北京市月坛社区高血压患者家庭血压测量及血压达标情况调查

Survey on home blood pressure measurement and blood pressure control rate among hypertensive patients in Beijing Yuetan community

目的了解月坛社区高血压患者家庭血压测量情况及其影响因素,并对被调查者进行血压测量,了解血压达标情况。方法2018年6月1日至2019年1月31日采用方便取样法调查北京市月坛社区卫生服务中心及下属各站门诊就诊高血压患者504例,采取调查问卷法了解患者进行家庭血压测量的行为、相关知识的知晓率以及未进行血压测量的原因。其中119例患者同意接受并记录3周家庭血压测量,通过其诊室及家庭血压测量结果了解受测患者的血压达标情况。结果504例患者中,93.7%(472/504)能够做到规律用药,但是规律进行血压测量的患者仅61.5%(310/504),92.5%(466/504)的患者家中备有血压计,以臂式电子血压计为主。89.9%(453/504)的患者知道血压测量的方法,但是仅有11.5%(52/453)的患者表示其血压计进行过校准。测量血压者能做到每周测量1次以上血压者占77.4%(240/310),未进行规律测量血压最主要的原因是认为没有不适症状没必要测量血压,占50.0%(97/194)。受测患者诊室血压(台式水银血压计)的达标率为62.3%(314/504)。家庭血压测量晨起及睡前均达标者占61.3%(73/119),晨起血压达标率为68.1%(81/119),睡前血压达标率为75.6%(90/119)。患者家庭测量晨起和睡前收缩压达标率和心率达标率明显均高于诊室收缩压和心率达标率(χ^2=5.02、9.97、15.51、13.72,均P<0.05)。结论月坛社区高血压患者规律进行家庭血压测量的比例较低,相关知识知晓率低。诊室血压的达标率和家庭血压的达标率之间存在一定差异,在管理过程中需要综合评估,根据患者具体情况调整治疗方案。

Objective To survey on the home blood pressure measurement and blood pressure control rate among patients with hypertension in Beijing Yuetan community.Methods A questionnaire survey was conducted among 504 hypertensive patients,who were visiting Beijing Yuetan Community Health Service Center and selected by convenience-sampling method during June 2018 to January 2019.The status of home blood pressure measurement,the awareness of hypertension,the blood pressure control rate and factors related to not regularly measuring were surveyed.Results Of the 504 patients,93.7%(472/504)took regular medication,but only 61.5%(310/504)had regular blood pressure measurements;92.5%(466/504)had sphygmomanometers at home with electronic type mainly;89.9%(453/504)patients knew the method of blood pressure measurement,but only 11.5%(52/453)had their sphygmomanometer calibrated.Among those who measured blood pressure,77.4%(240/310)measured per week.The main reason for not measuring blood pressure regularly was that there was no need to measure blood pressure without any discomfort,accounting for 50.0%(97/194).The office blood pressure control rate(with desktop mercury sphygmomanometer)was 62.3%(314/504);the blood pressure control rate both in the morning and at bed time was 61.3%(73/119),that in the morning was 68.1%(81/119)and at bed time was 75.6%(90/119).The control rates of systolic blood pressure and heart rate by home measurement at morning and bedtime were significantly higher than those by office measurement(χ^2=5.02,9.97,15.51,13.72;all P<0.05).Conclusions The home blood pressure monitoring rate and knowledge level of hypertension among patients with hypertension in Yuetan community are relatively low.There are some differences in blood pressure control rate between office measurement and home measurement.Comprehensive evaluation is needed in the management process,and the treatment plan should be adjusted according to the specific condition of patients.