中西部地区老年未控制高血压患者家庭血压监测情况及其影响因素

Status of home blood pressure monitoring and influencing factors of regular home blood pressure monitoring among elderly uncontrolled hypertensive patients in Central and Western China

目的调查我国中西部地区血压未控制的老年高血压患者家庭血压监测情况,并分析其影响因素。方法该研究为横断面调查,于2019年9月至2020年7月从我国中西部地区72家医院及基层医疗机构纳入年龄≥60岁且诊室血压≥140/90 mmHg(1 mmHg=0.133 kPa)的高血压患者,并依据是否规律进行家庭血压监测分为规律家庭血压监测组和非规律家庭血压监测组。对入选患者进行问卷调查和血压测量,记录患者使用不同类型血压计及规律测量血压(至少每周测量1次)的情况。使用广义线性混合模型分析影响患者规律进行家庭血压监测的因素。结果共纳入患者3857例,年龄67(64,71)岁,男性2163例(56.1%)。入选患者中3044例(78.9%)拥有家庭血压计,2168例(56.2%)规律进行家庭血压监测;在拥有家庭血压计的患者中,2370例(77.9%)拥有上臂式电子血压计。年龄大、家庭收入高、高血压病史长、服用降压药数量多、知晓高血压诊断标准及有并发症的患者规律进行家庭血压监测的可能性更大(P均<0.05)。结论在我国中西部地区血压未控制的老年高血压患者中,家庭血压计较为普及,近六成的患者规律进行家庭血压监测。年龄、家庭收入、高血压病史、服用降压药数量、知晓高血压相关知识是此类患者规律进行家庭血压监测的影响因素。

Objective To describe the prevalence of home blood pressure monitoring and analyze the factors influencing regular blood pressure monitoring among elderly uncontrolled hypertensive patients in Central and Western China.Methods It was a cross-sectional study,which enrolled hypertensive patients aged over 60 years with office blood pressure≥140/90 mmHg(1 mmHg=0.133 kPa)from September 2019 to July 2020 in 72 hospitals in Central and Western China.Patients completed the electronic questionnaires,and were divided into regular and irregular home blood pressure monitoring groups.The proportion of patients using different types of sphygmomanometers and the percentage of patients with regular home blood pressure monitoring(at least weekly)were explored.The generalized linear mixed model was used to define the influencing factors of regular home blood pressure monitoring.Results A total of 3857 patients were included in this study.Age was 67(64,71)years old and there were 2163 males(56.1%).Overall,sphygmomanometer was available at home for 3044(78.9%)patients,2168(56.2%)patients conducted regular home blood pressure monitoring.Among the patients with a sphygmomanometer at home,2370(77.9%)of the sphygmomanometers were upper arm electronic device.Older age,higher income,longer history of hypertension,multiple antihypertensive medications and awareness of diagnostic criteria of hypertension and hypertension complications were associated with a higher prevalence of regular home blood pressure monitoring(all P<0.05).Conclusions Among the elderly hypertensive patients with uncontrolled blood pressure in Central and Western China,there is a relatively high prevalence of home sphygmomanometer ownership and regular monitoring.Age,family income,history of hypertension,number of antihypertensive drugs and knowledge of hypertension are the influencing factors of regular home blood pressure monitoring in this population.