Affecting Factors To Blood Pressure Control And Interference In Community Hypertensives

Objective: To filtrate the factors that affect hypertensives blood pressure control, therapy compliance and awareness, by baseline investigation in community. To carry out comprehensive interference with individualized therapy guided by chronotherapeutics, and explore the ultimate effect on them after interference.Methods:1 Take the hypertensives of four communities out of seventy-five after simple sampling in Kaifu Changsha, which were over 35 years old by inquirying the history, after simple random sampling.2 Take 120 hypertensives which uncontrolled in the first part as the object of study, after simple random sampling. And divide the 120 cases into intervention and control groups, each of the 60 cases after simple random grouping; Monitor all the blood pressures at the end of one month, two month, three month and four month, and corry out interference (blood pressure monitoring, medication and lifestyle) in the intervention group by chronotherapeutics, while general nurse and helthy guide in the control; All fill the questionarie before and after interference; And use the blood pressure control rate, hypertension awareness and therapy compliance as the evaluate target.3 Design《The Questionnaire of Essential Hypertension Cognize and Compliance》, To investigate face to face and family follow-up, and to collect the objects basic information, blood pressure control, hypertension awareness and therapy compliance, etc.4 The general to hypertension awareness and therapy compliance by Chi-square test and rank correlation under SPSS (version 11.5), and on the base of single factor results, multi-variate unconditional logistic regression adopted the backward methods, selecte the influencing factors of blood pressure control; The intervention group and the control to hypertension awareness and therapy compliance by Chi-square test and rank test, alse the intervention group before and after, and the blood pressure control rates of the two groups by Chi-square test.Results:1 Baseline investigation of hypertensives in community①1169 persons mainly in middle-aged and elderly were investigated, with only 33.0% blood pressure control rate among 54.6 percent males and 45.4 percent females.②The basic information affected the hypertension awareness and therapy compliance, and blood pressure monitoring was positive correlation with medication compliance.③single factor and multi-variate unconditional logistic regression showed the affecting factors of blood pressure control invole in medication awareness, medication compliance, lifestyle compliance and blood pressure monitoring compliance. 2 Randomized clinical trial study The intervention group to hypertension awareness and therapy compliance, all the score changes after intervention were statistical significance (P<0.01), alse between the intervention group and the control, with significantly increased in the intervention (P<0.01) .②In the three components of the intervention (blood pressure monitoring, medication and lifestyle) after continuous four months, the blood pressure control was 86.7 percent, while 25.0 percent in the control group with statistical significance (P<0.01) .③In the three dosage forms of the control group(long-acting drugs, middl-acting drugs, short-acting drugs), the blood pressure control rates were (P<0.01) , but out of the intervention group (P>0.05) .Conclusions:1 The awareness and therapy compliance of hypertension was low in community. And alse the blood pressure control rate, it was only 33.0 percent.2 Continuous intervention to hypertensions with individualized therapy guided by chronotherapeutics could effectively improve the therapy compliance and awareness, alse the blood pressure control after four months of continuous observation. Intervention guided by chronotherapeutics can be used to community hypertensions.