| Objective:Blood pressure variability is one of the important factors affecting long-term prognosis of patients with hypertension.One important reason for the blood pressure variability is long-term smoking.Therefore,quitting smoking is one of the effective ways to reduce the blood pressure of the smokers in a scientific manner.Related research indicates that,to a considerable extent,whether smokers can quit smoking successfully or not is influenced by the education way of smoking cessation that given to them.Participation of family members in the intervention can affect the patient’s mental and social environment,which may help improve smoking cessation.However,in clinical practice,this factor is often overlooked.There is also few relevant evaluation research in academic.In this study,the effect on smoking cessation behavior and blood pressure variability of three types of smoking cessation education modes was compared,including smoking cessation education accompanied by relatives,smoking cessation education without relatives as well as absent from smoking cessation education from clinic.By analyzing the effect of different education methods,we attempt to explore the effective education methods for smoking cessation in hypertensive patients Methods:1.literature research: by using Chinese knowledge network,Wanfang,Pub Med and other domestic and foreign databases,we systematically access and sort out the relative results of smoking cessation and blood pressure variability as the solid theoretical support for this study.2.Subjects: A total of 168 male hypertrophy volunteers were enrolled in the Department of Cardiology,Shenyang Fourth People’s Hospital from July 2016 to February 2017.The standards included suffering from essential hypertension,aging over 35,having a history of hypertension in more than 5 years,having normal blood pressure under treatment by antihypertensive drug(controlled at 140/90 mm Hg or less).Those who have been selected all have more than a year smoking history and smoke more than 20 cigarettes per day,who have the desire to quit smoking.Exclusion candidates are those who mainly accompanied by other serious illness,such as hyperthyroidism,anemia,atrial fibrillation,diabetes,structural heart disease,liver and kidney dysfunction,et.al.3.Study process: First,ambulatory blood pressure monitoring for 24 h as well as the 24 h ambulatory electrocardiogram were performed for all selected subjects.The blood pressure variability and 24-hour mean heart rate of these volunteers were measured.Then,according to the principle of randomized control,168 subjects were divided into three groups: A,B and C.Group A: Subjects accompanied by one certain family member(wife or children)accepted smoking cessation lectures in the hospital;group B: Subjects went to the hospital to accept smoking cessation lectures without family members;group C: patients did not need to come to the hospital and only received information on smoking cessation thought text messages.We gave one lecture on three groups each week and made sure that each group accepted 6 lectures.At the same time,the same smoking cessation education hand-outs were produced.In three groups of patients,those who started to quit smoking from the first education lecture in the first day and lasted for 60 days without smoking were considered as a successful smoking cessation.Such as patients who relapsed within 60 days,or failed to start smoking cessation after the first education lecture in the first day were not a successful smoking cessation.Finally,all patients were followed by dynamic blood pressure monitoring and dynamic electrocardiographic examination for the second time after 60 days since the first education lecture from the first day.All the data was recorded.In the end of the study,the success rate of smoking cessation,blood pressure variability and heart rate were all calculated in three groups of different education models.Results:1.Comparison of the successful rate of smoking cessation in three ways of education: The success rates of smoking cessation in groups A,B and C were 39.30%,23.20% and 5.40% respectively.The χ2 test shows that the success rates of three education methods in smoking cessation were significantly different(χ2=18.432,P <0.05).Therefore,to a certain extent,the success rates of smoking cessation would be influenced by education methods.It suggested that accepting smoking cessation lecture with relatives strengthened awareness of smoking cessation.Supervision by relatives provided a higher success rate of smoking cessation.2.Factors Affecting Smoking Cessation in Basic Conditions: There was a significant difference in the success rates of smoking cessation in patients with different family support(χ2=4.205,P<0.05).Patients who had family support had a higher chance of quitting smoking,which suggested that the attitude of family members had an impact on smoking cessation behavior.There were significant differences in the success rates of smoking cessation between different academic qualifications of the patients(χ2=8.623,P<0.05).The success rate of smoking cessation for undergraduate or above was higher than that of other educational background.3.Blood pressure variability before and after education:There were statistically significant differences in blood pressure variation before and after education(P<0.05).The results showed that it made sense to quit smoking,which can alter and improve blood pressure variability.Here were statistically significant differences in the variation of blood pressure variation before and after the three groups of groups A,B and C(χ2=18.432,P <0.05).Different education ways of smoking cessation have an effect on types of blood pressure variation.4.Comparison of BPV in the successful group of smoking cessation and the unsuccessful quitting group: There was a significant difference in the type of blood pressure fluctuation between the successful group and the unsuccessful group(χ2=29.219,P<0.05).It can be seen that smoking cessation can improve the type of BPV,changing the non-dipper blood pressure to the dipper type blood pressure and reducing the proportion of non-dipper blood pressure.5.Comparison of average heart rate after 24 hours before and after smoking cessation in successful smoking cessation group: 70 times/min before smoking cessation and 63 times/min after smoking cessation.It was suggested that successful smoking cessation can improve heart rate parameters and reduce the average heart rate of 24 hours.Conclusion:The success rate of smoking cessation,the blood pressure variability and the change average heart rate of 24 hours were analyzed based on different education ways.By comparing the data,quitting smoking was significant for improving variability in blood pressure.Patients who accept smoking cessation lectures accompanied by relatives had a high success rate of smoking cessation.To some extent,the success rates of smoking cessation would be influenced by the way of education.It was suggested that accepting smoking cessation lectures with relatives strengthened the awareness of smoking cessation.Patients who supervised by relatives would have a high success rate of smoking cessation. |
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