摘要
目的探讨高血压社区规范化管理对城郊高血压治疗率、控制率及心血管危险分层的影响。方法 2009年6月至2011年12月期间对内蒙古包头城区及郊区85家基层医院、社区门诊登记的2653例高血压患者按照心血管危险因素水平进行分层,共分为低危(292例)、中危(980例)、高危(1381例)3个级别进行管理2年,建立健康档案,定期健康教育,监测血压及相关危险因素、制定并调整治疗方案。结果与城区比较,郊区高血压人群收缩压/舒张压降低更明显[降低幅度(7.84±0.41)/(4.62±0.52)比(6.56±0.49)/(3.38±0.39)mm Hg,均P<0.05]。总人群管理后高血压治疗率和控制率较管理前提高(分别88.6%比62.6%,53.0%比18.0%,均P<0.05)。重新评估高血压管理人群危险分层,与管理前比较,整体危险水平降低,低危患者人群比例增加(16.1%比11.0%),中、高危患者人群比例减少(分别35.7%比36.9%,48.2%比52.1%)。结论通过规范化管理可以使本地区高血压人群血压水平明显降低,部分危险因素得到改善,整体危险水平降低,治疗率、控制率明显提高。与城区比较,郊区治疗率、控制率的提升空间更大。
Objective To investigate the effect of community-based standardized management on the treatment and control rates of hypertension,as well as on cardiovascular risk profiles in urban and suburban communities.Methods A total of 2653 hypertensive patients registered at 85 community hospitals and clinics in urban and suburban areas of Baotou city,Inner Mongolia from June 2009 to December 2011 were enrolled. Over a two-year period,based on the risk factors for cardiovascular diseases,patients were classified into low-risk（n=292）,medium risk（n=980）or high risk（n=1381）categories;the medical archives for all patients receiving regular health education,blood pressure monitoring and assessment of risk factors were established and corresponding treatment protocols were prescribed or adjusted. Results The systolic/diastolic blood pressures were reduced more significantly in patients from suburban communities than from urban communities[（7.84±0.41）/（4.62±0.52）vs（6.56±0.49）/（3.38±0.39）mm Hg,both P〈0.05]. The treatment rate（88.6% vs 62.6%）and control rate（53.0% vs18.0%）of hypertension after management were greatly improved compared with baseline levels among all patients（both P〈0.05）. After re-evaluating the hypertension risk profiles for cardiovascular diseases and corresponding managing,the overall risk level decreased compared with baseline with increased number of patients at low risk（16.1% vs 11.0%）and decreased number of patients at medium（35.7% vs 36.9%）or high（48.2% vs 52.1%）risk levels. Conclusion The community-based standardized management can significantly reduce blood pressure levels,improve some risk factors,lower the overall risk profiles,and increase the treatment and control rates of hypertension. In suburban areas there is more room for improvement in the treatment and control rates of hypertension.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2014年第12期1139-1143,共5页
Chinese Journal of Hypertension
基金
内蒙古自治区卫生基金项目(2010164)
关键词
高血压
社区
规范化管理
Hypertension
Community
Standardized management
