| 茹小娟,王文志,吴升平,江滨,杜晓立,鲍秋菊.社区人群高血压管理与脑卒中发病关系的研究[J].Chinese journal of Epidemiology,2008,29(2):116-120 |
| 社区人群高血压管理与脑卒中发病关系的研究 |
| Study on the relationship between hypertension management and the risk of stroke at community level |
| Received:July 05, 2007 Revised:June 12, 2012 |
| DOI： |
| KeyWord: 脑卒中 高血压管理 社区人群 控制率 |
| English Key Word: stroke Hypertension management community-based Control rate |
| FundProject:北京市科技计划重点课题资助项目(H030930030330);国家自然科学基金资助项目(30671804);北京市自然科学基金资助项目(7072011);国家科技支撑计划资助项目(2006BAI01A01) |
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| Abstract: |
| 目的 了解高血压患者血压水平的控制情况以及管理控制效果能在多大程度上降低脑卒中的发病.方法 对国家"八五"和"九五"科技攻关课题的全国脑血管病社区人群综合性预防研究的北京市天坛医院、普仁医院和体育馆路医院所在地的3个社区年龄≥35岁队列人群共36 863人进行基线调查,随访管理其中的高血压患者,每年监测脑卒中发病情况,将新发脑卒中作为研究终点.结果 无论是临界高血压还是确诊高血压,管理率和控制率逐年上升,女性管理率高于男性,但控制率却低于男性,差异有统计学意义(P＜0.05).随访管理第三年血压控制率达18%.随着逐年血压控制达标,无论是总的脑卒中、缺血性卒中还是出血性卒中的发病风险均逐年下降,并且血压控制达标对出血性卒中发病下降更有作用.3年控制达标可使总的脑卒中、缺血性卒中和出血性卒中的发病风险分别减少25.7%、19.1%、27.4%.将血压控制在140/90 mm Hg(1 mm Hg=0.133 kPa)以下,比控制在160/95 mm Hg以下可分别减少12.3%总的脑卒中、12.8%缺血性卒中、14.9%出血性卒中的发病风险.结论 对社区人群中的高血压患者进行长期随访管理,将血压尽可能控制在较低水平能明显减少脑卒中的发病风险. |
| English Abstract: |
| objective To obServe whether the community_based management for patients with hypertension can reduce the incidence of stroke.Methods Sample of this study included 36 863 people aged 35 years or more who came from a cohort consisting three communities from Tiantan Hospital,Puren Hospital and the Gymnasium Road Hospital in Beijing,based on the surveys on the Integrated Community Intervention Measures of Cerebro-vascular Diseases.some patients with hypertension in this cohort were followed up and under management．First-ever stroke was considered as the end-point event.Results In both groups diagnosed as borderline hypertension or definite hypertension group,the rates of management and control showed an annual increase．The nlanagement rate for women was higher,but the control rate was 10wer(P<0．05)than that for men．In the third year of this study,the control rate was nearly 18%.With the qualification of control rate,the risk factors of overall stroke,ischemic stroke or hemorrhagic stroke reduced gradually,and the qualification of control rate showed more effects on hemorrhagic stroke.The quallfication of control rate in the three years could cause the risk factors of total stroke,ischemic stroke or hemorrhagic stroke to reduce by 25．7%,19,1%,27．4%,respectively.When comparing with bl∞d pressure leveI at<160／95 mm Hg(1 mm Hg=0．133 kPa),the 1evel of<140／90 mm Hg could reduce the risk factors as： 12．3% to total stIDke,12．8% to ischemic stroke and 14．9% to hemorrhagic stroke.Conclusion Programs as long-term followed-up and management for patients with hypertension,and control the blood pressure at low level etc.could significantlv reduce the incidence of stroke． |
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