (1.01, 1.03) 〕 and leisure physical activity score〔OR (95%CI) =0.98 (0.96, 0.99) 〕 were influencing factors for the development of cognitive impairment in older patients with hypertension. Further analysis found that the leisure physical activity score was an influential factor in the MMSE for scores on the attention and calculation power dimension〔b (95%CI) =0.02 (0.01, 0.03) 〕, the language ability dimension score〔b (95%CI) =0.02 (0.01, 0.03) 〕. After refining the categories to leisure physical activity style, the results of multivariate Logistic regression analysis showed that older adults with hypertension who participated in writing〔OR (95%CI) =0.34 (0.12, 0.95) 〕, board games〔OR (95%CI) =0.21 (0.06, 0.72) 〕 daily were less likely to be cognitively impaired than those who occasionally/never participated in this activity.

Leisure physical activity is a protective factor of cognitive function in elderly patients with hypertension, which mainly affects two dimensions of cognitive function: attention and calculating ability, and language ability. Daily participation in writing and checkerboard games play a positive role in cognitive function in elderly patients with hypertension.

IgA nephropathy (IgAN) is the most common primary glomerular disease, and one major cause of malignant hypertension (MHT) secondary to renal parenchymal disease. The clinical conditions and severity of renal lesion have been reported to be more serious when IgAN is accompanied by MHT, but risk factors of MHT in IgAN analyzed from Traditional Chinese Medicine (TCM) perspective are still unclear.

To explore the TCM-related factors and pathogenesis associated with MHT in IgAN patients.

From 518 cases of primary IgAN who were diagnosed by renal biopsy in First Medical Center of Chinese PLA General Hospital during December 2013 to September 2021, a sample of 12 cases accompanied by MHT (IgAN-MHT group) computed by PASS 15.0 were selected for correlation power analysis, and they were matched at a ratio of 1∶5 with other randomly selected 85 cases without MHT (IgAN group) . Clinical, pathological and TCM syndromes between the two groups were compared. Lasso regression was used to screen 93 TCM syndromes, among which those with significant associations with IgAN-MHT were identified by multivariate Logistic regression.

Compared with IgAN group, IgAN-MHT group had higher prevalence of headache and dizziness or nausea and vomiting as the first clinical manifestations, and clinically diagnosed nephrotic syndrome, higher levels of baseline mean arterial pressure, highest systolic and diastolic blood pressure, blood urea nitrogen, serum creatinine, serum inorganic phosphorus, serum magnesium, and quantitatively estimated 24-hour urinary protein excretion, higher prevalence of CKD stages 3-5, blood stasis syndrome, subtypes of qi-deficiency syndromes (including mental fatigue and lack of strength, limb fatigue, tibia and leg weakness, dizziness, headache with nausea, and vomiting) , subtypes of yin-deficiency syndromes (including blurred vision and eye floaters) , subtypes of blood stasis syndromes (including nail cyanosis, and dark purple tongue) , and intrarenal arteriosclerosis (P<0.05) . Moreover, IgAN-MHT group had lower prevalence of abnormal urine test results as the first clinical manifestations, previous hypertension and clinical diagnosed chronic nephritic syndrome, as well as lower levels of mean serum IgM and IgG levels, and eGFR (P<0.05) . Both groups had no significant difference in the prevalence of interstitial fibrosis/tubular atrophy (T) lesions among the two groups (P<0.05) . The common TCM syndrome in IgAN-MHT group was qi-yin deficiency syndrome combined with blood stasis syndrome. Correlation analysis showed that IgAN-MHT was positively associated with blood stasis syndrome (P<0.05) ; in IgAN-MHT group, male and quantitatively estimated 24-hour urinary protein excretion was positively associated with qi-deficiency syndrome (P<0.05) ; serum inorganic phosphorus and potassium was negatively associated with yin-deficiency syndrome (P<0.05) , and renal tubular atrophy/interstitial fibrosis was positively associated with blood stasis syndrome (P=0.040) . Multivariate Logistic regression analysis showed that headache〔OR=7.895, 95%CI (1.643, 37.935) , P=0.010〕, blurred vision〔OR=5.499, 95%CI (1.207, 25.053) , P=0.028〕, dry mouth with desire for drink 〔OR=10.079, 95%CI (2.289, 44.373) , P=0.002〕, and nail cyanosis〔OR=18.312, 95%CI (2.179, 153.884) , P=0.007〕 were associated with MHT in IgAN.

IgAN-MHT patients had worse renal function and more serious renal pathological damage. The common TCM syndrome in IgAN-MHT was qi-yin deficiency syndrome with blood stasis syndrome. The clinical and pathological indices of IgAN-MHT patients had a certain level of correlation with qi-deficiency syndrome, yin-deficiency syndrome and blood stasis syndrome. The subtypes of TCM syndromes, such as headache, blurred vision, dry mouth with desire for drink, and nail cyanosis were the influencing factors of MHT in IgAN. Early detection, diagnosis and treatment, concern for and improvement of symptoms related to syndromes of qi-deficiency, yin-deficiency, and blood stasis, may contribute to decreased risk of MHT in IgAN.

Inter-arm systolic blood pressure difference (IASBPD) is associated with an increased risk of cardiovascular events, which may be involved with arterial stiffness.

To investigate the association of IASBPD with arterial stiffness in essential hypertension.

This retrospective study consecutively included 6 834 patients with essential hypertension who were admitted to Beijing Anzhen Hospital, Capital Medical University from December 2019 to September 2021. The patients were divided into three groups according to IASBPD. Arterial stiffness was assessed by the value of brachial-ankle pulse wave velocity (baPWV). Multiple linear regression and multivariate Logistic regression models were used to analyze the association of arterial stiffness with IASBPD, then based on this, multivariate Logistic regression was further used for subgroup analysis to explore the impact of each influencing factor and their interaction on arterial stiffness.

The IASBPD tertile groups were: IASBPD<5 mm Hg (n=4 248), 5 mm Hg≤IASBPD<10 mm Hg (n=1 806) and IASBPD≥10 mm Hg (n=780) .The median baPWV was 1 572 (1 392, 1 702) cm/s. The prevalence of arterial stiffness (defined as baPWV>1 800 cm/s) was 15.26% (1 043/6 834). Multiple linear regression analysis showed that IASBPD was associated with baPWV, and an increase in IASBPD by 1 mm Hg corresponded to an increase of 4.31 cm/s in baPWV〔B=4.31, 95%CI (3.29, 5.31), P<0.05〕. Multivariate Logistic regression analysis demonstrated that IASBPD≥10 mm Hg was associated with increased risk of arterial stiffness〔OR=2.28, 95%CI (1.76, 2.94), P<0.05〕, and the risk was much higher in those with LDL-C≥3.4 mmol/L (P=0.021) indicated by further subgroup analysis.

IASBPD≥10 mm Hg was a risk factor of arterial stiffness among essential hypertensive patients, especially in those with LDL-C≥3.4 mmol/L. IASBPD might be used as a simple and effective predictor of arterial stiffness.

Launched in 2009, the National Essential Public Health Service Program has been conducted for 13 years. Among which the antihypertensive care ranks first among all types of antihypertensive care in terms of population coverage in China. To promote the sustainable development of the National Essential Public Health Services (NEPHSs) , it is important to understand the feedback of hypertensive population on the antihypertensive care.

To explore hypertension patients' self-rated improvement gained from and satisfaction with the NEPHSs and associated factors, providing a scientific basis for promoting the quality development of the services.

By use of multi-stage stratified sampling, 2 419 hypertensive patients (≥35 years old) were selected from 20 community (township) health centers in 10 districts (counties) of 5 cities in eastern, central and western China from November to December 2019. A questionnaire survey was conducted with them for understanding their general demographic information and management of hypertension.

The prevalence of having self-rated health improvement associated with the NEPHSs in the survey respondents was 86.26% (2 072/2 402) . The prevalence of self-reported satisfaction with healthcare workers' attitudes toward patients, and their care quality, physical examination, health education, TCM treatment, follow-up service, screening for hypertension complications, blood pressure control effect and overall services was 97.15% (2 349/2 418) , 94.09% (2 275/2 418) , 88.16% (2 129/2 415) , 87.81% (2 118/2 412) , 61.36% (1 469/2 394) , 95.04% (2 297/2 417) , 83.67% (2 013/2 406) , 82.34% (1 981/2 406) , and 95.53% (2 310/2 418) , respectively. The prevalence of self-rated improvement gained from the NEPHSs varied significantly by education level, self-rated health, prevalence of blood pressure abnormalities first detected in primary care, and the number of different follow-up services received within the past year (P<0.05) . The prevalence of self-reported satisfaction with overall services differed significantly by education level, prevalence of blood pressure abnormalities first detected in primary care, and the number of different follow-up services received within the past year (P<0.05) .

The prevalence of self-rated improvement gained from and self-reported satisfaction with the NEPHSs in hypertension patients were high on the whole. To promote the sound and sustainable development of these services, priority should be given to the standardization of the provision of NEPHSs and the homogeneity of NEPHSs provided to both urban and rural areas.

Hypertensive patients with moderate or high risk of ASCVD had low lipid goal attainment rate. And those with high risk of ASCVD and concomitant other high risk factors had unsatisfactory lipid control status. Attention should be paid to the management of blood lipid in hypertension patients to improve their blood lipid control rate and reduce their risk of ASCVD.

Hypertension is closely related to serum uric acid (SUA) level, and often accompanied by thyroid function changes. However, there are few reports on the relationship between thyroid hormone level and hyperuricemia (HUA) in euthyroid hypertensive patients.

To explore the correlation between serum thyroid hormone level and HUA in euthyroid individuals with essential hypertension (EH) .

Two hundred and sixty-seven euthyroid patients with EH were retrospectively selected from Department of Cardiology, Xianyang Hospital of Yan'an University from January 2019 to December 2020, including 101 with HUA (combined HUA group) and 166 without HUA (non-HUA group) . The general demographic data and laboratory examination indices of the two groups were compared, including gender, age, body mass index (BMI) , systolic blood pressure (SBP) , diastolic blood pressure (DBP) , smoking history, drinking history, total cholesterol (TC) , triacylglycerol (TG) , high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) , serum creatinine (Scr) , SUA, thyroid-stimulating hormone (TSH) , free triiodothyronine (FT₃) , and free thyroxine (FT₄) . Multivariate Logistic regression analysis was used to explore factors associated with HUA. Pearson correlation was used to examine the correlation between thyroid hormone level and SUA level.

There were significant intergroup differences in gender ratio, mean age, BMI, and DBP, as well as prevalence of smoking history and drinking history (P<0.05) . Moreover, the mean levels of TC, TG, LDL-C, Scr and SUA were also significantly different in the two groups (P<0.05) . In particular, the mean level of FT₃ in combined HUA group was significantly higher (t=-5.066, P<0.05) . Multivariate Logistic regression analysis demonstrated that male〔OR=2.843, 95%CI (1.121, 7.215) , P=0.028〕, higher BMI〔OR=1.126, 95%CI (1.020, 1.234) , P=0.018〕, TG〔OR=1.824, 95%CI (1.300, 2.560) , P=0.001〕, LDL-C〔OR=2.804, 95%CI (1.157, 6.795) , P=0.022〕, Scr〔OR=1.071, 95%CI (1.041, 1.102) , P<0.001〕and FT₃〔OR=2.297, 95%CI (1.326, 3.977) , P=0.003〕were associated with increased risk of HUA. Advanced age〔OR=0.959, 95%CI (0.931, 0.989) , P=0.007〕was decreased risk of HUA. Pearson correlation analysis revealed that the level of FT₃ was positively correlated with SUA (r=0.327, P<0.001) .

Being male, high BMI, elevated TG, LDL-C, Scr and FT₃ levels may be risk factors for HUA in euthyroid patients with EH. Advanced age may be protective factor for HUA in euthyroid patients with EH. As FT₃ level is positively correlated with SUA in these patients, those with elevated serum FT₃ level are prone to HUA, which should be paid attention by clinicians.

Primary care physicians play a vital role in the health management of hypertensive patients. Health assessment is an important tool for screening, diagnosis, and risk prediction of hypertension. Risk assessment allows early detection of target organ damage in hypertensive patients and provides a basis for treatment planning. Currently, the national public health service specification has clear requirements for health assessment for hypertensive patients, and such assessments have been carried out in primary health care institutions, but there are few reports on the competence of primary care physicians in health assessment for hypertensive patients.

To understand the levels of knowledge, attitude and practice (KAP) about health assessment for hypertensive patients among primary care physicians, and to analyze their influencing factors.

From May to June 2022, an online questionnaire survey was conducted among a multistage stratified sample of 420 primary care physicians in northern, central and southern Shanxi Province for collecting information of their baseline demographics, levels of KAP for health assessment for hypertensive patients, and hypertension assessment devices equipped in their medical institutions. Multiple linear regression was used to identify factors associated with primary care physicians' level of health assessment for hypertensive patients.

A total of 402 cases (95.7%) who returned responsive questionnaires were finally included. The total average score of KAP of the primary care physicians on the health assessment for hypertensive patients was (127.16±18.65) , with an average score of (53.68±8.95) on the knowledge dimension, (28.62±4.09) on the attitude dimension and (44.86±7.53) on the practice dimension. The results of multiple linear regression analysis showed that work unit, the level of highest educational attainment, specialty, participation in standardized training, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, receiving health management-related training, frequency of learning chronic disease knowledge and skills organized by their medical institutions, and weekly hours of independent learning were associated with the knowledge dimension of hypertension health assessment among primary care physicians (P<0.05) . The participation in standardized training, mode of employment, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, frequency of learning chronic disease-related knowledge and management skills organized by their medical institutions, and weekly hours of independent learning were factors influencing primary care physicians' scores on the attitude dimension of hypertension health assessment (P<0.05) . Acquisition of physician qualifications, the participation in standardized training, learning the latest National Guidelines for the Management of Primary Hypertension in Primary Care, receiving health management-related training, frequency of learning chronic disease-related knowledge and management skills organized by their medical institutions, and weekly hours of independent learning were factors influencing primary care physicians' scores on the behavioral dimension of hypertension health assessment (P<0.05) . In terms of the hypertension assessment equipment equipped in the medical institutions of primary care physicians, except for sphygmomanometer, height and weight measuring instruments and soft rulers for measuring waist circumference with a configuration rate of more than 96.8%, the configuration rates of routine hematology analyzers, routine urine chemistry analyzers, blood biochemistry analyzers, electrocardiogram machines, and chest X-ray (radiography) equipment (35.6%, 35.8%, 26.9%, 42.8%, and 23.1%, respectively) were all less than 45.0%, and the configuration rates of ambulatory blood pressure monitor, cardiac ultrasound machines, vascular color Doppler ultrasound equipment and funduscopic examination equipment were even lower (less than 15.0%) .

Primary care physicians have a relatively positive attitude toward health assessment for hypertensive patients, and there is still room for improvement in their levels of related knowledge and practical skills. In the future, we can improve primary healthcare services and standards by strengthening the standardized training of professional knowledge and skills of primary care physicians, improving the incentive and assessment system of primary healthcare institutions, and stimulating the awareness of independent learning of primary care physicians.

Hypertension and diabetes are two major chronic diseases affecting population health, and need to be controlled through chronic diseases follow-up. However, there is currently insufficient understanding of the impact of different chronic diseases follow-up forms and contents on disease control and healthy behaviors of patients.

To explore the impact of the chronic diseases follow-up on health behaviors and blood pressure/glucose control of patients with hypertension and diabetes in the context of treatment-prevention integration.

Yiyang County in Henan Province, Xianfeng County in Hubei Province and Yangqu County in Shanxi Province were selected as study sites to collect data from the basic public health information system from 2017-01-01 to 2022-06-30. Patient survey was conducted in July 2022 to collect information on basic public health follow-up receiving, health behaviors and disease control of patients. Finally, 102 769 patients with hypertension and 26 586 patients with diabetes were obtained from the basic public health information system, the data of 1 172 patients with hypertension and 456 patients with diabetes were obtained through patient surveys. Multivariate Logistic regression was used to analyze the effects of the standard-reaching frequency of follow-up, follow-up forms and contents on health behaviors and disease control of patients.

In 2021, the standard-reaching rates of follow-up frequency of patients with hypertension and diabetes were 90.83% (67 709/74 545) and 83.35% (13 390/16 065) , with frequency≥4 times/year as the standard. The follow-up forms included household follow-up〔25.74% (408/1 585) 〕, follow-up at institutional visits〔58.80% (932/1 585) 〕, telephone or network follow-up〔15.46% (245/1 585) 〕. The follow-up contents included blood pressure and blood glucose measurements〔91.15% (1 484/1 628) 〕, lifestyle guidance〔74.14% (1 207/1 628) 〕, disease inquiry〔70.02% (1 140/1 628) 〕, and drug use understanding〔69.29% (1 128/1 628) 〕. Multivariate Logistic regression analysis showed that patients with higher standard-reaching rates of follow-up frequency had higher rates of blood pressure control (OR=1.09, P<0.05) and glucose control (OR=1.31, P<0.05) , lower rates of smoking and drinking (OR=0.83, P<0.05) , and higher rates of regular exercise habits (OR=1.30, P<0.05) . The proportions of smoking and alcohol cessation (OR=2.38, P<0.05) and regular exercise habits (OR=1.62, P<0.05) were higher in the patients followed up at institutional visits than those followed up by telephone or network. The proportions of smoking and alcohol cessation (OR=2.33, P<0.05) and regular exercise habits (OR=2.54, P<0.05) of patients received household follow up were higher than those followed up by telephone or network. Patients who received lifestyle guidance, disease inquiry, and drug use understanding had higher rates of blood pressure control (OR=1.61, 1.34, and 1.62, respectively; P<0.05) , smoking and alcohol cessation (OR=3.59, 3.54, and 2.91, respectively; P<0.05) and regular exercise habits (OR=3.16, 2.15, 2.45, respectively; P<0.05) .

Receiving chronic diseases follow-up at least 4 times per year, with follow-up at institutional visits and household follow-up as the forms, provided with blood pressure and blood glucose measurements, lifestyle guidance, disease inquiry and drug use understanding as the contents in patients were positive correlated with blood pressure/glucose control, smoking and alcohol cessation, and regular exercise habits.

In China, a country owning a large number of hypertensive patients, offline management is still a major approach for hypertension prevention and control, but the efficiency and effectiveness of this approach are unsatisfactory. Therefore, it is necessary to develop a closed-loop hypertension management path using online management approaches actively explored based on cognitive-behavioral models.

To assess the effect of cognitive-behavioral change model-based online health education in the management of hypertension.

A total of 122 essential hypertension outpatients and inpatients were recruited from General Practice Department, General Hospital of Medical University of Ningxia Medical University from November 2018 to October 2019, and randomly divided into online management group (n=61) and off-line management group (n=61) . Off-line management group received routine management. Online management group received online health education (including systematic courses and personalized self-management information in line with the five stages of behavior transformation of hypertension patients provided via the WeChat platform for gradually changing their health-related behaviors) based on the cognition-behavioral change model (a model built upon improved knowledge-attitudes-behavior model, health belief model, and transtheoretical model) . Systolic blood pressure (SBP) and health-related behaviors at baseline and 12 weeks after intervention were compared between the groups.

The average SBP levels at baseline demonstrated no significant difference between the groups (P<0.05) . After intervention, the average SBP level decreased significantly in both groups (P<0.05) , and it decreased more significantly in the online management group (P<0.05) . Two groups showed no significant differences in the prevalence of self-monitoring blood pressure, taking medications, eating a diet and exercising as well as taking actions to improve psychological state according to the doctor's advice at baseline (P<0.05) . After intervention, the prevalence of self-monitoring blood pressure according to the doctor's advice was significantly increased in the online management group (P<0.05) although the prevalence of other four of the above-mentioned health-related behaviors was still similar in both groups (P<0.05) .

This hypertension management approach developed based on mobile health technologies and the cognition-behavioral change model could help general practitioners to effectively manage hypertension patients, which will contribute to the improvement of work efficiency of general practitioners, and the achievement of long-term preservation and real-time analysis of patient management data. So this management is worthy of application and promotion.