The Survey Of Essential Hypertension Prevalence And Antihypertension Drug Compliancy In The Rural Area Of Liaoning Province

PrefaceHigh prevalence rate,disabling and high mortality-"three highs"of features in essential hypertension patients in china is very popular, at the same time there is a low awareness rate,low therapy rate and low control rate. In 2002 in rural areas of china, the rates of awareness,treatment and control are 13.7%,5.4%and 0.9%. The Epidemiology survey of EH in FuXin and ZhangWu in rural areas in Liaoning province suggests that the high blood pressure rate is from 32.8%to 53.9%in the population over 35 years, the medicine treatment leads to 12.7%～20.1%, the control leads to 1.1%～4.2%, control level is lower than the national village average level.The good antihypertension drug compliancy is only 40%-50%in the EH patient. Widespreadly think an obeying of high blood pressure medicine treatment isn't high to is the important reason that makes it can not got an effective control.But delivered an using of high blood pressure sufferer at first at the our country village region currently medicine circumstance and the medicine compliancy, blood pressure control rate further instruction that hasn't seen a big sample epidemiology survey, caused to have no from start to do. Therefore, the survey of EH prevelence and compliancy in the large village region is very necessary, can guide large country in the meantime as well the medical personnel is in aftertime's clinical fulfillment, well consider the influence takes a medicine compliancy from person to person and looks for the management measure of patients, can availably raise a high blood pressure control thus rate and lower the heart cerebral paroxysm occurrence and death.Subjects and Methods1.The research object's choicePress layering random the whole flock of sampling method, sample≥35 years old often live 5174 residents to carry on a survey. Diagnose 1772 EH patients, and make sure 386 patients takes the survey of antihypertension drug compliancy.2.Diagnosis standard and measure methodEH diagnosis and ratings standard with《Chinese high blood pressure prevention and cure guidebook (revise a version in 2005)》is basis.The diagraph of blood pressure is pressed under the standard condition by the medical personnel united of norm operation. Adoption OMRON 431 C that pass through correct type the electronics blood pressure account.3.The contents of epidemiology investigateThe adoption unifies the survey questionnaire of establishment, all investigators all after strict training and investigate. Investigate a contents to mainly include a general circumstance,such as the age, sex and race and the blood pressure level, high blood pressure's awearness, the treatment take a medicine, erupt disease and the knowlage of EH to prevent and cure knowledge, etc.4.Main research factor and endow with a value method(1)Knowlage rate for EH can be diagnosed for EH of the survey object know the comparison that oneself gets a EH before investigating;(2)Treatment rate for can be diagnosed for the survey object of EH about 2 with in the week take to decline the comparison of pressing the medicine;(3)Control rate for can be diagnosed for the comparison that passes and cures the blood pressure which is under 140/90 mmHg currently in the survey object of high blood pressure; (4)Take a medicine control the rate point about 2 with in the week take medicine of in the EH patients, the blood pressure is controled in the comparison that 140/90 mmHg following has.(5)The compliancy evaluation:①The adherence-adoption Mofisky recommend of the evaluation 4 problems and is divided into for"good", "midden" and "bad" in differs of adherence.②The persistense-inquire a patient to take medicine according to doctor's order.It is divided into "persistense is good", "midden" and " bad".③The compliancy:Will take the adherence and persistense to mutually add and is also divided into to good", "midden" and " bad".(6)The blood pressure keeps on control level:Inquire a patient the blood pressure inside a year measure a result level, is divided into good, "fair" and"bad".5.The statistics analyzes method Use Epidata 3.1 establishment databases, logarithms according to carry on 2 times to record to go into and check.The data analyzes the adoption SPSS 11.5 statistics software package,α=0.05.6.The quality controls(1)Strict performance diagnosis standard and result measurement standard;(2)Carry on a training to the investigator, the adoption unifies of the survey form carry on a survey;(3)Test an operation to standardize, blood pressure diagraph before take a rest for 3～5 minutes.The high blood pressure diagnoses standard to press the SBP≥140 mmHg or DBP≥90 mmHgs;Results1 Prevalence rate:Total have 5122 people, among them there are 2264 male(44.2%),2858 female (55.8%), average age is 53.63±12.24 years old. The EH prevalence rate is 34.6%over 35 years of age, the male(33.88%) is more slightly low than a female(35.16%) and the rate go up with the age increase, the set over 75 years of age reaches to 68.63%.2 Blood pressure degreeds and variety trend:With the age increase, the ideal blood pressure comparison is quickly reduced to 11.20%of 75-year-old set by 50.18%of 35-year-old set, the reduction is 38.98%;The normal blood pressure comparison slowness descends,55 years old decline to soon speed behind, reduction is 12.11%; Normal high blood pressure comparison is opposite stable(12.95%-16.14%), the 65-year-old set reaches high peak (16.14%);35 years old setⅠ,ⅡandⅢclass blood pressure fall ill the rate distinguish to 10.04%,3.42%and 2.91% and all show increase with the age increment and increase distinguish are 21.34%, 16.47%and 13.06%.3 The awareness, treatment and control:The awareness rate of EH, medicine treatment rate, control rate and take medicines control rate distinguish to 36.68%,21.78%,3.05%and 13.99%. The awareness rate (43.06%), treatment rate(28.03%) to leads(3.51%) difference with control at 65 years old and the 55-year-old set attain high peak, then have to descend;Take medicine control's rate to show to descend with the age growth.4 The blood pressure control rate and compliancy:1772 EH patients,386 take medicines, take medicines rate is 21.78%.Take medicine blood pressure the control lead to 13.99%, the female is higher than a male and show decrease with the age increment.The adherence,persistence and compliancy is distinguish to 51.30%,31.09%and 22.28%.Take medicines control rate with the lower of the adherence,persistence and compliancy show descend.5 Control rate of different blood pressure level patients:Only 8.03%patients can control for more than 9 months annually,52.85%controls for 6-9 months,39.12%controls at less than 6 months.In 54 blood pressure controllers, only 25.93%whole year the blood pressure control for more than 9 months,25.93% controls time for less than 6 months. The blood pressure keeps on control's level to lower with the patient's blood pressure level increase,Ⅲclass patient's only 2.40% blood pressures control for more than 9 months.6 The relationship between blood pressure keep on to control level and complications diseases:With the blood pressure level of lowering, take coronary heart disease,stroke and kidney disease gradual enlargement.DiscussionSurvey suggests that the EH prevalence rate is 34.6%over 35 years of age, high rate is widespreadly the reality that Liaoning province village to exist.The rate go up along with the age increment,45 years old later female's rate is higher than male, in accordance with local other investigation results.35-44-year-old set with 75-the year old set compares, ideal blood pressure and normal blood pressure comparison reduction distinguishes to 38.98%and 12.11%,Ⅰ,ⅡandⅢclass blood pressure patients's rate increase distinguish are 21.34%,16.47%and 13.06%, normal high value comparison narrow motion(12.95%～16.14%), this kind of blood pressure level moves mode together province community crowd in Zhejiang similar,but Liaoning province village high blood pressure normal high value (14.39%:12.00%),Ⅱclass (9.10%:7.70%) andⅢclass blood pressure (6.50%:3.30%) higher than Zhejiang, the condition of village high blood pressure patients is more serious, having more people will soon develop into the high blood pressure.The awareness and treatment of hypertension are 36.68%and 21.78%, both higher than the national village average level(22.5%and 17.4%), the control rate and medicine control rate distinguishes to 3.05%and 13.99%, are both lower than the national village average level(3.5%and 20.4%), reflect whole control level lowly, the results is badly.The "good" adherence of takes medicine in Liaoning province village is 31.09%,lower than other countries reported (43.1%),is similar to Shanghai, take medicine persistensly (51.3%) is higher than doctor Dong invests in FuXin in Liaoning (23.09%), the control rate of the better compliancy patients is higher than the "bad" compliancy patients,espacially in adherence;The age aggrandizement is a blood pressure control to lead another low main reason.Get the blood pressure control of patients from village in Liaoning province leads low reason first is take medicine rate is (21.78%), second is compliancy bad, finally is short time for control pressure.This survey all expressed formely with a great deal of clinical trial result, the medicine treatment made the descendent degree of DBP and complications incidence rate descended percentage to present just related.Proved more thus compliancy poorly result blood pressure to can not get an effective control, while the blood pressure can not get an effective control is form the coronary, myocardial infarction, cerebral accident and congestive heart failure and kidney failure dangerous factor.ConclusionsHigh blood pressure prevalence rate is the character in Liaoning Province village region, especially normal high value and II, III class blood pressure patients are more than others.It is lowly to control level.It is the main cause that the bad compliancy and result complications taken place.The quality that needs an exaltation urgently to synthesize an intervention, adopts comprehensive intervention measure to lift a high blood pressure control rate, lower a merger disease occurrence.