| Objective: To standardize the management of hypertension patients in outpatient clinics through the Internet Wechat Public Number Platform.On this basis,to understand the blood pressure compliance of patients receiving follow-up management of hypertension in cardiovascular medicine outpatient clinics and analyze the influencing factors of blood pressure control,so as to realizing fine management of hypertension.Methods: 1.Patients with essential hypertension who were diagnosed and treated in the Department of Cardiovascular Medicine from January 20 to March 2018 in our hospital.The basic data of patients were collected by questionnaire and hematological examination(including blood glucose,blood lipid,blood uric acid).The cross-sectional study was conducted to analyze the blood pressure control rate,blood glucose,blood lipid control and its impact in the outpatient department of cardiovascular medicine.In addition,univariate logistic regression was used to analyze the risk factors affecting blood pressure control.2.Establish personal health records through the public number of "Good Home Doctor".Based on the Internet and outpatient follow-up management for at least nine months,SPSS was used for statistical analysis.The difference was statistically significant(P<0.05).The changes of blood pressure,blood glucose and blood lipid before and after the management were analyzed.Results: 1.This study included 368 patients with hypertension,196 males and 172 females.The average SBP was 140.70±15.31 mm Hg,the average DBP was 79.49±10.83 mm Hg,the FBG was 5.20±2.30 mmol/L,and the LDL was 2.52.±0.90 mmol/L,TC was 4.17±1.01 mmol/L,TG was 1.58±0.90 mmol/L,HDL was 1.14±0.31 mmol/L,158 patients in the blood pressure standard group,the blood pressure control rate was 42.93%.There were significant differences in average BMI,LDL,TCHO and HDL between the standard group and the non-standard group(P<0.05),but no significant differences in average age,course of disease,fasting blood glucose and triglyceride(P>0.05).Statistical analysis showed that smoking,family history of hypertension,family self-test of blood pressure,overweight or obesity,combined with coronary heart disease,diabetes mellitus,kidney disease,stroke,hypercholesterolemia,low density lipoprotein cholesterolemia had significant differences in blood pressure control rate(P<0.05),however,there were significant differences among different gender,age,low density lipoprotein cholesterolemia.There was no significant correlation between hypertension patients of different occupations,different educational levels,alcohol consumption,hyperuricemia,arrhythmia(P<0.05).2.Logistic regression analysis of the baseline data revealed that the risk factors affecting blood pressure control were smoking(OR=1.914,95% CI=1.135-3.228),overweight(0R=1.906,95% CI=1.010-3.594)and obesity(0R=2.861,95% CI=1.571-5.208),family history of hypertension(0R=1.742,95% CI=1.120-2.708),Coronary heart disease(0R=2.408,95% CI=1.260-3.331),diabetes(0R=2.095,95% CI=1.321-3.322),combined stroke(0R=4.387,95%CI=1.783-10.796),Combined with hypercholesterolemia(0R=1.846,95% CI=1.098-3.105),combined with low-density lipoprotein cholesterolemia(0R=2.167,95% CI=1.391-3.377);protective factors for blood pressure compliance were carried out in the family Self-test blood pressure(OR=0.494,95% CI=0.324-0.753)? 3.Through the Internet + outpatient follow-up management,301 patients were included in the management.The average systolic blood pressure(139.92±15.24 vs 132.93±12.63 vs 129.79±11.91 vs 126.73±11.61),average diastolic blood pressure(79.25±10.61 ? 75.80±8.31 vs 71.67±7.19 vs 70.46±7.35),low density lipoprotein cholesterol(2.51±0.85 vs 2.36±0.75 vs 2.32±0.74 vs 2.23±0.75),total cholesterol(4.17±1.00 vs 3.95±0.98 vs 3.94±0.96 vs 3.88±0.97)and fasting blood glucose(5.57±1.81 vs 5.47±1.65 vs 5.39±1.61 vs 5.20±2.44)in the consulting room before the management were significantly lower than those in the third months,sixth months and ninth months after the follow-up management(P<0.05).After 3 months,6 months and 9 months of follow-up management,the blood pressure control rate in clinic(45.85% vs 64.45% vs 76.08% vs 81.40%),the blood lipid contro rate(33.6% vs 53.6% vs 61.8% vs 71.8%),the rate of blood glucose reaching the standard(33.3% vs 52.8% vs 65.7%)and controlling rate of blood pressure in patient's clinic for home blood pressure monitoring(55.3% vs 66.7% vs 76.8% vs 85.4%)were significantly different from those before management(P<0.05).Conclusion: hypertension control rate is related to multiple factors.The joint management based on Internet plus helps to enhance patients' attention to their own diseases,increase awareness of prevention and control,may raise blood pressure control rate and the control of complications. |
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