武汉市中老年高血压患者血压控制的影响因素及对策

Analysis on Influencing Factors and Strategies on Blood Pressure Control of the Middle- aged and Elderly Patients with Hypertension in Wuhan

目的:分析武汉市中老年高血压患者血压控制和急性发作的影响因素,为改进社区慢性病管理提供政策建议。方法:高血压患者问卷调查和关键知情人访谈相结合。采用多阶段抽样,按照是否纳入高血压规范管理分组,选取武汉市3个社区卫生服务中心的45岁及以上高血压患者共363名进行问卷调查。结果:血压控制率为57.8%,紧急发作率为38.9%。经卡方检验和Logistic分析发现,较高的文化程度是血压控制的保护性因素,高血压严重程度是血压控制的危险因素;较高的文化程度、良好的血压控制情况和优先选择社区就诊的习惯是高血压急性发作的保护性因素,而高血压严重程度是高血压紧急发作的危险因素。结论:落实高血压分级管理,强化对3级高血压患者和低学历人群的干预;社区就医习惯的养成可以有效降低高血压紧急发作的风险。

Obejective： To analyze the Influence factors of blood pressure control and hypertensive emergencies of the middle - aged and eld- erly patients with hypertension in Wuhan. And to offer suggestions on hypertension management for community health care. Methods： Question- naire survey and interview with key persons were taken. According to weather accepted community standardized management, all the patients were divided into two groups. 363 hypertension patients（ 345 years old） in 3 community health care centers were surveyed with structured question- naire through multistage sampling in Wuhan. Results： Blood pressure control rate was 57.8%, and hypertensive emergencies rate was up to 38. 9%. By chi -square test and logistic analysis, better effect of hypertension control was observed in patients with higher education level, while worse effect was observed in patients with higher hypertension grade. The higher education level, better hypertension control and the preferred choice of community care were protective factors for hypertensive emergency, while the severity of the hypertension was its risk factor. Conclu- sion： In order to effectively reduce the risk of hypertension emergency attack, it is important to Implement the management of different hyperten- sion grades, strengthen the intervention of the grade 3 hypertension and less educated patients, and develop the habit of preferred choice of com- munity care.