| 马爱娟,董忠,李刚.北京市社区脑卒中高危人群血压干预效果的评价[J].Chinese journal of Epidemiology,2013,34(8):759-763 |
| 北京市社区脑卒中高危人群血压干预效果的评价 |
| Effect of intervention program on stroke regarding blood pressure control among Beijing community population at high-risk |
| Received:April 08, 2013 |
| DOI： |
| KeyWord: 脑卒中|高血压|控制率|发病率 |
| English Key Word: Stroke|Hypertension|Control rate|Incidence |
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| Abstract: |
| 目的 了解北京市45-79岁社区脑卒中高危人群的血压干预效果.方法 2011年5月至2012年4月对北京市7604名45-79岁社区脑卒中高危人群每月随访-次,由社区医生制定个体化的随访管理方案,分析干预后血压平均水平、高血压控制率、脑卒中发病率.结果 干预前高血压患病率为64.1％.干预后,收缩压、舒张压分别下降2.9、1.5 mm Hg,血压下降明显(t值分别为-20.987、-15.494,P值均为0.000)；前四次随访血压下降幅度最大；收缩压下降幅度表现为高年龄组下降幅度大(F=14.287,P=0.000),男性高于女性(t=-2.885,P=0.004),郊区人群高于城区(t=5.314,P=0.000),初中及以下文化程度者下降幅度大(t=-6.943,P=0.000)；舒张压下降幅度表现为低年龄组人群下降幅度大(F=22.864,P=0.000),男性高于女性(t=-2.259,P=0.024),初中以上文化程度者下降幅度大(t=2.428,P=0.015).干预后高血压控制率由67.7％上升到87.9％,明显升高(χ2=324.595,P=0.000).脑卒中发病率为2.7‰,郊区人群明显高于城区(χ2=5.293,P=0.021).结论 社区干预可降低脑卒中高危人群的血压平均水平,提高高血压控制率,进而降低脑卒中发病率；以早期血压干预效果好,其中男性血压下降明显. |
| English Abstract: |
| Objective To evaluate the effect of blood pressure intervention program on stroke among high risk population aged 45-79 at the community level,in Beijing.Methods 7604 subjects were followed and given specific advice according to the situation of each individual,every month.Data regarding average blood pressure,number of hypertension control and the incidence of stroke among people in the community,were recorded and analyzed.Results Prior to the follow-up program,the hypertension prevalence was 64.1％ but both the systolic and diastolic blood pressure showed a reduction of 2.9 and 1.5 mm Hg,respectively after the intervention program was implemented,with t value as-20.987,-15.494,respectively,and P values were both 0.000.Decrease of BP at the first four follow-up experiences was more obvious.Decrease of systolic blood pressure appeared more in elderly (F value was 14.287,and P value was 0.000),in males (t value was-2.885,P value was 0.004),people living in suburban areas (t value was 5.314,P value was 0.000) and with poorer education (t value was-6.943,P value was 0.000).However,decrease of diastolic blood pressure was seen more in younger age population (F value was 22.864,P value was 0.000),in males (t value was-2.259,P value was 0.024) and those having received better education (t value was 2.428,P value was 0.015).Rate regarding hypertension control increased from 67.7％ to 87.9％ after the intervention program was implemented (χ2 value was 324.595,P value was 0.000).Incidence of stroke was 2.7‰ and seen higher in suburban area (χ2 value was 5.293,P value was 0.021).Conclusion Community intervention program on hypertension could both reduce the blood pressure and the incidence rate of stroke among high-risk population.The earlier the blood pressure intervention program started,the better the effect would be seen.Reduction of blood pressure in males seemed more obvious.In order to prevent or delay the occurrence of stroke,knowledge on hypertension prevention should be improved among populations at high risk.Individualized and comprehensive follow-up management programs should be strengthened among the community health care takers. |
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