| Objectivescreen the focus groups and high-risk groups who were managed by the Primary Care Provider(PCP)and explore the effect of the PCP to provide a reference for making rural communities based,low-cost and effective Cardiovascular and Cerebrovascular Disease(CCVD)prevention schemes in the rural areas in the future.MethodsRandomly Select Yangcheng and Gaoping as a project counties in Jincheng.12 townships were randomly selected in each project county.Then select a village in each township to enter into the study.Thus there were 24 project villages.The PCP was carried out from 2010 to 2012.There was a baseline investigation before the PCP.There was also another investigation after the PCP.In the two investigations,the first was to collect the people lists in every village which were 50 years and old with men and 60 years and above with women.Generate a random list by the simple random sampling method.The object of the investigation was carried out in accordance with strict random lists.The PCP was that the village doctors screen high-risk patients from the village residents through asking the medical history and measuring blood pressure.People which agreed the intervention and meet the standards of high-risk patients were seen as managed objects.The datum were input by the EpiData3.0 software and analyzed by the SPSS 13.0 statistical software.the percentage were used for counting datum.And the measurement data were descriped with the mean and standard deviation.The statistical methods contained frequency distribution,t test,rank non-parametric test,?2 test,analysis of variance,and so on.ResultsThe survey results of pre-and post-intervention:The number of baseline survey before intervention was a total of 1056 people.The number of the Yangcheng people and Gaoping people was respectively 518 people(49.05%)and 538 people(50.57%).The number of male and women respondents was respectively 534people(50.57%)and 522 people(49.43%).The average age with men was(61.02±7.08)years old.The average age with women was(68.18±6.15)years old.The number of investigation after intervention was 1041 people.The number of the Yangcheng people and Gaoping people was respectively 513 people(49.28%)and 528 people(50.72%).The number of male and women respondents was respectively 532 people(51.10%)and 509 people(48.90%).The average age with men was(61.71 ±7.62)years old.The average age with women was(67.24±6.04)years old.Compare with the pre-intervention,the mean systolic blood pressure(SBP)after the intervention declined 5.12 mmHg(t=5.37,P<0.001).Compare with the pre-intervention,the mean diastolic blood pressure(DBP)reduced 2.36 mmHg(t=4.25,P<0.001).After the intervention the proportion of the number of people with manual labor rose(Z=-2.64,P=0.008),and that of physical exercise also increased(Z=-16.12,P<0.001).After the intervention the proportion of knowing the knowledge that the adult daily amount of salt is less than or equal to 6 gram and eating more salt was harmful respectively increased 372 people(35.32%)(?2=418.71,P<0.001)and 211 people(21.09%)(?2=106.43,P<0.001).The proportion of high-sodium diet decreased(Z=-26.55,P<0.001).Compared with pre-intervention,the incidence of hypertension after the intervention decreased 22 people(2.11%)(?2=10.00,P=0.002).The results of the PCP:The managed number of the high-risk people was 501 people in first potion.The number of men was 270 people(53.89%),the average age(62.84±7.61)years old.The number of women was 231 people(46.11%),the average age(66.96±6.00)years old.After the PCP,the number of management was 465people.The number of lost to follow-up for 1 year and follow-up for 2 years were separately 19people(3.79%)and 36 people(7.19%).The mean SBP of the first diagnosis,following up for 1 year and following up for 2 years was respectively(152.58±21.73)mmHg,(133.88± 12.69)mmHg and(132.53±9.51)mmHg.The mean SBP was a declining trend.There was statistically significant of the difference of the three SBP(F=250.63,P<0.001).The mean DBP of the first diagnosis,following up for 1 year and following up for 2 years was respectively(85.15± 11.40)mmHg,(78.61 ±8.55)mmHg and(76.58±8.11)mmHg.There was statistically significant of the difference of the three DBP(F=19.66,P<0.001).Compare with the first diagnosis,the mean SBP and DBP of following up for 1 year separately dropped 18.70mmHg(P<0.001)and 6.54mmHg(P<0.001),And that of following up for 2 years separately dropped 20.05mmHg(P<0.001)and 8.57mmHg(P<0.001).Compare with the first diagnosis,the number of blood pressure control of following up for 1 year rose 221 people(46.96%)(?2=216.81,P<0.001),and that of following up for 2 years rose 259 people(57.88%)(?2=327.87,P<0.001).Compared with the first diagnosis,the number of smokers of following up for 1 year fell 65 people(12.71%)(?2= 33.90,P<0.001),and that of following up for 2 years fell 23 people(14.88%)(?2=47.97,P<0.001).Compared with the first diagnosis,the number of paying attention to the salt of following up for 1 year increased 126 people(28.87%)(?2=148.04,P<0.001),and that of following up for 2 years increased 114 people(29.88%)(?2=157.37,P<0.001).Compared with the first diagnosis,the number of medication of following up for 1 year increased 21 people(7.60%)(?2=11.92,P= 0.001),and that of following up for 2 years increased 10 people(8.53%)(?2=15.08,P<0.001).ConclusionThe standardized management of the patients with CCVD can reduce the SBP levels,the DBP levels and the incidence of hypertension of the high-risk patients.The standardized management can increase the control ratio of blood pressure of the high-risk patients.There was the decline of the smoking rate,high-sodium diet intake rate when the high-risk patients were managed.The standardized management can increase the rate of high-sodium diet knowledge awareness,physical exercise and medication of the high-risk patients.There were not significant changes in the proportion of heavy drinking,overweight and obesity,the incidence of coronary heart disease and stroke. |
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