Study On Common Cardio-cerebrovascular Diseases And The Management Of High-risk Patient Among The Rural Aged In Jincheng

Objective A large-scale rural health investigate was carried in rural Jincheng of Shanxi, The aims were to understand the prevalence and risk factors of common cardio-cerebrovascular diseases, to enhance identification and standardized medical management of individuals at high risk of cardio-cerebrovascular diseases, based on the village doctors in this rural area, and to provide the basis for further prevention and control work in rural area.Methods This survey selected the subject-"China’s rural health action" in Jincheng, first selected Gaoping (county-level cities) and Yangcheng County as the project counties, and then selected12townships from each project county. Last selected a village from each township as the project villages, a total of24project villages was selected. During September2010and October2011, all the villagers aged60and over were selected, and then give everyone its random number by simple random sampling method. We should investigate by order. According to the project implementation requires, village doctors screened all the villagers by measuring blood pressure and asked the history of their cardio-cerebrovascular diseases. The villagers who met the standard of high-risk patient would be managed during November2010and November2011. Investigation considered the prevalence of cardio-cerebrovascular diseases and risk factors, and standardized management of patients at high risk of cardiovascular and cerebrovascular diseases. SPSS16.0statistical software was used for statistical analysis, used statistical description of the qualitative and quantitative data,χ2test, two independent samples t-test, non-conditional Logistic regression.Result1, Baseline survey results:A total of784people were investigated, including407(51.9%) form Gaoping and377(48.1%) from Yangcheng,262(33.4%) were males and522(66.6%) females. Prevalence of cardio-cerebrovascular diseases in elderly of survey area was75.8%(594/784), the prevalence of hypertension was49.4%(387/784), stroke prevalence was8.7%(68/784), coronary heart disease risk of3.3%(26/784). There were516people suffering from a kind of cardio-cerebrovascular disease,74people suffering from two,4people suffering from three, respectively accounting for65.8%,9.4%,0.5%. The results showed that:age and BMI were the major risk factors for cardio-cerebrovascular diseases, years of education was the major protective factors for cardio-cerebrovascular diseases by unvaried analysis and multivariate analysis.2, The standardized management of patients at high risk of cardio-cerebrovascular diseases: A total of893were managed through the first diagnosis according to the standards of cardio-cerebrovascular diseases patients at high risk including438men and455women, mean age (63.32±9.23) years old. Until November2011,16were lost to follow (nine people died, seven people left village), accounting for1.8%.Before the management,there were613(68.6%) pay attention to the salt volume, after management there were859(97.9%) pay attention to the salt volume, after management more people pay attention to the salt volume (χ2=271.338, P <0.05); there were148people smoking before management accounting for16.6%(148/893), after management there were101people smoking, accounting forll.5%(101/877), the proportion of the smoking reduced(χ2=8.781, P<0.05); there were731people taking medicine before the management, accounting for81.9%(731/893), after management there were832people taking medicine, accounting for94.9%(832/877), the proportion of people taking medicine increased(χ2=72.518, P<0.05).Before the management, the average value of systolic, diastolic and BMI, were (152.23±33.88) mmHg and (85.31±11.80) mmHg and (24.91±7.35) Kg/m2respectively, after the management they were (135.63±13.60) mmHg and (79.62±8.90) mmHg and (24.41±7.94) Kg/m2respectively. The systolic blood pressure, diastolic blood pressure and BMI were lower than management before, systolic blood pressure, diastolic blood pressure change difference was statistically significant (p<0.05) by t test, BMI change was no significant difference.Conclusion1, The prevalence of common cardio-cerebrovascular diseases of elderly people in surveyed areas is higher than that of the people living in another area, hypertension is the most prominent.2, The results showed that:age and BMI were the major risk factors for cardio-cerebrovascular diseases, years of education was the major protective factors for cardio-cerebrovascular diseases by unvaried analysis and multivariate analysis.3, Patients at high risk of cardio-cerebrovascular diseases has improved in the amount of salt, smoking and medication through the implementation of the standardized management based on the village doctor, systolic blood pressure, diastolic blood pressure declined.