摘要
Objective To explore the effects of standardized management among high risk cardiovascular patients in rural areas and to supply data facilitating the establishment of targeted effective strategies to reduce the cardiovascular events in this population.Methods Data from the present study were derived from the“China Rural Health Action”.A total of 651 eligible patients from 12 villages of 2 counties(6 townships in each county and 1 village in each town)from Shanxi province,who received standardized management by 44 village doctors,were enrolled in this study.Standardized management refers to detection of high risk patients,evidenced based therapy,regular follow-up(once per month)and timely transfer to higher level hospitals.Changes on the prevalence of blood pressure control rate,smoking,medication adherence and low-salt diet during the follow-up period were analyzed.Results The total follow up time was 10 274.Blood pressure control rate was significantly increased at the 6th follow up as compared to the baseline level(80.53% vs 33.64%,P<0.01).Smoking rate was significantly lower at the 15t h follow up as compared to baseline level(52.04% vs 66.05%,P<0.01).Medication adherence increased from 82.64% at baseline to 98.43% at 1s t follow up and thereafter(P<0.01).Percent of low-salt diet increased from 67.74% at baseline to 99.84% post 1th follow up(P<0.01).Multiple regression analysis showed that age,BMI,follow-up times,medication adherence,low-salt diet and smoking were the determinants affecting the blood control rate.Conclusion The standardized management operated by village doctors is an effective strategy to prevent and treat the cardiovascular diseases and effectively controls the blood pressure.Targeted management based on controlling related risk factors could further improve the efficacy of standardized management in individual patient.
