Study On The Status And Influencing Factors Of Blood Pressure Control In Community Standardized Management Of Hypertension Patients

Objective: To understand the present situation of blood pressure control in hypertension patients with standardized community management in Chengguan District of Lanzhou City,and to explore the factors affecting the blood pressure control of patients.It provides the basis for further promoting the standardized management of hypertension community and the construction of national demonstration area for comprehensive prevention and control of chronic diseases.Methods:From October 2017 to August 2018,patients over 35 years old with essential hypertension were selected from Chengguan District of Lanzhou City by stratified convenient sampling method,and a face-to-face survey was conducted with a self-designed questionnaire.The survey included demographic characteristics,drug compliance,lifestyle,health knowledge,and data on physical examination,blood lipid and blood pressure.SPSS21.0 is used to analyze the data.The rate and composition ratio of counting data were described.T test was used to measure the data,and multivariate Logistic regression was used for multivariate analysis.Test The level ? = 0.05,P < 0.05,the difference was statistically significant.Results: 1.A total of 1261 patients with hypertension who met the inclusion criteria were investigated in this study.The overall blood pressure control rate of the study subjects was 53.53%,the control rate of blood pressure between male and female patients was statistically significant(2=7.280,P<0.05),and that of female patients(57.73%)was higher than that of male(48.92%).2.The mean systolic blood pressure(SBP),diastolic blood pressure(DBP)and pulse pressure difference(PP)were136.37±7.541 mmHg,79.20±6.450 mmHg and 57.17±7.206 mm respectively.3.41.55% of the subjects had hypertension complications,and there was no significant difference in the total composition ratio between male(43.11%)and female(39.98%)(P>0.05).Among the people whose blood pressure was not up to the standard,the main type of blood pressure was SBP substandard(65.19%),and the blood pressure grade was grade 2 and grade 3,accounting for 36.00% and 40.27%,respectively.4.The results of multivariate Logistic regression analysis showed that the risk factors of blood pressure control in patients with hypertension were male,long course of hypertension and type 2 diabetes mellitus,complicated with central obesity,complicated with dyslipidemia,smoking,salty;The protective factors of blood pressure control were as follows: under 55 years old,high educational level,family history of hypertension,family income of more than 5000 yuan,good drug compliance,combined use of drugs,regular / daily physical exercise,high score of health knowledge.The self-assessment score of health status is high.Conclusion:1.Community standardized management can significantly improve the blood pressure control rate of patients,and play a positive role in promoting the knowledge of patients' health and the cultivation of health behavior.2.The main manifestation of patients whose blood pressure was not up to standard that systolic blood pressure was not up to standard.It is suggested that attention should be paid to the control of systolic blood pressure in hypertension management in the future,and the systolic blood pressure should be steadily reduced under the condition that patients can tolerate it.3.Among the people whose blood pressure is not up to standard,most of them are complicated with type 2 diabetes mellitus,central obesity and so on.It is suggested that in the management of hypertension patients,we should pay close attention to the early related indexes of complications in patients with hypertension and diagnose them in time.4.Whether the patient's blood pressure is controlled or not is affected by many factors.It is suggested that patients should strengthen their own blood pressure monitoring,improve drug compliance and change their bad lifestyle.General practitioners should strengthen their health guidance on diet and weight loss.5.Community general practitioners should pay attention to the mental health of patients,evaluate and intervene the mental health status of patients during follow-up,and help patients adjust their bad emotions.