家庭自测血压值与高血压患者生存质量的关系

The relationship between home monitored blood pressure and quality of life of hypertension patients

目的 探讨安徽省界首市农村地区高血压患者的家庭自测血压值及其他常见因素与高血压患者生存质量的关系。方法 采用整群抽样的方法,于2021年7月在界首市5个乡镇共计48个行政村中参与了家庭医生签约服务且领取了可实时上传血压测量数据的智能语音血压计的高血压患者开展问卷调查,使用欧洲五维五水平生存质量量表(European quality of life five dimension five level scale questionnaire,EQ-5D-5L)中文版和自制问卷作为数据收集工具,结合家庭自测血压数据,分析高血压患者的生存质量现状并构建多因素回归模型,探索家庭自测血压值与高血压患者生存质量的关系。结果 共招募高血压患者3005例,平均年龄为(65.50±9.84)岁。疼痛/不舒服维度是界首市高血压患者的主要健康问题。多因素回归模型结果显示,年收缩压(β=-0.064,P=0.043)和高血压患者健康相关生存质量呈负相关关系,年舒张压(β=0.073,P=0.020)与高血压患者健康相关生存质量呈正相关关系。性别(β=-0.135,P<0.001)、年龄(β=-0.206,P<0.001)、文化程度(β=0.066,P=0.002)、婚姻状况(β=-0.041,P=0.023)、体质指数(β=-0.076,P<0.001)、腰臀比(β=-0.043,P=0.024)、患病年数(β=-0.104,P<0.001)和血压测量间隔天数(β=0.038,P=0.038)是高血压患者生存质量的影响因素。结论 家庭自测血压值是影响高血压患者生存质量的重要因素。同时应重视女性、老年人、文化程度低、非在婚状态、肥胖、病程较长、收缩压> 140 mmHg和血压测量频率密集的高血压患者的生存质量。

Objective To explore the relationship between home monitored blood pressure and quality of life(QoL)of hypertension patients in rural areas of Jieshou City,Anhui Province.Methods Using the method of cluster sam-pling,a questionnaire survey was carried out in July 2021 among hypertensive patients who purchased family doctor contrac-ting services and received an intelligent voice blood pressure monitor that could upload blood pressure measurement data in real-time in a total of 48 administrative villages in 5 townships in Jieshou city.The European quality of life five dimension five level scale(EQ-5D-5L)and self-designed questionnaire were used to collect data.Data of patient home monitored blood pressure were extracted from the city hypertension patient management system.Analyzed the current status of the QoL of hy-pertensive patients and constructed a multivariate regression model.Explore the relationship between home monitored blood pressure and QoL of hypertension patients.Results The study recruited 3005 hypertensive patients with an average age of(65.50±9.84)years old.Pain/discomfort was the main health problem.The multifactorial regression model showed that the average systolic blood pressure measured by patients themselves at home during the past year(β=-0.064,P=0.043)was negatively associated with QoL,and the average diastolic blood pressure measured by patients themselves at home during the past year(β=0.073,P=0.020)was positively associated with QoL in hypertensive patients.Sex(β=-0.135,P<0.001),age(β=-0.206,P<0.001),education(β=0.066,P=0.002),marital status(β=-0.041,P=0.023),body mass index(β=-0.076,P<0.001),waist-to-hip ratio(β=-0.043,P=0.024),length of hypertension(β=-0.104,P<0.001)and frequency of blood pressure measurement(β=0.038,P=0.038)were found with statical significance.Conclusion The average diastolic and systolic blood pressure measured by patients themselves at home during the past year was an important factor affecting the QoL.Attention should also be paid to the QoL of women,the elderly,low education,non-marriage status,obese,those with longer duration of illness,systolic blood pressure>140 mmHg,and those with more frequent blood pressure measurements.