不同收入水平高血压患者健康状况及血压控制水平研究

Research on the Health Condition and Blood Pressure Control Level of Different Income Hypertensions

目的:研究重庆地区不同收入水平高血压患者的健康状况及血压控制水平,探讨不同经济收入对高血压治疗状况的影响。方法:采取整群抽样的方法在重庆的4个街道调查239名高血压患者,随访2年,将有完整收入信息的高血压患者纳入分析。收集纳入对象的血压、血糖、血脂水平信息,并通过问卷调查其收入水平、就医行为、高血压危险因素等。结果:与高收入成人比较,低收入人群吸烟与饮酒的比例更高。低收入患者参与公费医疗保险和城镇职工医疗保险的比例低于高收入组(18%Versus 65%,P<0.01)。低收入高血压患者选择在县医院或3级医院治疗疾病的比例低于高收入患者(27%Versus 52%,P<0.01)。低收入高血压患者服用两种或两种以上药物的比例低于高收入患者(19%Versus 32%)。低收入患者的收缩压与舒张压平均水平高于高收入患者(收缩压:138.23mm Hg Versus 133.97mm Hg,P=0.03,舒张压:87.03mm Hg Versus 79.57mm Hg,P<0.01)。结论:与高收入人群比较,低收入高血压患者的健康状况与医疗保险补偿水平较低,血压控制率较低。

Objective To study on the health condition and blood pressure control of different income hypertensions in the Chongqing area, and to analyses the influence of different incomes to hypertension treatment performance. Methods Stratified ran- dom cluster sampling was used to choose four communities and 239 hypertensions who had been followed up for two years and had income information were included in the analysis. Information about the blood pressure, glucose and lipid level were collected and the income level, medical care conduct and risk factors of hypertension were obtained by questionnaire. Results Compared with those high income adults, low- income adults were more likely to smoking and drinking. They also were less likely to have free Medicare and social medical insurance （18% versus 65% ,P 〈 0. 01 ）. And 27% of low income hypertensions compared with 52% of those high income individuals treated disease at county hospital or grade 3 and first - class hospital （P 〈 0.01 ）. Besides, low - income hypertensions were less likely to take two or more kinds of drugs combining （ 19% versus 32% ） , and less likely to have blood pressure controlled. The systolic blood pressure （SBP） and diastolic blood pressure （DBP） were lower in low - income individuals than that of high - income adults （ SBP： 138.23mmHg versus 133.97mmHg, P = 0. 03, DBP： 87.03mmHg versus 79. 57mmHg ,P 〈 0. 01 ）. Conclusions Compared with adults with high - income, low - income adults are potentially just to have a lower level of health status and medical care. A substantial proportion of low - income adults with hypertension did not have good blood pressure control.