天津市社区居民血压分级管理的效果

The effect of grade-based hypertension management in community of Tianjin

目的评价以社区为基础的血压分级管理方式的血压控制效果,探索经济高效的血压管理模式。方法选取天津市城市社区高血压患者897例参加卫生部"维持健康血压和体质量综合干预项目",建立健康档案并根据危险因素分级将研究对象分为4个血压管理组,对各组分别开展为期1年的血压分级管理。结果血压分级管理1年后,研究对象血压水平相较于基线水平收缩压和舒张压分别下降7.74和3.78mmHg(P<0.05);按照危险因素分层后,低危组、中危组、高危组和很高危组舒张压水平分别下降了3.60、3.78、4.04和3.50mmHg(P<0.05),除低危组外,中危组、高危组和很高危组收缩压水平分别下降了7.44、6.77和9.58mmHg(P<0.05)。经过为期1年的管理,研究对象血压控制率由49.3%升高到86.6%(P<0.05);除低危组外,其余3组血压控制率均有明显提高(P<0.05)。血压水平随规范化随访次数的增加呈明显的下降趋势。结论以社区为基础的血压分级管理措施效果明显,能够明显改善城市社区高血压患者的血压控制,同时有助于合理膳食和健康生活方式的推广普及。

Objective To evaluate the effect of grade-based blood pressure management in community and explore a cost-effect modei of blood pressure management. Methods Eight hundred and ninty-seven patients with hypertension from urban communities of Tianjin were involved in the Comprehensive intervention project of Maintaining healthy blood pressure and body weight proposed by ministry of health. The health record of the subjects was established. Based on risk factors, the subjects were divided into four groups, and every group received grade-based blood pressure management for a period of one-year. Results After one-year of the grade-based blood pressure management, the level of blood pressure of the subjects was significantly decreased compared with baseline, systolic and diastolic blood pressure decreased by 7.74 and 3.78 mm Hg respectively （P〈0.05 ）. The level of diastolic blood pressure in four groups including low, average, high and very high-risk group was decreased by 3.60, 3.78, 4.04 and 3.50 mm Hg respectively（P〈0.05）. While the lever of systolic blood pressure in other 3 groul3s except low-risk one was decreased by 7.44, 6.77 and 9.58 mm Hg respectively （P〈0.05）. The blood pressure control rate of the subjects was increased from 49.3 % to 86.6 % （P〈0.05）, and the control rate was significantly improved in other 3 groups except low-risk one （P〈 0.05）. With an increased standardized follow-up times, the level of blood pressure tended to be reduced. Conclusion The gradeased blood pressure management was effective among urban communities, which significantly improved the blood pressure control of patients with hypertension and helped to popularize a balanced diet and healthy lifestyle.