Current Status Of High Blood Pressure Control And Its Associated Factors Among Patients With Essential Hypertension Under Community Management

Objective:To determine the current status of hypertension control among patients with essential hypertension under community management in urban of Tianjin, and identify factors related to poor control of blood pressure. To provide theoretical basis for comprehensive intervention and taking effective measures to blood pressure control.Methods:1098diagnosed essential hypertensive patients, who were under the health management, were recruited from a Community Health Centre in Tianjin for cross-sectional study. And the samples for case-control study were randomly selected from1098participants, included150cases and150controls respectively. Date was collected for their questionnaire, laboratory testing and physical examination. Univariate logistic regression and unconditional logistic regression analysis were used to analyze the factors associated with poor control of blood pressure.Results:l.The rate of blood pressure control was53.19%, the adjusted rate according to the composition of whole country population by2010census was50.51%and the standardized rate based on composition of Tianjin population was51.83%. Controlled hypertension was more common among women than that among men. Rates of blood pressure control among patients declined with of the age. The constituent ratios of uncontrolled hypertension subgroups ranked as:Isolated systolic pressure uncontrolled> Systolic and diastolic blood pressure uncontrolled> Isolated diastolic pressure uncontrolled. The means of SBP, DBP and PP of all patients were137.6±11.33mmHg,83.6±7.31mmHg and53.9±9.45mmHg, respectively. There were76.30%patients had different complications, the most common one was renal dysfunction.2. Results from unconditional logistic regression analysis showed that risk factors for BP control included:levels of BP (OR=1.950,95%CI:1.171-3.245), course of disease (1.907,1.293～2.812.), addicted to salty (2.564,1.273～5.314), insomnia (2.203,1.424-3.409), hypertriglyceridemia (3.991,1.413～11.131), hypercholesterolemia (2.437,1.270～4.657), abdominal obesity (2.564,1.237～5.314). Protective factors for BP control included:family history of hypertension (0.191,0.079～0.463), combination therapy (0.322,0.163～0.639), adherence for medication (0.283,0.147～0.547), regular blood pressure monitoring (0.382,0.197～0.740).Conclusion:The rate of blood pressure control among patients with essential hypertension under community management in Tianjin is in the general level of the nation. Patients in each age-group have different main types of uncontrolled BP. Most of them suffered from other chronic diseases or in unhealthy state. Hypertension control was affected by lots of different influential factors. Treatment of hypertension should be individualized and take comprehensive intervention. It is recommended that patients improve medication compliance, unhealthy lifestyles, and accept the treatment of complications actively. Community health service institutions should strengthen the management of hypertension, especially the screening of individuals with prehypertension.