Objective:To explore difference between effect of remote blood pressure monitoring management mode and traditional blood pressure management mode on hypertension.Methods:This study is a multicenter prospective study.414 patients with hypertension who were treated in the outpatient department of Qingdao University’s Affiliated Cardiovascular Hospital,Qingdao University’s Affiliated Hospital Laoshan Hospital,Qingdao New Minsheng Hospital,Qingdao Ankang Hospital and Qingdao Botai Hospital from December2020 to June 2021 were selected and divided into remote group(147 cases),non-remote group(135 cases)and conventional group(132 cases),Among them,the remote group adopted the remote blood pressure management mode for blood pressure management,including applying the blood pressure meter that can upload data to measure blood pressure,receiving remote education,remote health guidance,etc.The non-remote group could also obtain the blood pressure meter but the remote function was turned off,while the conventional group was managed according to the traditional blood pressure management mode.The follow-up frequency of the three groups of patients was once per 2 months.After6 months of intervention,the changes of the clinic blood pressure,family self-test blood pressure,blood pressure variability,lifestyle and medication were compared.Statistical methods:All data were analyzed by SPSS25.0 software.Kolmogorov-Smirnov test was used to determine whether the measurement data was normal distribution.The measurement data conforming to the normal distribution was expressed by the?±s.The comparison between the two samples adopted the independent sample t-test,and the paired sample t-test.The comparison between multiple groups was performed by one-way ANOVA,and the comparison between two groups was performed by LSD-t test;The measurement data of non-normal distribution was expressed by M(Q1,Q3),the Wilcoxon signed rank test was used for the comparison of independent samples and paired samples,and Kruskal-Wallis H test was used for the comparison between multiple groups.The grade data was represented by examples(%).Kruskal-Wallis H test was used for comparison between multiple groups,and Dunn method was used for comparison between two groups.The counting data was expressed in cases.The paired samples and the comparison between multiple groups were tested by Chi-square or Fisher’s exact probability method,and compared with each other after being corrected by Bonferoni’s method.The difference was statistically significant(P<0.05).Results:There was no significant difference in baseline data(gender,age,family history of hypertension,history of other cardiovascular diseases,history of diabetes,white blood cells,red blood cells,platelets,hemoglobin,urinary protein,triglyceride levels)among the three groups(all P>0.05).There was no significant difference in the rate of reaching the standard of systolic blood pressure,diastolic blood pressure and blood pressure among the three groups before intervention(all P>0.05).Among the three groups of patients,after intervention,there were statistically significant differences in the rate of reaching the standard of blood pressure(?~2=8.217,P=0.016),clinic systolic blood pressure(F=4.45,P=0.012)and diastolic blood pressure(F=5.504,P=0.004).Compared with the conventional group,the systolic blood pressure(131.6±13.6mm Hg vs 136.6±16.0mm Hg,P=0.004)and diastolic blood pressure(79.7±9.3mm Hg vs 83.0±9.7mm Hg,P=0.003)in the remote group decreased,and the rate of reaching the standard of blood pressure(68.0%vs 53%,P<0.05)increased;compared with the non-remote group,the systolic blood pressure(131.6±13.6mm Hg vs 135.2±13.9mm Hg,P=0.041)and diastolic blood pressure(79.7±9.3mm Hg vs 82.8±9.5mm Hg,P=0.006)in the remote group also decreased,and the rate of reaching the standard of blood pressure(68.0%vs 54.1%,P<0.05)increased.There was no significant difference in blood pressure and blood pressure reaching the standard rate between the non-remote group and the conventional group(P>0.05).Before intervention,there was no statistically significant difference between the remote group and the non-remote group in the family self-test systolic blood pressure,diastolic blood pressure,standard deviation of systolic blood pressure,standard deviation of diastolic blood pressure(Z=-0.496,P=0.620),coefficient of variation of systolic blood pressure and coefficient of variation of diastolic blood pressure(all P>0.05);after intervention,compared with the non-remote group,the family self-measured systolic blood pressure(127.7±10.3mm Hg vs 130.6±10.3mm Hg,P=0.016),diastolic blood pressure(79.1±9.0mm Hg vs 81.5±6.7mm Hg,P=0.010),standard deviation of systolic blood pressure(5.4(3.8,7.0)vs 5.9(4.9,7.3),P=0.009),standard deviation of diastolic blood pressure(4.0(2.9,5.3)vs 4.9(4.3,5.8),P<0.001),coefficient of variation of systolic blood pressure(0.041(0.030,0.056)vs 0.044(0.037,0.058),P=0.043)The coefficient of variation of diastolic blood pressure[0.051(0.038,0.067)was lower than 0.060(0.051,0.072),P<0.001].There was no statistically significant difference in lifestyle related indicators(BMI,smoking,drinking,exercise)and drug use among the three groups before intervention(P>0.05).After intervention,compared with the conventional group,the drinking status(P=0.02)and exercise status(P=0.019)of the remote group were improved,the proportion of non-drug use decreased(P<0.05),and the application rate of single compound preparation increased(P<0.05);Compared with the non-remote group,the drinking situation of the remote group was improved(P=0.024),and the proportion of non-medication was decreased(P<0.05).There was no significant difference in BMI and smoking among the three groups after intervention(P>0.05).Multivariate linear regression analysis showed that compared with the blood pressure management mode in the conventional group,remote blood pressure monitoring could affect the blood pressure drop in the consulting room(P<0.05),while the blood pressure management mode in the non-remote group had no significant effect(P>0.05).Conclusion:Compared with the traditional blood pressure management mode,the remote blood pressure monitoring management mode plays a better role in the comprehensive management of hypertension patients. |