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Background <p>Occupational health examinations provide repeated and standardized health data for workers under surveillance and may offer a valuable resource for long-term blood pressure monitoring. However, evidence on age-related and temporal patterns of blood pressure among occupational populations in China remains limited.</p> Methods <p>We used occupational health examination records from male industrial workers in Shanghai between 2013 and 2023. After retaining the first examination record for each participant in each calendar year, analyses were restricted to records with valid systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements. Blood pressure status was classified as normal blood pressure, prehypertension, or hypertension according to the 2024 Chinese hypertension guideline. Age-related patterns were examined using generalized additive models. Crude and age-standardized prevalence estimates were calculated by calendar year, using the single-year age distribution of workers examined in 2018 as the internal standard population. Observed longitudinal patterns were further examined among workers with at least 8 valid annual blood pressure records.</p> Results <p>A total of 1,180,955 examination records with valid SBP and DBP measurements were included. Both SBP and DBP increased with age, with a more pronounced rise in SBP. Prehypertension was common across adulthood, whereas hypertension increased markedly with age. The age composition of the examined population changed across calendar years, but age-standardized analyses indicated that these changes did not fully account for the observed temporal differences in prehypertension and hypertension. In the repeated-examination subgroup, prehypertension was frequently observed before hypertension was first recorded. Among workers with first observed hypertension, 76.9% had at least 1 previous prehypertension record and 41.5% had at least 4 previous records. Under the 2017 ACC/AHA thresholds, 75.8% of records classified as prehypertension in the primary analysis met the threshold for stage 1 hypertension.</p> Conclusions <p>In this large occupational health examination dataset of male industrial workers in Shanghai, blood pressure status showed clear age-related and calendar-year patterns. Prehypertension was common and often preceded first observed hypertension, suggesting its potential value as an early warning state in occupational health surveillance. Periodic occupational health examinations may provide practical opportunities for earlier blood pressure risk identification and follow-up management, although the findings should be interpreted as observed blood pressure status rather than clinical diagnoses.</p>

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Age-related and temporal patterns of blood pressure among male industrial workers in Shanghai: evidence from occupational health examinations, 2013–2023

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Jiming Zhang,
  • Tengxiao Shan,
  • Tianyang Shen,
  • Yan Yin,
  • Xuetao Zhang,
  • Meixia Liu,
  • Qiang Hou,
  • Zhijun Zhou

摘要

Background

Occupational health examinations provide repeated and standardized health data for workers under surveillance and may offer a valuable resource for long-term blood pressure monitoring. However, evidence on age-related and temporal patterns of blood pressure among occupational populations in China remains limited.

Methods

We used occupational health examination records from male industrial workers in Shanghai between 2013 and 2023. After retaining the first examination record for each participant in each calendar year, analyses were restricted to records with valid systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements. Blood pressure status was classified as normal blood pressure, prehypertension, or hypertension according to the 2024 Chinese hypertension guideline. Age-related patterns were examined using generalized additive models. Crude and age-standardized prevalence estimates were calculated by calendar year, using the single-year age distribution of workers examined in 2018 as the internal standard population. Observed longitudinal patterns were further examined among workers with at least 8 valid annual blood pressure records.

Results

A total of 1,180,955 examination records with valid SBP and DBP measurements were included. Both SBP and DBP increased with age, with a more pronounced rise in SBP. Prehypertension was common across adulthood, whereas hypertension increased markedly with age. The age composition of the examined population changed across calendar years, but age-standardized analyses indicated that these changes did not fully account for the observed temporal differences in prehypertension and hypertension. In the repeated-examination subgroup, prehypertension was frequently observed before hypertension was first recorded. Among workers with first observed hypertension, 76.9% had at least 1 previous prehypertension record and 41.5% had at least 4 previous records. Under the 2017 ACC/AHA thresholds, 75.8% of records classified as prehypertension in the primary analysis met the threshold for stage 1 hypertension.

Conclusions

In this large occupational health examination dataset of male industrial workers in Shanghai, blood pressure status showed clear age-related and calendar-year patterns. Prehypertension was common and often preceded first observed hypertension, suggesting its potential value as an early warning state in occupational health surveillance. Periodic occupational health examinations may provide practical opportunities for earlier blood pressure risk identification and follow-up management, although the findings should be interpreted as observed blood pressure status rather than clinical diagnoses.