基于社区管理的原发性高血压患者血压控制效果的影响因素研究

Factors associated with blood pressure management of primary hypertension patients of community management

目的对重庆市双碑社区开展的社区居民高血压随访资料进行研究,了解随访效果和血压控制效果并对其影响因素进行分析,为更有效地开展高血压社区干预提供依据。方法对双碑社区自2014年经二级以上医疗机构确诊的原发性高血压患者进行随访管理。采用问卷调查和体格检查,了解血压控制效果和影响因素。结果纳入随访管理的高血压患者共3 362例,70%以上的高血压患者最后1次血压和平均血压都控制在正常范围内。62.4%的高血压患者的血压管理效果为优良,不良的比例为15.4%。多因素Logistic回归发现随访方式为家庭访视或门诊随访、心理调整良好、摄盐量为轻、服药规律、吸烟控制较好、饮酒控制较好、运动时间长可促进高血压管理效果良好。结论双碑社区2014年高血压患者的管理效果良好。加强健康教育,改善患者的不良生活行为,加强心理调适,能达到更好的管理效果。

Objective To investigate the effects of blood pressure management in primary hypertension patients and the influencing factors,based on the community management of Shuangbei District in Chongqing,to further provide valuable evidence for hypertension community intervention. Methods The primary hypertension patients diagnosed by at least second-class hospital in Shuangbei District in 2014 were followed up. Questionnaire survey and physical examination were used to investigate the effects of blood pressure management and influencing factors. Results A total of 3 362 patients with primary hypertension were included. 70% of them had normal mean and last blood pressure. The proportion of patients with good and bad blood pressure control were 62. 4% and 15. 4%,respectively. Home or clinic visit,salt reduction,regular medication,smoking control,drinking control and enough exercise promote good blood pressure management according to multivariate logistic regression. Conclusion The effect of blood pressure management is good in Shuangbei district in 2014. More health education,changing bad life styles and good psychological adjustment are benefit for blood pressure management.