Effects of “Hypertension Center” model on health management in patients with hypertension

Objective To investigate the impact of the “Hypertension Center” management model on the blood pressure control level, costs and health management in hypertensive patients.

Methods A randomized controlled trial was conducted. A total of 4 000 hypertensive patients who visited four satellite hospitals affiliated to Foshan Fosun Chancheng Hospital from June 2023 to December 2023 were selected and were randomly divided into control group and intervention group using a random number table. In the control group, 2 000 cases were managed by routine hypertension management mode, while in the intervention group, 2 000 cases were managed by "Hypertension Center" management mode. After 6 months of intervention, the changes in blood pressure, lifestyle, self-management ability, and cost of antihypertensive drugs between the two groups were compared. Finally, regression analysis was used to explore the relevant influencing factors of blood pressure transition from uncontrolled to controlled.

Results Six months later, 1 840 cases in the intervention group and 1 826 cases in the control group successfully completed follow-up. There was no significant difference in systolic blood pressure (140.83±7.74) vs (140.76±7.70) mmHg, t＝−0.254, P＝0.799 and diastolic blood pressure (89.05±6.42) vs (88.74±6.57) mmHg, t＝−1.474, P＝0.141 between intervention group and control group before intervention. After intervention, the systolic blood pressure (130.78±7.43) vs (135.84±8.88) mmHg, t＝18.682, P＜0.001 and the diastolic blood pressure (83.86±6.57) vs (85.81±6.60) mmHg, t＝8.972, P＜0.001 were lower in the intervention group than those in the control group. The blood pressure control rate in the intervention group was higher than that in the control group (76.25% vs 63.58%, χ²＝69.961, P＜0.001) after intervention. The types of antihypertensive drugs in the intervention group were fewer than those in the control group after intervention (Z＝−7.026, P＜0.001). The average monthly cost of antihypertensive drugs in the intervention group within 3 months after intervention was less than that in the control group 70.00 (59.24, 116.20) vs 89.35 (59.43, 125.28) Yuan, Z=−6.520, P＜0.001. There was statistically significant differences in the smoking control rate (89.43% vs 78.83%, χ²＝20.240, P＜0.001), drinking control rate (91.79% vs 80.93%, χ²＝27.306, P＜0.001), exercise habits improvement rate (50.11% vs 37.40%, χ²＝60.100, P＜0.001), salt intake improvement rate (74.34% vs 57.07%, χ²＝87.652, P＜0.001), medication adherence improvement rate (77.09% vs 59.89%, χ²＝74.817, P＜0.001) and medical compliance behavior improvement rate (82.77% vs 63.08%, χ²＝141.702, P＜0.001) between the intervention group and the control group after intervention. During the intervention period, the proportion of patients participating in health education activities in the intervention group was higher than that in control group (Z＝−7.695, P＜0.001) . The results of multiple logistic regression analysis showed that controlling smoking (OR＝0.578, 95%CI 0.378−0.884), controlling alcohol consumption (OR＝0.662, 95%CI 0.444−0.987), improvement of exercise habits (OR＝0.811, 95%CI 0.671−0.981), improvement of salt intake (OR＝0.751, 95%CI 0.607−0.928), improvement of medication adherence (OR＝0.275, 95%CI 0.219−0.345), and improvement of medical compliance behavior (OR＝0.714, 95%CI 0.560−0.911) were protective factors for uncontrolled hypertensive patients to achieve blood pressure targets.

Conclusion After the management of “Hypertension Center” mode, hypertensive patients can achieve better blood pressure control results, with lower costs and better health management levels.