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Clinical practice guidelines for hypertension in China: a systematic review of the methodological quality
  1. Yin Chen1,
  2. Shilian Hu1,2,
  3. Lei Wu3,
  4. Xiang Fang4,
  5. Weiping Xu1,
  6. Gan Shen1
  1. 1Anhui Evidence-based Medicine Center, Anhui Provincial Hospital, Hefei, Anhui, China
  2. 2Gerontology Institute of Anhui Province, Anhui Provincial Hospital, Hefei, Anhui, China
  3. 3Department of Neurology, Anhui Provincial Hospital, Hefei, Anhui, China
  4. 4Department of Cardiology, Anhui Provincial Hospital, Hefei, Anhui, China
  1. Correspondence to Professor Shilian Hu; hushilian{at}


Objective Clinical practice guidelines (CPGs) provide clinicians with specific recommendations for practice, but due to the increasing number of CPGs developed by diverse organisations over the past few years, there are concerns about the quality of some CPGs. This paper proposes a systematic review of the methodological quality of the CPGs for hypertension that were developed in China.

Design A systematic review of CPGs for the management of hypertension in adult patients in China.

Data resources Chinese electronic databases, Chinese guideline websites and Google Scholar were searched, and the reference lists of relevant publications were also screened for additional information. CPGs for the management of hypertension in adult patients were identified. The main characteristics of the CPGs were extracted, and the scaled Appraisal of Guidelines, REsearch and Evaluation II (AGREE II) domain percentages were independently evaluated by two reviewers.

Results A total of 17 CPGs, with publication dates ranging from 2001 to 2011, were identified. There was considerable variation in the quality of the CPGs across the AGREE II domains. Overall, the domains of ‘rigor of development’ and ‘editorial independence’ were poorly addressed, with an average score of 18% and 16%, respectively. Also less well addressed were the ‘stakeholder involvement’ and ‘applicability’ domains, for which the average domain scores were 28% and 20%, respectively. The CPGs performance was less problematic in the domains of ‘scope and purpose’ and ‘clarity and presentation’, with a median of 41% for both. After considering the domain scores, 8 CPGs could be recommended with modification for use.

Conclusions There is considerable room for improvement of the methodological quality of CPGs for hypertension in China. Greater efforts should to be devoted to ensure the explicit and transparent reporting of potential conflicts of interest of stakeholders, and to consider the quality of the evidence and grade recommendations in the CPG development process.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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