国家慢性病综合防控示范区居民高血压患病、治疗和管理现状研究

靳荣荣; 张娟; 李晋磊; 李娟娟; 马帅; 边峰; 邓桂娟; 苏夏雯; 沈忠周; 王宇萍; 江宇

文章摘要

靳荣荣,张娟,李晋磊,李娟娟,马帅,边峰,邓桂娟,苏夏雯,沈忠周,王宇萍,江宇.国家慢性病综合防控示范区居民高血压患病、治疗和管理现状研究[J].中华流行病学杂志,2018,39(4):401-406

国家慢性病综合防控示范区居民高血压患病、治疗和管理现状研究

Current status on prevalence, treatment and management of hypertension among Chinese adults in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases

收稿日期:2017-10-27 出版日期:2018-04-18

DOI：10.3760/cma.j.issn.0254-6450.2018.04.003

中文关键词: 慢性病国家慢性病综合防控示范区高血压治疗管理

英文关键词: Non-communicable diseases National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases Hypertension Treatment Management

基金项目:国家卫生和计划生育委员会委托项目

作者	单位	E-mail
靳荣荣	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
张娟	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
李晋磊	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
李娟娟	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
马帅	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
边峰	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
邓桂娟	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
苏夏雯	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
沈忠周	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
王宇萍	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院
江宇	100730 北京, 中国医学科学院/北京协和医学院公共卫生学院	jiangyu@pumc.edu.cn

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中文摘要:

目的了解国家慢性病综合防控示范区（示范区）居民高血压的患病、治疗和管理情况，为示范区高血压管理提供科学依据。方法 2016年11-12月采用多阶段抽样方法抽取10个示范区4 000名≥ 18岁常住居民，采取问卷调查方式收集信息，分析不同人群的高血压自报患病、治疗、管理现状以及随访满意情况。结果有效问卷为3 891份。≥ 35岁人群高血压自报患病率为31.47%（1 011/3 213）。在过去2周，高血压自报治疗率为86.75%（877/1 011），且56.87%（575/1 011）得到身体活动指导、40.95%（414/1 011）得到膳食指导、38.33%（385/1 011）得到体重管理指导、22.75%（228/1 011）得到戒烟指导。在过去12个月里，高血压自报管理率为74.68%（755/1 011），自报规范化管理率为62.12%（628/1 011）。社区医生对其随访形式主要是门诊随访（53.51%），其次是入户随访（22.91%）和电话随访（13.64%）。社区医生对患者的随访次数为6（P₂₅~P₇₅：4~12）次，每次随访时间为15（P₂₅~P₇₅：10~20）min。被随访的高血压患者对社区医生随访满意率为94.83%（716/755）。多因素分析结果显示，慢性病管理实施评分较高的示范区高血压自报治疗率（OR=1.986，95% CI：1.222~3.228）、自报规范化管理率（OR=2.204，95% CI：1.519~3.199）均较高。结论示范区高血压防治和管理工作取得一定成效，已达到"十二五"期间示范区创建要求，示范区创建工作对于高血压规范化管理起着积极作用。

英文摘要:

Objective To investigate the current status of prevalence, treatment, and management on hypertension among Chinese adults from the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods We selected a total of 4 000 residents aged ≥ 18 years for this questionnaire-based survey by multi-stage clustering sampling in 10 National Demonstration Areas between November and December, 2016. Results There were 3 891 effective questionnaires. The self-reported prevalence of hypertension among aged ≥ 35 years was 31.47% (1 011/3 213). For the past two weeks, the self-reported treatment of hypertension was 86.75%(877/1 011), with the rates of guidance as 56.87% (575/1 011) on physical activity, 40.95% (414/1 011) on diet, 38.33% (385/1 011) on weight management, and 22.75% (228/1 011) on smoking cessation. For the past 12 months, 74.68% (755/1 011) of the residents aged ≥ 35 years were under the proper management and 62.12% (628/1 011) of them were under the standardized management programs. The follow-up program lasted for 4 (P₂₅-P₇₅:4-12) times per year, with 15 (P₂₅-P₇₅:10-20) minutes per each visit. Hypertensive patients would mainly visit the outpatient clinics (53.51%), followed by home visits (22.91%) and telephone calls (13.64%). Rate of satisfaction on management services was 94.83% (716/755) from the hypertensive patients. Multivariate analysis showed that the rate of self-reported treatment (OR=1.986, 95% CI:1.222-3.228) and self-reported standardized management (OR=2.204, 95% CI:1.519-3.199) on hypertension were higher in the Demonstration Areas with higher implementation scores of self-reported non-communicable diseases management. Conclusions Prevention and management on hypertension in the Demonstration Areas had met the requirement set for the Demonstration Areas during the "12th Five-Year Plan". Projects on setting up the National Non-communicable Diseases Demonstration Areas had played an active role in promoting the standardized management program on hypertension.

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