Long Term Intervention Effect Of Standardized Management Of Hypertension In Community

Objectives:Through the implementation of project management for hypertension in community norms,improve the doctor's standardized management ability and patient self management ability,improve the awareness rate,treatment rate and control rate,reduce the incidence of cardiovascular and cerebrovascular diseases;through the process and final evaluation,evaluation of project performance.Find out the factors that affect the control of hypertension.Methods:Methods epidemiological field test in the local,using stratified cluster sampling method to select community health service institutions as a number of standardized management group(Management Group),and select the similar social and economic development level,the allocation of health resources and the level of technology,organization and location have similar intervals as conventional medical group(Control group),management group and control group were selected for 5:1.The management group received training according to the content of the program and received regular guidance;the control group did not receive relevant training during the project.Two groups were not allowed to participate in similar studies at the same time,two groups were followed up for 4 years.Results:There were 12893 patients in the analysis group(10910 cases in the management group and 1983 cases in the control group).After 1 years of community standardized management,the proportion of obesity and central obesity decreased in the management group,and the rate of eating salty,smoking,drinking,bad emotions decreased by 20.5%,9%,11.3%and 7.9%,respectively,and the change was obvious.After 4 years of follow-up,the systolic blood pressure of the management group decreased by 14.95mmHg,which was higher than that of the control group(13.31mmHg)(P<0.05);The blood pressure control rate of the management group was 65%,which was higher than that of the control group(53.2%)(P<0.05).The majority of blood biochemical indexes in the management group decreased or the average rate decreased.The incidence of stroke in the management group was 2.36%,which was lower than 3.73%in the control group(P<0.05);the mortality caused by cardiovascular and cerebrovascular diseases was 2.8%in the management group,which was lower than 4.7%in the control group(P<0.05).The influencing factors of blood pressure in 11756 patients(10173 management group and 1583 control group)were analyzed.In order to control whether the blood pressure as the dependent variable,the single factor analysis,BMI,waist circumference,baseline blood pressure,degree of culture,eating salty are the influence factors of two groups of blood pressure control;regression analysis,the factors influencing management group blood pressure control are the main cultural degree,waist circumference,blood pressure,triglyceride and baseline in standardized management;effect of control group blood pressure control with waist circumference,systolic blood pressure,drinking.Conclusions:?Standardized management has a good effect on reducing the proportion of salt,smoking,drinking and bad mood,which can reduce the ratio of obesity and central obesity.?Standardized management can reduce the level of blood pressure,increase the control rate of blood pressure,reduce the incidence of stroke,and reduce the mortality of cardiovascular and cerebrovascular diseases.?High level of education and standardized management are favorable factors for blood pressure control.Waist circumference,baseline blood pressure,triglycerides and alcohol consumption are unfavorable factors for blood pressure control.In summary,standardized management of hypertension in the community to help change the unhealthy life style,improve the control rate of blood pressure,lower blood pressure and reduce cardiovascular and cerebrovascular events.