重庆地区高血压社区健康管理5年随访效果研究

Analyzing The Effect of Follow-up Studies of Community Health Management on Hypertension in Chongqing

目的:通过5年队列随访探讨社区健康管理对血压控制的效果。方法:在社区健康管理干预5年期及3年期与基线血压水平进行比较,分析血压控制的效果,并控制影响血压水平的主要危险因素。结果:本研究纳入4235例高血压患者进行分析。经过5年的健康管理血压控制率从2009年的28.33%提高至2014年的64.05%(2342/3656)。2012年与2009年比较收缩压和舒张压分别降低7.7 (7.1-8.3) mmHg与6.2 (5.8-6.5) mmHg。2014年与2009年比较收缩压与舒张压分别降低5.8 (5.1-6.5) mmHg与5.9 (5.5-6.4) mmHg。2012年血压水平与2009年比较,采用降压药物治疗的对象比非药物治疗的对象血压水平降低2.0 (0.7-3.2) mmHg。将2012及2014年的血压水平与2009年比较,城市对象比农村高血压患者收缩压均降低1.4 mmHg。2014年与2009年比较,采用两种或多种降压药物联合治疗的高血压患者收缩压与舒张压分别降低7.1 (4.65-9.54) mmHg与6.93 (5.48, 8.38) mmHg。研究表明糖尿病与吸烟为影响高血压患者血压控制效果的主要危险因素。结论:全科医生实施高血压社区管理能长期有效的控制患者的血压水平。

Objective To explore the effect of five year follow-up studies of community health management on blood pres sure control.Methods The data of blood pressure control in different period was comparatively studied to analyze the effect and its risk factors.Results 24235 cases of hypertensive patients were included in this research.The rate of blood pressure control in creased from 28.33%in 2009 to 64.05%after 5 years intervention.The SBP decreased by 7.7(7.1-8.3)mmHg,and DBP decreased by 6.2(5.8-6.5)mmHg in 2012.And the SBP decreased by 5.8(5.1-6.5)mmHg,DBP decreased by 5.9(5.5-6.4)mmHg in 2014.The SBP of individuals who received antihypertensive medicinal treatment decreased by 2.0(0.7-3.2)mmHg in 2012.The SBP of individuals who lived in urban areas decreased by 1.4 mmHg both in 2012 and 2014.The SBP and DBP of individuals who received combined antihypertensive medicinal treatment decreased by 7.1(4.65-9.54)mmHg and 6.93(5.48,8.38)mmHg,respectively.The main risk factors to blood pressure control were diabetes and smoking.Conclusion Com munity management on hypertension conducted by general practitioners can achieve significant effect on blood pressure control.