Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Capital Medical University, 100029, Beijing, China.
Department of Chronic Non-communicable Diseases Prevention, Chinese Center for Disease Control and Prevention, 100050, Beijing, China.
J Hum Hypertens. 2019 Jun;33(6):466-474. doi: 10.1038/s41371-018-0158-7. Epub 2019 Jan 15.
A series of guidelines concerning hypertension emphasize the importance of follow-up in patients' management. The aim of this study was to assess the impact of routine follow-up on blood pressure (BP) control. A total of 1511 patients with hypertension aged ≥ 35 years were selected randomly from 17 communities in two cities and four townships located in Shandong and Jiangsu provinces in China. About half of the patients visited the community clinic four or more times yearly; follow-up was conducted by telephone for 43.3%. Forty-four point two percent of patients who did not visit a community clinic received telephonic follow-up; a higher percentage of telephonic follow-up was found in patients who visited community clinics frequently. Positive changes in BP level and BP control were associated with the number of clinical visits, while no significant correlations were found with telephonic follow-up. After adjustment for covariates, a higher number of clinic visits was associated with better BP control, with odds ratios of 1.628 (95% confidence interval (CI): 1.141-2.322), 1.472 (95% CI: 1.008-2.271), and 1.790 (95% CI: 1.154-2.778) for 4-6, 7-12, and >12 visits/year, respectively. Taking an antihypertensive drug showed a strong, positive association with the number of clinic visits (OR 1.747, 95% CI: 1.484-2.056). These data suggest that health care systems may achieve greater success by increasing the frequency of clinical visits and that the positive changes may be related to improvement in medication adherence. Routine follow-up by telephone was not significantly associated with BP level and BP control.
一系列关于高血压的指南强调了在患者管理中进行随访的重要性。本研究旨在评估常规随访对血压（BP）控制的影响。共从中国山东和江苏两省的两个城市和四个乡镇的 17 个社区中随机选择了 1511 名年龄≥35 岁的高血压患者。大约一半的患者每年到社区诊所就诊 4 次或以上；43.3%通过电话进行随访。未到社区诊所就诊的 44.2%的患者接受了电话随访；在经常到社区诊所就诊的患者中，电话随访的比例更高。BP 水平和 BP 控制的积极变化与就诊次数有关，而与电话随访无关。在调整了协变量后，就诊次数越多，BP 控制越好，OR 值分别为 1.628（95%CI：1.141-2.322）、1.472（95%CI：1.008-2.271）和 1.790（95%CI：1.154-2.778），分别为 4-6、7-12 和>12 次/年。服用降压药与就诊次数呈正相关（OR 1.747，95%CI：1.484-2.056）。这些数据表明，通过增加就诊次数，医疗保健系统可能会取得更大的成功，并且积极的变化可能与改善药物依从性有关。常规电话随访与 BP 水平和 BP 控制无显著相关性。
