老年患者门诊高血压检测控制和家庭自测控制达标率及因素分析

Analysis of the compliance rate and factors of outpatient hypertension detection and control and family self-test control in elderly patients

目的分析老年患者门诊高血压检测控制和家庭自测控制达标率及相关因素。方法选取2021年2月至2023年2月的老年高血压患者160例,门诊检测和家庭自测监测血压,比较不同方法的达标率和一致性,分析影响门诊和家庭血压检测达标的相关因素。结果门诊检测达标99例(61.88%),达标患者心率、吸烟和靶器官损伤率较高、锻炼和用药依从率较低。心率升高和吸烟是门诊检测控制的危险因素,锻炼和服药依从性是保护因素,心率、锻炼、吸烟和服药依从性的AUC分别为0.779、0.752、0.821和0.704。家庭自测达标68例(42.50%)。家庭自测和门诊检测达标率不具一致性。达标患者吸烟、饮酒、盐摄入量过多、高血压并发症和靶器官损伤比率较低,锻炼、睡眠质量良好,了解高血压知识,定期随访和门诊血压达标比率较高。吸烟、盐摄入量过多和高血压并发症是家庭自测达标的危险因素,门诊血压达标、了解高血压知识和定期随访是保护因素,了解高血压知识、定期随访、门诊血压达标、吸烟、盐摄入量过多和高血压并发症的AUC分别为0.719、0.704、0.807、0.725、0.694和0.757。结论督促患者日常锻炼,告诫戒烟,提高用药依从性,可提高门诊控制达标率。普及高血压知识、定期进行随访,减少盐摄入量,可有效提高家庭自测血压的控制效果。

Objective To analyze the compliance rate and related factors of outpatient hypertension detection and control and home self-test control in elderly patients.Methods A total of 160 elderly patients with hypertension were selected from February 2021 to February 2023,and blood pressure was detected by outpatient blood pressure detection and home blood pressure self-detection.The compliance rate and consistency of different methods were compared,and the risk factors and protective factors affecting the compliance rate of outpatient blood pressure detection and home blood pressure detection were analyzed.Results Totally 99 cases(61.88%)of outpatient testing met the standards,with higher rates of heart rate,smoking,and target organ damage,as well as lower compliance rates with exercise and medication.Ele-vated heart rate and smoking were risk factors controlled by outpatient detection,while exercise and medication compli-ance were protective factors,with AUC of 0.779,0.752,0.821 and 0.704 for heart rate,exercise,smoking and medi-cation compliance,respectively.Home self-test control 68 cases(42.50%)reached the standard.The compliance rate of home self-test and outpatient test was inconsistent.Qualified patients had lower rates of smoking,drinking,ex-cessive salt intake,hypertension complications and target organ damage,good exercise and sleep quality,and higher rates of regular follow-up and outpatient blood pressure compliance.Smoking,excessive salt intake and hypertension complications were risk factors for reaching the standard of home self-test control,while outpatient blood pressure reaching the standard,knowledge of hypertension and regular follow-up were protective factors.The AUC of knowledge of hypertension,regular follow-up,outpatient blood pressure compliance,smoking,excessive salt intake and hyperten-sion complications were 0.719,0.704,0.807,0.725,0.694 and 0.757,respectively.Conclusion Urging patients to exercise daily,warning them to quit smoking and improving medication compliance can improve the rate of outpatient control.Popularizing hypertension knowledge,conducting regular blood pressure follow-up survey and reducing salt in-take can effectively improve the control effect of self-measured blood pressure at home.