Lickvers K, Kottmair S, Rose I, Müller M, Middeke M
ArztPartner almeda AG, München.
Dtsch Med Wochenschr. 2005 Nov 18;130(46):2628-30. doi: 10.1055/s-2005-922045.
In 2003 the German Health Insurance (DKV: Deutsche Krankenversicherung) initiated a "Health Program Hypertension" for its insured persons with the aim of motivating patients to adopt the accepted general measures for blood pressure reduction and to self-monitor their blood pressure.
Participation in the program was voluntary and without charge. The interventional measures included regular contact by phone with trained medical personnel, personal consultations targeting general measures and self measurement of blood pressure. Each patient was given training material and a blood pressure monitor, and a risk profile was made for each patient. Regular reports were given to the patients and their physicians.
The data of the first 1373 hypertensives who have been in the continuing program were analysed. The patients" average age was 61+/-9.9 years, 81% males. 94% of the participants reported taking antihypertensive medication. Initially 615 patients (44.8%) had an increased blood pressure on self-measurement ((3)135/85 mmHg). The blood pressure of these patients was significantly reduced, after an average of 16.3 months, from 145/91+/-12.7 mmHg to 135/84 +/-12.8 mmHg (p<0.001). A statistically significant weight reduction was achieved in 308 patients (22.4%) with a body mass index (BMI) of (3) 30 kg/m2, from 33.4 to 32.9 kg/m2 (p<0.001). Lipid metabolism, important life-style parameters (food and physical activity) and a knowledge of important laboratory tests (glucose and creatinine) also changed positively. Antihypertensive medication remained nearly unchanged during the period of observation.
The patients participating in the Health Program Hypertension were already reasonably well controlled. The program achieved further lasting improvement of blood pressure. In addition the participants were motivated to adopt a more health-conscious life style. Training and care of the patients by a medical services centre would seem sensible and successful. But it remains a challenge, especially to reach poorly controlled hypertensives and to motivate them to an active participation in the program.
2003年，德国健康保险（DKV：德国法定医疗保险）为其参保人员启动了一项“高血压健康计划”，旨在激励患者采取公认的常规降血压措施并自行监测血压。
该计划为自愿参与且免费。干预措施包括与经过培训的医务人员定期电话联系、针对常规措施的个人咨询以及血压自我测量。为每位患者提供了培训材料和血压计，并为每位患者制定了风险概况。定期向患者及其医生提供报告。
对参与持续项目的首批1373名高血压患者的数据进行了分析。患者的平均年龄为61±9.9岁，男性占81%。94%的参与者报告正在服用抗高血压药物。最初，615名患者（44.8%）自我测量血压升高（≥135/85 mmHg）。这些患者的血压在平均16.3个月后从145/91±12.7 mmHg显著降至135/84±12.8 mmHg（p<0.001）。308名体重指数（BMI）≥30 kg/m²的患者（22.4%）实现了具有统计学意义的体重减轻，从33.4降至32.9 kg/m²（p<0.001）。脂质代谢、重要生活方式参数（饮食和体育活动）以及对重要实验室检查（血糖和肌酐）的了解也有积极变化。在观察期间，抗高血压药物用量几乎未变。
参与高血压健康计划的患者血压原本已得到较好控制。该计划使血压进一步得到持续改善。此外，参与者有动力采取更注重健康的生活方式。由医疗服务中心对患者进行培训和护理似乎是明智且成功的。但这仍然是一项挑战，尤其是要让血压控制不佳的高血压患者参与进来并激励他们积极参与该计划。
