社区高血压控制：血压管理效果的评价

王增武; 王馨; 张林峰; 王文; 陈伟伟; 朱曼路; 胡盛寿; 雷振龙; 孔灵芝; 刘力生

Abstract

王增武,王馨,张林峰,王文,陈伟伟,朱曼路,胡盛寿,雷振龙,孔灵芝,刘力生.社区高血压控制：血压管理效果的评价[J].Chinese journal of Epidemiology,2010,31(1):1-4

社区高血压控制：血压管理效果的评价

Hypertension Control in Communities(HCCJ：evaluation result of blood pressure management among hypertensive

Received:September 05, 2009

DOI：

KeyWord: 高血压社区卫生服务疾病管理干预效果

English Key Word: Hypertension Community health services Disease management Effecct of intervention

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Author Name	Affiliation	E-mail
WANG Zengwu	The National Center of Cardiovascular Disease, Beijing 100037, China
WANG Xin	The National Center of Cardiovascular Disease, Beijing 100037, China
ZHANG Linfeng	The National Center of Cardiovascular Disease, Beijing 100037, China
WANG Wen	The National Center of Cardiovascular Disease, Beijing 100037, China	wangwen5588@vip.sina.com
CHEN Weiwei	The National Center of Cardiovascular Disease, Beijing 100037, China
ZHU Manlu	The National Center of Cardiovascular Disease, Beijing 100037, China
HU Sheng-shou	The National Center of Cardiovascular Disease, Beijing 100037, China	huss@vip.sohu.com
LEI Zhenlong	Bureau of Disease Control, Ministry of Health of China
KONG Lingzhi	Bureau of Disease Control, Ministry of Health of China
LIU Lisheng	The National Center of CardiovascularDisease, Beijing 100037, China

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Abstract:

目的通过在社区开展高血压规范化管理，评价其对血压控制的效果。方法《中围高血压防治指南》为依据制定基层高血压规范化管理方案，进而用此方案对基层医务人员进行规范化培训，要求受训医务人员按照方案要求管理患者，主要进行非药物和药物十预、分级管理，每例患者至少管理1年。主要指标为血压控制率，干预效果为1年后的率(均值)一基线的率(均值)。结果到2008年底，资料齐全且规范化管理满1年的患者共2941l例(男性47.2％，年龄61.4岁±10.9岁)。其中危险分层低危、中危、高危(很高危)者分别占8.9％、50.8％、40.3％。规范化管理后，患者的吸烟率、饮酒率的干预效果分别为一7.1％和一7.3％(P<0.05)，SBP、DBP分别为一14.8mmHg和一8.3mmHg(P<0.05)；而超重肥胖率较基线高0-3％(P>O.05)。1年后高血压控制率上升至74.7％，干预效果为53.1％(P

English Abstract:

Objective To determine the effects related to community-based standardized blood pressure management programs on the cohenl of hypertension.Methods A protocol of community.based standardized blood pressure management was developed based on the current Chinese guideline for prevention，treatment of hypertension.Grass-roots caretakers from community health service centers across China were仃ained using this protocol and required to manage hypertensive patients according to the protoc01.Patients were treated on therapeutic life style change or/and medication.and followed up based on the Crl‘teria of risk stratification.The control rate of hypertension was evaluated after 1 year.Effect of intervention(EI)was estimated as‘l year rate (mean)’minus the number showed at the baseline.Results By the end of 2008，a total of 29 41l hypertensive patients(47.2％for male，mean age 61.4±10.9 years)with mll information had been under management for one year according to the protoc01.Among all patients.8.9％were classified as under low risk.50.8％as moderate risk and 403％as high and very high risk showed in baseline data. After standardized management，the El of smoking，drinking and systolic/diastolic blood pressure were一7.1％(P<0.05)，一7.3％(P<0.05)，and一14.8/-8。3 lnnl Hg(P<0.05)，respectively.However，El of overweighffobesity was 0.3％(P>0.05).For ail patients，the control rate rose to 74.7％，with El as 53.1％，and all ofthe sub.groups，including age，risk stratification，had significant increases.The longer the mallagement was ander.the higher the control rate was seen.Results from the multivariate logistic regression showed that older age.male and having higher blood level were adverse factors for the undertaking the control and management programs of hypertension.Conclusion Results from our study showed that standardized management could significantly improve the program on the control ofhypertension at the community level.in China.

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