强化干预对社区高血压伴糖代谢异常人群心脑血管事件影响研究

Influence study of strengthening intervention hypertension patints with the abnormal glucose metabolism in community population of Nanning City

目的了解强化干预是否可以降低社区高血压伴糖代谢异常人群血压和心脑血管事件。方法采用随机整群抽样方法抽取南宁市两个社区的1215人为研究对象,随机分成强化干预组和对照组。强化干预组按照是否患有高血压及其相关疾病分别采取不同的强化治疗方案进行干预;对照组人员维持志愿就诊和志愿服药的正常医疗状态,随访43.5个月,记录发生心脑血管事件情况。结果(1)两组高血压和糖代谢异常患者收缩压和舒张压较干预前明显降低(P<0.01)。(2)两组高血压伴糖代谢异常者收缩压和舒张压分别降低11.47、7.58和5.23、5.28mmHg,而高血压伴血糖正常者干预后分别降低16.78、10.38和9.6、6.02mmHg(P<0.01)。(3)本组心脑血管事件发生率为4.0%,事件发生率高血压、糖代谢异常患者明显高于非高血压和血糖正常者(P<0.01),其中对照组均明显高于相应的干预组(P<0.01)。(4)高血压伴糖代谢异常者事件发生率为8.4%,明显高于高血压伴血糖正常者(P<0.01)。高血压伴糖代谢异常干预组发生心脑血管事件的相对风险较对照组降低3.83倍。结论综合强化干预可明显降低社区高血压伴糖代谢异常人群血压水平,降低心脑血管事件发病风险。

Objective To understand whether the strengthening intervention of hypertension patients with the abnormal glucose metabolism can change their blood pressure and reduce the occurrence of cardiovascular events. Methods A random cluster sampling method was used in the two community population of Nanning City and 1215 people were selected as subjects, which were randomly divided into strengthening intervention and control groups. The strengthening intervention groups which according to whether or not people suffer from hyper- tension and related diseases, were taken different strengthening intervention measures; the control group re- mained to see a doctor and take medicine routinely. The follow - up time was 43.5 months and the occurring cardiovascular events were recorded. Results （1） two groups of hypertension and patients with the abnormal glucose metabolism systolic and diastolic blood pressure significantly lower than before intervention （ P 〈 0.01） . （2） Two groups of the high blood pressure with the abnormality of glucose metabolism systolic and diastolic blood pressure were reduced discern 11.47, 7.58 and 5.23 , 5.28 mmHg, and patients of hypertension and normal glucose systolic and diastolic blood pressure were reduced 16.78, 10.38 and 9.6 ,6.02 mmHg. （3） The group cardiovascular and cerebrovascular event rate was 4.0%, event rate of high blood pressure and the abnormality of glucose metabolism were significantly higher than the non - hypertensive and the normality of glucose （P 〈 O. 01）, and the control group are significantly higher than the intervention group （P 〈 0.01 ） . （4） The incidence of cardiovascular and cerebrovascular events of hypertension with the abnormality of glucose metabolism in the group were 8.4%, significantly higher than the hypertensive and nor- mality of glucose （P 〈 0.01） ;Compared with the control group, the intervention group have reduced the risk by 3.83 times in this patients. Conclusion The comprehensive strengthen intervention in hypertension patients with abnormal glucose metabolism can significantly lower the patient＇ s blood pressure levels and reduce the risk of the cardio - and cerebro - vascular incidents.