社区高血压控制:方案及患者基线特点
Hypertension Control in Communities:Protocol and Baseline Characteristics
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摘要: 目的通过推广基层高血压规范化管理模式,探讨其对高血压控制率的影响。方法以2005版《中国高血压防治指南》为依据,组织专家制定基层高血压规范化管理方案,按照方案要求征集参加单位,并进一步对参加单位的基层医务人员进行培训,要求其按方案管理患者,评价1年后血压控制情况。结果截至2008年底,入选患者中基线资料完整的有110 610人,男性占47.7%。基线收缩压/舒张压为(145.5±17.3)/(88.3±10.7)mmHg,膳食口味偏重的占31.5%,饮酒、吸烟的比例分别达到17.1%和18.5%,均为男性高于女性(P<0.05)。入选患者中,1、2、3级高血压分别占47.1%、22.4%、8.1%,男性所占比例高于女性(P<0.05)。低危占9.4%,中危为53.9%,高危和很高危为36.7%,男性高危和很高危的比例高于女性(P<0.05)。入选时有75.7%的患者接受了治疗,血压水平在140/90 mmHg以下的占22.5%。结论本文对项目基线资料进行了描述,结果提示为改善高血压控制状况,有必要开展规范化管理。Abstract: Objective The project of hypertension control in communities(HCC) aimed to determine the effect of standardized community-based management on control of hypertension.Methods The protocol of standardized community-based hypertension management was developed by expert board with being oriented by 2005 guidelines for prevention and treatment of hypertension in China.Community health service centers across China were selected to implement the protocol.After trained with the protocol,the primary care physicians from selected centers were asked to manage hypertensives using the protocol.The control of hypertension was evaluated after 1 year.Results By the end of 2008,there were 110 610 patients with eligible baseline data for analysis,47.7% were male.The mean entry systolic/diastolic blood pressure was(145.5±17.3)/(88.3±10.7) mmHg,about 31.5% patients like to eat highly seasoned food,17.1% drink,18.5% smoke.Prevalence was higher in male than in female(P<0.05).Grade 1,grade 2,and grade 3 hypertension were 47.1%,22.4% and 8.1%;low-,moderate-,and high-risk group were 9.4%,53.9% and 36.7%,respectively.At entry,75.7% were treated and 22.5% were under controlled(<140/90 mmHg).Conclusion The baseline characteristic of HCC subjects were described in this article.It showed that a standardized management protocal might improve the control rate of hypertension.
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