Lin Aihua, Zhang Guanrong, Liu Zhiting, Gu Jing, Chen Weiqing, Luo Futian
Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou 510080, China.
Health Management Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, No. 123 Huifu Xi Road, Guangzhou 510180, China.
Int J Environ Res Public Health. 2014 Nov 13;11(11):11645-63. doi: 10.3390/ijerph111111645.
Although evidence suggests that lifestyle interventions can reduce blood pressure (BP) and glucose levels, there is little information about the feasibility of such interventions when implemented in community settings. This study evaluated the effectiveness of a community-based lifestyle intervention on BP and glucose in the middle-aged and older Chinese population. By using a cluster randomisation approach, 474 participants from two communities were assigned to the intervention group which received intensive health education and behavioural intervention, or the control group which received conventional education. Linear mixed models were used to compare between-group differences on change in BP and fasting glucose after 6, 12 and 24 months. At the 12-month follow-up, the intervention group experienced significantly reductions in systolic BP (-4.9 vs. 2.4 mmHg; mean difference [MD] -7.3 mmHg; p < 0.001), diastolic BP (-1.9 vs. 1.9 mmHg; MD -3.8 mmHg; p < 0.001) and fasting glucose (-0.59 vs. 0.08 mmol/L; MD -0.67 mmol/L; p < 0.001). These differences were sustained at the 24-month follow-up. With only two communities, it was not possible to adjust for potential clustering by site. This approach of lifestyle interventions conducted through primary care services may be a potential solution for combating hypertension and diabetes in a resource-limited country context in China.
尽管有证据表明生活方式干预可以降低血压(BP)和血糖水平,但在社区环境中实施此类干预措施的可行性信息却很少。本研究评估了一项基于社区的生活方式干预对中国中老年人群血压和血糖的有效性。通过采用整群随机化方法,将来自两个社区的474名参与者分配到接受强化健康教育和行为干预的干预组,或接受常规教育的对照组。使用线性混合模型比较6个月、12个月和24个月后两组在血压和空腹血糖变化方面的组间差异。在12个月的随访中,干预组的收缩压(-4.9 vs. 2.4 mmHg;平均差[MD] -7.3 mmHg;p < 0.001)、舒张压(-1.9 vs. 1.9 mmHg;MD -3.8 mmHg;p < 0.001)和空腹血糖(-0.59 vs. 0.08 mmol/L;MD -0.67 mmol/L;p < 0.001)均显著降低。这些差异在24个月的随访中持续存在。由于只有两个社区,无法对潜在的地点聚类进行调整。通过初级保健服务实施的这种生活方式干预方法可能是在中国资源有限的国家背景下对抗高血压和糖尿病的一种潜在解决方案。