疾病细节管理对社区高血压患者血压和心血管危险分层的影响研究

Research on influence of disease detail management on the blood pressure and cardiovascular risk stratification of hypertension patients in communities

目的评价社区高血压疾病细节管理对控制高血压患者血压和降低心血管危险分层的效果。方法采用整群抽样的方法在上海市嘉定区抽取2个社区,随机分为细节管理组和日常对照组,共纳入726例原发性高血压患者,细节管理组553例和日常对照组173例。对细节管理组患者进行为期1年的疾病细节管理和干预,日常对照组只进行常规的管理。在基线期和末期分别以体格检查和问卷的形式对所有患者进行调查。结果干预后细节管理组和日常对照组的平均收缩压(systolic blood pressure,SBP)和平均舒张压(diastolic blood pressure,DBP)较日常对照组分别下降了6.52 mmHg和3.54 mmHg,差异均有统计学意义(均有P<0.05)。干预后细节管理组心血管危险分层低危人数增加比例大于日常对照组,差异有统计学意义(P<0.001)。结论社区高血压疾病细节管理不但降低了高血压患者的血压水平,还有助于减少高血压患者的危险因素,降低心血管危险分层级别,应在社区高血压防治工作中加以推广应用。

Objective To assess the effect of detail management of hypertension for controlling blood pressure and lowering cardiovascular risk stratification.Methods All 726 hyperpietics were recruited from 2 communities in Jiading District,Shanghai.553 cases were sampled randomly as the detail management group and other 173 as the control group.At the start and end of one-year management,all the participants were given physical examinations and investigated with questionnaires.Results The average systolic blood pressure（SBP） and diastolic blood pressure（DBP） decreased 6.52 mmHg and 3.54 mmHg respectively after intervention in both groups,and the SBP and DBP of detail management group were significantly lower than those of the control group（P0.05）.The improvement of cardiovascular risk stratification of detail management group was more than that of the control group（P0.001）.Conclusions Detail management of hypertension could lower the blood pressure and risk stratification of patients and would be a flexible measure to control hypertension in communities.