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目的分析淮安市高血压社区规范化管理患者血压控制状况及其影响因素。方法对2006年10月通过筛查并建立高血压专项档案的18岁以上高血压患者进行随访管理,截至2009年4月共陆续管理高血压患者17559名。采用自身对照的方法,对管理前、后的相关指标进行分析。结果共纳入7886例高血压现患病人,管理前患者的平均收缩压(SBP)为(155.99±16.00)mmHg,舒张压(DBP)为(94.57±9.63)mmHg,管理后SBP、DBP平均值分别为(138.08±12.15)mmHg、(84.81±7.66)mmHg,差别均有统计学意义(P<0.01)。高血压患者经社区规范化管理后的血压控制率为43.84%(3457/7886)。其中,男性血压控制率为43.41%,女性为44.26%,两组差别无统计学意义。多因素分析结果显示,血压控制率受年龄(OR=1.070,95%CI:1.023～1.120)、体质指数(超重OR=1.156,95%CI:1.047～1.276;肥胖OR=1.342,95%CI:1.155～1.560)、血压级别(OR=1.366,95%CI:1.281～1.456)、吸烟(OR=3.446,95%CI:1.093～10.868)、口味(OR=7.188,95%CI:3.472～14.885)、甘油三酯(OR=9.631,95%CI:4.161～22.289)的影响。结论社区规范化管理有助于高血压患者的血压控制;社区基层医生应结合体重、血压水平、生活方式、血脂等相关危险因素对高血压患者进行综合防治。
Objective To analyze the blood pressure control and its influencing factors in the standardized management of hypertension community in Huaian city. Methods Follow-up management was conducted on hypertensive patients over 18 years of age who passed the screening and establishment of special files of hypertension in October 2006. As of April 2009, 17,559 hypertensive patients were managed in succession. Using self-control method, the management of before and after the relevant indicators for analysis. Results A total of 7886 hypertensive patients were enrolled in this study. The mean systolic blood pressure (SBP), diastolic blood pressure (DBP) and diastolic blood pressure (DBP) were (94.57 ± 9.63) mmHg and (138.08 ± 12.15) mmHg and (84.81 ± 7.66) mmHg respectively, the differences were statistically significant (P <0.01). Hypertensive patients by community-based management of blood pressure control rate was 43.84% (3457/7886). Among them, male blood pressure control rate was 43.41%, women 44.26%, no significant difference between the two groups. Multivariate analysis showed that the control rate of blood pressure was influenced by age (OR = 1.070, 95% CI: 1.023-1.120), body mass index (overweight OR = 1.156, 95% CI: 1.047-1.276, obesity OR = 1.342, 95% CI: (OR = 7.188, 95% CI: 3.472-14.885), smoking (OR = 3.446, 95% CI: 1.093-10.868), blood pressure level (OR = 1.366,95% CI: 1.281-1.456) , Triglycerides (OR = 9.631, 95% CI: 4.161-22.289). Conclusion Community-based management can help to control blood pressure in hypertensive patients. Community-based physicians should combine prevention and treatment of hypertension with related risk factors such as body weight, blood pressure, lifestyle and blood lipids.