Evaluation On The Long-term Effect Of Hypertensive In Communiteis Management In Jiangsu Province

Objective: To determine the long-term effects related to community-based standardized blood pressure management programs on the control of hypertension in Jiangsu province. Mainly through the change of the control rate of the blood pressure in community experimental group. Discusses the influence factors of affect blood pressure control rates increase, understand the influence factors of affect blood pressure control and cardiovascular events, and then evaluate the long-term effect of hypertension standardized management in Jiangsu province.Methods: The object of the investigation can be divided into two groups: the experimental group and the control group. Adopting a cluster random sampling method, according to the community in the province. The experimental group accept the standardization management for at least five years. Lastly, 5074 subjects are fully and meet the requirements. The selection of the control group is in the place where the eating habits, the economic level are similar to the experimental group. Meanwhile the control group can obtain the baseline information over the same period of experimental group and not involved in hypertension or diabetes management before. Lastly, 2499 subjects are fully and meet the requirements.The Cardiovascular disease center of China trained the community physician according to the Chinese guideline for prevention, treatment of hypertension. When the project is undertaking, the specilists in Beijing will come to Jiangsu province to supervise and to promote the quality of the data. All subjects should be investigated with the uniform questionnaire by the Cardiovascular disease Center of China. Questionnaire is filled by the trained research team according to the actual situation. The questionnaire mainly includes the basic situation of maternal, such as age, occupation, residence, salt intake, smoking, alcohol drinking, experience, non-drug treatment measures, drug treatment measures, the history of the cardiovascular disease and the related cardiovascular disease events, etc.The control rate of hypertension was evaluated by the minus of the follow up and the baseline.The Cardiovascular disease Center of China distributed Epidata software to establish a database, and to complete the logical check by the SAS9.2 software. If there is any problem of the data, the data will be returned to the Jiangsu province center for disease control and prevention to verify. Make statistical description of the status of baseline of blood pressure control rates, blood pressure control rates of follow-up, the effect factors of the hypertensive control rate, and the incidence rate of the cardiovascular diseases events. And multiple logistic regression analysis is taken to analysis the effect factors of the hypertensive control rate.Results: According to the results of the survey, the blood pressure control rate of the baseline in experiments is 18.9%, the blood pressure control rates of follow-up was 67.5%, the EI is 48.6%, 95% CI: 46.6% ~ 50.6%.Meanwhile, the blood pressure control rate of baseline in the control group was 44.1%, the control rates of follow-up was 58.6%, the EI is 14.5%, 95% CI: 13.3% ~ 15.7%. Not only the blood pressure control rate but also the EI, the experimental group are higher than the control group. As experimental group, the baseline SBP was 146.8 mmHg, the follow-up was 133.5 mmHg, a drop of 13.4 mmHg, drop 95% CI: 13.9 ~ 12.9 mmHg. The control groups’ baseline SBP was 138.5 mmHg, SBP of follow-up was 135.6 mmHg, a drop of 2.9 mmHg, drop 95% CI: 3.3 ~ 2.5 mmHg. The baseline DBP of the experimental group is 89.9 mmHg, and the follow-up was 82.3 mmHg, a drop of 7.7 mmHg, drop 95% CI: 8.0 ~ 7.4 mmHg. And the baseline DBP of the control group was 84.1 mmHg, the follow-up was 82.7 mmHg, a drop of 1.3 mmHg, drop 95% CI: 2.4 ~ 0.3 mmHg. Thus it can be seen that although baseline systolic blood pressure and diastolic blood pressure in experimental group were higher than in the control group, but after standardization management, experimental group blood pressure values is lower than the control group.The EI of the experimental group is higher in the subgroups of overweight and obesity patients, smoking patients, alcohol drinking patients, doing exercise patients, the moderate risk patients, the high and very high risk patients. The EI of the control group is higher in the subgroups of smoking patients, alcohol drinking patients, not doing exercise patients, partial salty taste, the moderate risk patients, the high and very high risk patients.The multivariate logistic regression showed that higher blood level of baseline, overweight/obesity, and partial salty taste, lack of exercise were adverse factors for the undertaking the control and management programs of hypertension of experimental group. The multivariate logistic regression also showed that higher blood level of baseline, age were the adverse factors for the control rate of hypertension of control group.The incidence rate of the cardiovascular disease events in experimental group was 4.7%, the rate was 6.2% in control group.Conclusions:Results from the study showed that community standardized management could significantly improve the control rate of hypertension in Jiangsu province.?This research found the control rate of the patients who accept the management is higher than those who did not accept the management of hypertension. It is an effective way to modify unhealthy lifestyle and enhance medication compliance and control of blood pressure, and reduce complications among hypertensive population.