育龄女性避孕药使用与高血压社区干预效果评价

The effects of community-based intervention on the relationship between oral contraceptives and hypertension among child-bearing aged women

目的评价高血压社区综合干预对育龄女性高血压控制的效果。方法在江苏省太仓市沙溪镇和如东县马塘镇对1932年7月1日以后出生的已婚女性人群进行基线调查,对观察人群实施避孕药使用的知情选择等高血压防治综合干预措施,然后进行终点调查,评估干预效果。结果 (1)干预效果显著,高血压控制率由2.04%上升至22.84%(P<0.001),育龄高血压女性收缩压和舒张压分别下降5.19(95%CI:3.85～6.54)mmHg和6.45(95%CI:5.74～7.15)mmHg;干预效果地区差异明显,太仓市女性高血压收缩压下降达6.53 mmHg,高于如东县女性(3.78 mmHg)(P<0.05)。(2)育龄高血压女性降压药物使用率显著升高,由7.70%上升至55.62%(P<0.001)。(3)育龄高血压女性收缩压随口服避孕药(oral contraceptives,OC)使用时间的增加逐渐升高,呈剂量效应关系(P<0.001);干预后OC累积使用时间与收缩压/舒张压的剂量效应曲线均显著低于干预前(P<0.001)。结论育龄女性高血压社区综合干预效果显著,高血压患者降血压药物使用率显著升高,高血压控制率显著升高,OC累积使用时间与收缩压/舒张压的剂量效应曲线均显著下降。

Objective To assess the effects of a community intervention program on hypertension related to oral contraceptive（OC） use among child-bearing aged women.Methods Comprehensive intervention that includes the informed-choice,health screening,follow-up of OC users,introduction of new contraceptive methods,health education and health promotion based on the results of baseline investigation analysis were carried out.Final investigation was performed after intervention and comparison was made with baseline results.Results The effect of this intervention was significant,the control rate of hypertension among child-bearing aged women increased significantly from 2.04% to 22.84%（P〈0.001）,and there were 5.19（95% CI：3.85～6.54）mmHg reduced in systolic blood pressure（SBP） and 6.45（95% CI：5.74～7.15）mmHg reduced in diastolic blood pressure（DBP）,respectively.However,the effect of intervention varied in different areas,the reduction in SBP among women with hypertension in Taicang（6.53 mmHg） was significantly higher than women in Rudong（3.78 mmHg）（P〈0.05）.The ratio of antihypertensives use increased significantly from 7.70% to 55.62%（P〈0.001）.SBP of child-bearing aged women with hypertension elevated with the increasing of OC use time,with a marked dose-response relationship（P〈0.001）.After the intervention,both the dose-response curves of SBP and DBP decreased significantly.Conclusions The beneficial effect of this comprehensive intervention was confirmed in this study.Both the ratio of antihypertensives use and the control rate of hypertension increased significantly,and the dose-response curves of SBP and DBP decreased significantly.