| Objectives:To investigate the present management condition and blood pressure control of patients with hypertension in grassroots areas of Jiangxi Province,analyze the factors affecting the standards of blood pressure,evaluate the effectiveness of hypertension management,and provide a reference basis for formulating hypertension prevention and management strategies.Methods:This study mainly selected patients with hypertension from multiple community health service centers or township health centers in various cities of Jiangxi Province during the period from December 2022 to February 2023,and analyzed the current situation of hypertension management in the grassroots areas including demographic characteristics,lifestyle,knowledge about hypertension,treatment,management and blood pressure attainment by using the form of questionnaire and combining relevant data,and analyzed the factors affecting the blood pressure standard were tested by Chi-square test and multi-factor logistic analysis.In addition,the questionnaire survey was conducted on the general practitioners of the management team of the above-mentioned primary health institutions,and the results of the survey were statistically depicted.Results:1.A total of 412 patients with hypertension who met the criteria were collected by questionnaires,including 215 men(52.2%)and 197 women(47.8%),with an average age of 64.48±13.98 years old,the highest proportion of patients who were older than 65 years old was 51.2%,the average BMI was 23.16±3.3 kg/m~2,the overweight/obesity reached 43.2%,and 39.8%had a family history of hypertension;2.In terms of the degree of mastering the related knowledge of hypertension,64.8%of patients expressed they knew it clearly,35.2%said they did not know it very well or at all,and the overall awareness was reasonable;The main channel for patients to obtain knowledge about hypertension was to be informed by medical staff(89.6%);3.There were 343 cases(83.3%)with a history of hypertension≤10 years and 69cases(26.2%)with a history of hypertension more than 10 years.Among all the subjects,the patients who had one,two,and more than three other chronic diseases combined accounted for 21.6%,10.4%,and 13.8%,respectively.The most common comorbidities were dyslipidemia,stroke and coronary heart disease,and diabetes mellitus;the treatment rate of hypertension was as high as 87.4%,of which 51.2%were treated with drugs,and 36.2%were treated with non-drug and drug combination therapy.The patients mainly took single drugs,the most commonly was ACEI/ARB drugs,followed by CCB drugs;4.The management of hypertension in the grassroots areas has been well carried out,with the rate of establishing health records as high as 85.7%,and physician’follow-up,lifestyle and medication guidance have basically met the demand for standardized management≥4 times per year,but the self-monitoring of blood pressure was poor,with a regular monitoring rate of 31.3%and only 47.8%of patients equipped with blood pressure measuring devices at home;the latest blood pressure compliance rate was 33.5%;5.Among the factors affecting blood pressure reaching the standard,univariate analysis was performed for 20 factors such as age,education,occupation,monthly income,type of health insurance,family history,dietary habits,mental stress,comorbidities,blood pressure monitoring,location of blood pressure measurement,frequency of follow-up,physician follow-up,form of follow-up management,lifestyle and medication guidance,counseling and psychological guidance,conduct of lectures,and participation in health activities.Eventually incorporated into multivariate logistic analysis,the results showed that age ranged from 45 to 65 years old,the education level was above junior middle school,regular monitoring of blood pressure,blood pressure measurement in the community or hospital,and frequency of follow-up visits≥4 times per year were positively associated with blood pressure control(OR>1),while salty diet and≥3 complications were negatively associated with blood pressure control(OR<1);6.In the process of hypertension management,the main management contents of general practitioners are establishment of health records,monitoring of blood pressure changes,management of risk factors and complications,physical examination and medication guidance,as well as regular follow-up and health education lectures,etc.The current difficulties in hypertension management include,in order of priority,heavy workload,lack of recognition by patients,inadequate staffing and capacity,as well as lack of funding and lack of social recognition,etc.Conclusions:(1)At present,the management of hypertension in the grassroots areas of Jiangxi Province has been carried out relatively well,which has basically reached the requirements of standardized management;Moreover,patients’awareness of hypertension-related knowledge was acceptable;Hypertension patients were mainly accompanied with dyslipidemia,stroke,coronary heart disease,diabetes and other common disease;(2)Primary hypertensive patients were mainly treated with a single drug of ACEI/ARB or CCB class;The latest blood pressure compliance rate was 33.5%,and the blood pressure compliance was closely related to many influencing factors;(3)In the process of hypertension management in the future,we should:1)improve the treatment of primary care physicians and increase the number of general practitioners;2)support the policies of relevant departments to actively guide hypertensive patients to the community;3)improve social recognition and obtain the cooperation of patients. |
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