Despite an increasing popularity of home blood pressure monitoring (HBPM) over the last few decades, little is known about HBPM use among hypertensive patients in the rural areas. A cross-sectional survey including 31...Despite an increasing popularity of home blood pressure monitoring (HBPM) over the last few decades, little is known about HBPM use among hypertensive patients in the rural areas. A cross-sectional survey including 318 hypertensive patients was conducted in a rural community in Beijing, China, in 2012. Participants were mainly recruited from a community health clinic and completed the questionnaires assessing HBPM usage. Binary logistic regression models were used for the analysis of medication adherence with age, gender, level of education marital status, perceived health status, duration of hypertension, HBPM use, and frequency of performing BP measurement. Among the total population, 78 (24.5%) reported currently use of HBPM. Only 5.1% of the HBPM users cited doctor’s advice as the reason for using HBPM. Analysis of the risk factors of poor medication adherence by multivariable modeling indicated significant associations between the duration of hypertension (adjusted OR, 3.31;95% CI, 1.91-5.72;P 01), frequency of performing BP measurements (adjusted OR, 2.33;95% CI, 1.42-3.83;展开更多
Objective:Home blood pressure monitoring(HBPM)is viewed as a facilitating factor in the initial diagnosis and long-term management of treated hypertension.However,evidence remains scarce about the effectiveness of HBP...Objective:Home blood pressure monitoring(HBPM)is viewed as a facilitating factor in the initial diagnosis and long-term management of treated hypertension.However,evidence remains scarce about the effectiveness of HBPM use in the real world.This study aimed to examine the associations of HBPM use with blood pressure(BP)control and medication adherence.Methods:This prospective cohort study included hypertensive patients with high cardiovascular risk who were aged≥50 years.At baseline,information about types of BP monitor,frequency of HBPM,perception of anti-hypertensive treatment,and measured office BP were collected.During the 1-year follow-up(visits at 1,2,3,6,and 12 months),information on medication adherence was collected at each visit.The 2 major outcomes were BP control at baseline and medication adherence during the 1-year follow-up.A log-binomial regression model was used to examine the association between frequency of HBPM and outcomes,stratified by the perceptions of anti-hypertensive treatment.Results:A total of 5,363 hypertensive patients were included in the analysis.The age was(64.6±7.2)years,and 41.2%(2,208)were female.Of the total patients,85.9%(4,606)had a home BP monitor and 47.8%(2,564)had an incorrect perception of anti-hypertensive treatment.Overall,24.2%(1,299)of patients monitored their BP daily,37.6%(2,015)weekly,17.3%(926)monthly,and 20.9%(1,123)less than monthly.At baseline,the systolic BP and diastolic BP were(146.6±10.8)mmHg and(81.9±10.6)mmHg,respectively,and 28.5%(1,527)of patients had their BP controlled.Regardless of whether the patients had correct or incorrect perceptions of anti-hypertensive treatment,there is no significant association between HBPM frequency and BP control at baseline.During the 1-year follow-up,23.9%(1,280)of patients had non-adherence to medications at least once.In patients with an incorrect perception of anti-hypertensive treatment,those monitoring BP most frequently(daily)had the highest non-adherence rate(29.9%,175/585).Compared with those monitoring their BP less than monthly,patients who monitored their BP daily were more likely not to adhere to anti-hypertensive medications(adjusted relative risk=1.38,95%confidence interval:1.11–1.72,P=0.004).Conclusions:HBPM performance among hypertensive patients in China is,in general,sub-optimal.No association was observed between using HBPM alone and hypertension control,indicating that the effects of HBPM could be conditional.Patients’misconceptions about anti-hypertensive treatment may impair the role of BP monitoring in achieving medication adherence.Fully incorporating the correct perception of hypertension into the management of hypertensive patients is needed.展开更多
目的探讨家庭自测血压管理对老年高血压病人血压控制的干预效果。方法收集362例老年高血压病人,随机分为2组,每组181例。家庭自测血压组进行家庭自测血压干预6月,每日定时测量3次,每周门诊测量血压1次,血压<140/90 mm Hg视为达标,对...目的探讨家庭自测血压管理对老年高血压病人血压控制的干预效果。方法收集362例老年高血压病人,随机分为2组,每组181例。家庭自测血压组进行家庭自测血压干预6月,每日定时测量3次,每周门诊测量血压1次,血压<140/90 mm Hg视为达标,对照组未进行家庭自测血压。记录干预期间病人高血压并发症的发生情况。干预前后分别进行病人生活质量评分,并在干预后进行依从性评分。结果研究结束时,家庭自测血压组还有病人160例,对照组有168例。干预后,家庭自测血压组的收缩压(P=0.011)、舒张压(P=0.038)较对照组显著降低,血压达标率显著高于对照组(P<0.001),并发症发生率显著低于对照组(P<0.001)。干预后,家庭自测血压组病人的遵医行为、服药行为、日常生活管理、烟酒嗜好以及总评分显著高于对照组(P<0.05);生活质量评分结果提示,其生理机能、心理职能、一般健康状态、精神健康评分亦高于对照组(P<0.05)。结论家庭自测血压是协助降压治疗的有效手段,可提高病人依从性,减少并发症发生,提高病人生活质量。展开更多
文摘Despite an increasing popularity of home blood pressure monitoring (HBPM) over the last few decades, little is known about HBPM use among hypertensive patients in the rural areas. A cross-sectional survey including 318 hypertensive patients was conducted in a rural community in Beijing, China, in 2012. Participants were mainly recruited from a community health clinic and completed the questionnaires assessing HBPM usage. Binary logistic regression models were used for the analysis of medication adherence with age, gender, level of education marital status, perceived health status, duration of hypertension, HBPM use, and frequency of performing BP measurement. Among the total population, 78 (24.5%) reported currently use of HBPM. Only 5.1% of the HBPM users cited doctor’s advice as the reason for using HBPM. Analysis of the risk factors of poor medication adherence by multivariable modeling indicated significant associations between the duration of hypertension (adjusted OR, 3.31;95% CI, 1.91-5.72;P 01), frequency of performing BP measurements (adjusted OR, 2.33;95% CI, 1.42-3.83;
基金supported by the National Key Research and Development Program of China(2018YFC1312404,2018YFC1312400)by the National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(NCRC2021001).
文摘Objective:Home blood pressure monitoring(HBPM)is viewed as a facilitating factor in the initial diagnosis and long-term management of treated hypertension.However,evidence remains scarce about the effectiveness of HBPM use in the real world.This study aimed to examine the associations of HBPM use with blood pressure(BP)control and medication adherence.Methods:This prospective cohort study included hypertensive patients with high cardiovascular risk who were aged≥50 years.At baseline,information about types of BP monitor,frequency of HBPM,perception of anti-hypertensive treatment,and measured office BP were collected.During the 1-year follow-up(visits at 1,2,3,6,and 12 months),information on medication adherence was collected at each visit.The 2 major outcomes were BP control at baseline and medication adherence during the 1-year follow-up.A log-binomial regression model was used to examine the association between frequency of HBPM and outcomes,stratified by the perceptions of anti-hypertensive treatment.Results:A total of 5,363 hypertensive patients were included in the analysis.The age was(64.6±7.2)years,and 41.2%(2,208)were female.Of the total patients,85.9%(4,606)had a home BP monitor and 47.8%(2,564)had an incorrect perception of anti-hypertensive treatment.Overall,24.2%(1,299)of patients monitored their BP daily,37.6%(2,015)weekly,17.3%(926)monthly,and 20.9%(1,123)less than monthly.At baseline,the systolic BP and diastolic BP were(146.6±10.8)mmHg and(81.9±10.6)mmHg,respectively,and 28.5%(1,527)of patients had their BP controlled.Regardless of whether the patients had correct or incorrect perceptions of anti-hypertensive treatment,there is no significant association between HBPM frequency and BP control at baseline.During the 1-year follow-up,23.9%(1,280)of patients had non-adherence to medications at least once.In patients with an incorrect perception of anti-hypertensive treatment,those monitoring BP most frequently(daily)had the highest non-adherence rate(29.9%,175/585).Compared with those monitoring their BP less than monthly,patients who monitored their BP daily were more likely not to adhere to anti-hypertensive medications(adjusted relative risk=1.38,95%confidence interval:1.11–1.72,P=0.004).Conclusions:HBPM performance among hypertensive patients in China is,in general,sub-optimal.No association was observed between using HBPM alone and hypertension control,indicating that the effects of HBPM could be conditional.Patients’misconceptions about anti-hypertensive treatment may impair the role of BP monitoring in achieving medication adherence.Fully incorporating the correct perception of hypertension into the management of hypertensive patients is needed.
文摘目的探讨家庭自测血压管理对老年高血压病人血压控制的干预效果。方法收集362例老年高血压病人,随机分为2组,每组181例。家庭自测血压组进行家庭自测血压干预6月,每日定时测量3次,每周门诊测量血压1次,血压<140/90 mm Hg视为达标,对照组未进行家庭自测血压。记录干预期间病人高血压并发症的发生情况。干预前后分别进行病人生活质量评分,并在干预后进行依从性评分。结果研究结束时,家庭自测血压组还有病人160例,对照组有168例。干预后,家庭自测血压组的收缩压(P=0.011)、舒张压(P=0.038)较对照组显著降低,血压达标率显著高于对照组(P<0.001),并发症发生率显著低于对照组(P<0.001)。干预后,家庭自测血压组病人的遵医行为、服药行为、日常生活管理、烟酒嗜好以及总评分显著高于对照组(P<0.05);生活质量评分结果提示,其生理机能、心理职能、一般健康状态、精神健康评分亦高于对照组(P<0.05)。结论家庭自测血压是协助降压治疗的有效手段,可提高病人依从性,减少并发症发生,提高病人生活质量。
