| Objective: To understand the status of blood pressure control in community comprehensive management of patients with hypertension in Yinzhou District of Ningbo City,analyze the factors that affect patients’ blood pressure control,and develop individualized management measures for different characteristics of the population to provide scientific basis for the prevention and treatment of hypertension in Yinzhou District.Methods: Using a cross-sectional study,through the Yinzhou Hypertension Management Platform,selected hypertensive patients over 35 years of age who were included in the comprehensive management of hypertensive communities for more than 1 year and completed the annual assessment in June-July 2019 as the research object.To collect the hypertension management data of the research subjects,the collection content includes basic demographic characteristics and community management follow-up data,and reflects the blood pressure control status of community management through the blood pressure compliance rate.RStudio software was used for statistical data analysis.The measurement was conducted using a paired t test,the count data was expressed as a percentage composition ratio or rate,and the comparison between groups was performed using a 2 test.Multivariate analysis uses Logistic regression analysis model.Results: A total of 20633 hypertensive patients were included in this study,and the blood pressure compliance rate was 52.92%.Among them,male patients(51.96%)had a lower blood pressure control rate than female patients(53.09%).± 9.89 mm Hg and 79.27 ± 6.55 mm Hg.Among patients with unsatisfactory blood pressure,systolic blood pressure did not meet the standard(68.64%);48.54% of hypertensive patients were accompanied by various complications,of which central obesity(36.25%)was the most common;It was 97.25%,and 70.82% of the patients had good medication compliance.Multivariate logistic regression analysis showed that:low education level(OR = 2.343,95% CI: 1.157-4.736),long course of hypertension(OR = 1.518,95% CI: 1.355-1.701),and type 2 diabetes(OR = 1.574,95% CI: 1.402-1.766),combined with central obesity(OR = 3.990,95% CI: 1.953-8.155),combined dyslipidemia(OR = 2.582,95% CI:2.097-3.178),smoking(OR = 2.307,95% CI: 1.76-3.013),occasional exercise(OR = 2.640,95%CI: 1.339-5.201);hardly exercise(OR = 3.489,95% CI: 1.447-8.407),engaged in commercial service work(OR = 1.916,95% CI: 1.277-2.879)is a risk factor for blood pressure control in patients with hypertension.Married status(OR = 0.629,95% CI: 0.455-0.868),family history of hypertension(OR = 0.869,95% CI: 0.814-0.928),combined medication(OR = 0.369,95% CI:0.297-0.453)1.Good medication compliance(OR = 0.307,95% CI: 0.153-0.622),salt-restricted diet(OR = 0.686,95% CI: 0.518-0.907)are protective factors for blood pressure control.Conclusion:(1)The blood pressure compliance rate of community comprehensive management of hypertension patients in Yinzhou District is at a medium level in Zhejiang Province;(2)Among the people whose blood pressure has not reached the standard,the main reason is that the systolic blood pressure has not reached the standard,and the pulse pressure difference is at a relatively high level.In the process of blood pressure management,attention must be paid to the level of systolic blood pressure.Within the tolerable range of the patient,the systolic blood pressure is gradually reduced,and the pulse pressure difference is stabilized within a reasonable range.(3)Most of the comorbidities of hypertension patients are central obesity,dyslipidemia and type 2 diabetes.Therefore,the management process should promptly diagnose the comorbidities of patients with hypertension,and take corresponding treatment measures to improve the management of hypertension.(4)The patient’s blood pressure control is closely related to various influencing factors.This study clearly pointed out the risk factors and protective factors of hypertension,which will help general practitioners to more targetedly guide hypertension patients to seek benefits and avoid harm,thereby increasing the blood pressure compliance rate and further reducing the incidence of cardiovascular and cerebrovascular events. |
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