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[2015年中国35岁及以上人群高血压社区健康管理与控制研究]

[Study on community health management and control of hypertension in patients aged 35 years and above in China, 2015].

作者信息

Song Z W, Zhang M, Zhang X, Zhao Z P, Huang Z J, Li C, Deng X Q, Wang L M

机构信息

Division of Non-communicable Disease Risk Factor Surveillance, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Nov 10;42(11):2001-2009. doi: 10.3760/cma.j.cn112338-20210727-00590.

Abstract

To understand the current status of community health management, treatment and control of hypertension in patients aged 35 years and above in China in 2015, and identify the influencing factors. Using the questionnaire survey results and physical measurement information collected by China Chronic Diseases and Nutrition Monitoring System in 2015, hypertension patients aged 35 years and above diagnosed at township health center level (community health service centers) or above were selected as the research subjects. The patients were complexly weighted to analyze their general characteristics, community health management, treatment and control status. This study included 23 974 hypertension patients aged 35 years and above diagnosed by medical and health institutions at township level and above in 2015. After complex weighting, the community health management rate of hypertension patients aged 35 years and above was 54.10% (95%: 51.02%-57.17%), the standardized community management rate was 45.72% (95%: 42.93%-48.51%), the treatment rate was 88.16% (95%: 87.00%-89.31%), and the control rate was 22.67% (95%: 21.25%-24.09%), the treatment control rate was 27.76% (95%: 26.09%-29.42%). Multivariate analysis showed that patients in urban areas as well as in rural areas who were aged over 65 years old (=1.40, 95%: 1.05-1.87; =3.11, 95%: 2.22-4.36), taking medicine as prescribed (=2.15, 95%: 1.46-3.15; =1.35, 95%: 1.13-1.62), monitoring blood pressure (=2.34, 95%: 1.88-2.90; =3.10, 95%: 2.72-3.53) were more willing to accept community health management of hypertension. Urban hypertension patients with high education level (=0.51, 95%: 0.39-0.66), moderate alcohol consumption (=0.69, 95%: 0.57-0.84) or excessive alcohol consumption (=0.73, 95%: 0.58-0.92) had a poor acceptance of community hypertension management. Overweight (=0.74, 95%: 0.61-0.91; =0.83, 95%: 0.71-0.98), obesity (=0.54, 95%: 0.45-0.65; =0.67, 95%: 0.54-0.83) patients in urban areas as well as in rural areas with hypertension had poor blood pressure control, and patient taking medication as prescribed (=4.58, 95%: 3.16-6.63; =2.84, 95%: 2.18-3.69) had better blood pressure control. Urban hypertension patients in central China (=0.74, 95%: 0.61-0.89) or with excessive alcohol consumption (=0.72, 95%: 0.54-0.97) had poor blood pressure control while urban hypertension patients with other chronic diseases (=1.22, 95%: 1.04-1.44) and participating in standardized hypertension community management (=1.29, 95%: 1.06-1.58) had better blood pressure control.Rural hypertension patients who located in central and western China (=0.71, 95%: 0.58-0.87; =0.62, 95%: 0.47-0.80), with moderate alcohol consumption (=0.81, 95%: 0.67-0.98), taking salt more than 6 g per day (=0.80, 95%: 0.69-0.93) had poor blood pressure control, and the rural hypertension patients who underwent blood pressure monitoring (=1.38, 95%: 1.18-1.61) had better blood pressure control. The community health management of hypertension in patients aged 35 years and above has been improved in China, but there is still a certain gap between the control of hypertension and related indicators. It is necessary to take multi standardized intervention measures for the better prevention and control of hypertension.

摘要

了解2015年我国35岁及以上人群高血压社区健康管理、治疗及控制现状,并找出影响因素。利用2015年中国慢性病与营养监测系统收集的问卷调查结果和体格测量信息,选取在乡镇卫生院(社区卫生服务中心)及以上机构确诊的35岁及以上高血压患者作为研究对象。对患者进行复合加权以分析其一般特征、社区健康管理、治疗及控制情况。本研究纳入了2015年由乡镇及以上医疗卫生机构确诊的23974例35岁及以上高血压患者。复合加权后,35岁及以上高血压患者的社区健康管理率为54.10%(95%:51.02%-57.17%),标准化社区管理率为45.72%(95%:42.93%-48.51%),治疗率为88.16%(95%:87.00%-89.31%),控制率为22.67%(95%:21.25%-24.09%),治疗控制率为27.76%(95%:26.09%-29.42%)。多因素分析显示,65岁以上的城乡患者(=1.40,95%:1.05-1.87;=3.11,95%:2.22-4.36)、遵医嘱服药(=2.15,95%:1.46-3.15;=1.35,95%:1.13-1.62)、监测血压(=2.34,95%:1.88-2.90;=3.10,95%:2.72-3.53)更愿意接受高血压社区健康管理。城市高血压患者中,高学历(=0.51,95%:0.39-0.66)、中度饮酒(=0.69,95%:0.57-0.84)或过量饮酒(=0.73,95%:0.58-0.92)对社区高血压管理的接受度较差。城乡超重(=0.74,95%:0.61-0.91;=0.83,95%:0.71-0.98)、肥胖(=0.54,95%:0.45-0.65;=0.67,95%:0.54-0.83)的高血压患者血压控制较差,而遵医嘱服药的患者(=4.58,95%:3.16-6.63;=2.84,95%:2.18-3.69)血压控制较好。中国中部地区的城市高血压患者(=0.74,95%:0.61-0.89)或过量饮酒的患者(=0.72,95%:0.54-0.97)血压控制较差,而患有其他慢性病(=1.22,9

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