Construction And Application Of Heart-brain "Co-prevention And Co-management" Model In Blood Pressure Management Among The Community Population

Objective To construct the "Internet+"-based information management platform of heart-brain co-prevention and heart-brain "co-prevention and co-management"model,and to explore the effect of heart-brain "co-prevention and co-management"model on blood pressure among community population.Methods The current status of chronic diseases management and management platform was analyzed,and the methods of person interview and field investigation was adopted to understand the current status of chronic diseases management in Xintang Town,Zengcheng District,Guangzhou.The association between the participation frequency of annual physical examination of residents who participated in basic public health service projects in this area from January 2015 to December 2019 and the control of cardiovascular risk factors was also explored.Based on the above research,through introducing the electronic data acquisition system/data management system(EDC),we constructed the "Internet+"-based heart-brain"co-prevention and co-management" of chronic diseases information management platform and "Internet+"-based standardized management model of heart-brain co-prevention and co-management based on domestic and international prevention/management guidelines or expert consensus.To verify the effect of the model,target community population who participated in the annual physical examination provided by the National Basic Public Health Service project at least twice in Xintang Town,Zengcheng District,Guangzhou from January 2020 and July 2021 were enrolled,and divided into regular management group(n=2987)and"co-prevention and co-management" model group(n=2876)based on whether they had received heart-brain "co-prevention and co-management" model for cardio-cerebrovascular diseases or not.The main endpoint was the change of blood pressure before and after intervention in the two groups.Results The previous research showed that the prevalence of hypertension in the target area was more than 50%,and the blood pressure control was unsatisfactory.The analysis also found that higher annual physical examination rate was associated with lower systolic blood pressure(SBP),fasting blood glucose(FBG)and total cholesterol(TC),indicating that residents regularly participate in annual health check was beneficial to the control of cardio-cerebrovascular diseases risk factors such as SBP,FBG,and TC.Based on the above findings,the research constructed the heart-brain"co-prevention and co-management" model and carried out relevant verification studies.After the intervention,the study found that the mean SBP in the regular manage group changed by 2.92mmHg(95%CI= 2.29-3.54,P<0.001)compared with baseline level,and the change of the mean diastolic blood pressure(DBP)was-0.12mmHg(95%CI=-0.51-0.28,P=0.554).Compared with baseline level,the change of the mean SBP and the mean DBP in the "co-prevention and co-management" model group were-0.28mmHg(95%CI=-0.94-0.37,P=0.398)and-0.68mmHg(95%CI=-1.09-0.27,P=0.001),respectively.Comparing the changes of blood pressure between the two groups,it was found that compared the regular treatment group,the "co-prevention and co-management" model group could significantly reduce SBP by 3.20mmHg(95%CI=2.29-4.11,P<0.001)and DBP by 0.56mmHg(95%CI=-0.01-1.13,P=0.055).Covariance analysis showed that after adjusted for baseline blood pressure,the mean SBP after intervention in the"co-prevention and co-management" model group was still significantly lower than that in the regular treatment group(P<0.001).In terms of blood pressure compliance,after 6 months of intervention,in the regular treatment group,401(13.42%)subjects had blood pressure<130/80mmHg,and 1065(35.65%)subjects had blood pressure<140/90mmHg;there were 515(17.91%)subjects with blood pressure<130/80 mmHg in the co-management group,at the same time,there were 1317(45.79%)subjects of blood pressure<140/90 mmHg,and there were significant differences in the above two groups of blood pressure<130/80 mmHg and blood pressure<140/90 mmHg(P<0.05).The results of multivariate linear regression analysis showed that "co-prevention and co-management" model intervention was significantly correlated with the decrease of SBP(P<0.001).By the implementation of this model,the standardized management rate of the elderly in the community population was increased by 27.08%,and the blood pressure control of the community population was improved.Conclusion Based on the results of the previous investigation and the basis of the previous research,the "Internet+"-based heart-brain "co-prevention and co-management" model is constructed.The application of blood pressure management in the community population has verified that our management model helps to improve the SBP and the blood pressure compliance rate among the community population.