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目的评价社区高血压疾病细节管理对控制高血压患者血压和降低心血管危险分层的效果。方法采用整群抽样的方法在上海市嘉定区抽取2个社区,随机分为细节管理组和日常对照组,共纳入726例原发性高血压患者,细节管理组553例和日常对照组173例。对细节管理组患者进行为期1年的疾病细节管理和干预,日常对照组只进行常规的管理。在基线期和末期分别以体格检查和问卷的形式对所有患者进行调查。结果干预后细节管理组和日常对照组的平均收缩压(systolic blood pressure,SBP)和平均舒张压(diastolic blood pressure,DBP)较日常对照组分别下降了6.52 mmHg和3.54 mmHg,差异均有统计学意义(均有P<0.05)。干预后细节管理组心血管危险分层低危人数增加比例大于日常对照组,差异有统计学意义(P<0.001)。结论社区高血压疾病细节管理不但降低了高血压患者的血压水平,还有助于减少高血压患者的危险因素,降低心血管危险分层级别,应在社区高血压防治工作中加以推广应用。
Objective To evaluate the effect of community-based hypertension management on the control of blood pressure and cardiovascular risk stratification in hypertensive patients. Methods A total of 726 essential hypertension patients were included in the cluster management and daily control group. Two community groups were selected from a cluster sampling method in Jiading district of Shanghai. A total of 553 patients in the detail management group and 173 in the control group were enrolled. . A one-year disease detail management and intervention was performed on a detail-management group of patients, with routine controls routinely administered. All patients were surveyed in the baseline and end of life by physical examination and questionnaire, respectively. Results After the intervention, the average systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the detail management group and the daily control group decreased by 6.52 mmHg and 3.54 mmHg, respectively, compared with the control group Significance (all P <0.05). After intervention, the proportion of cardiovascular risk stratification risk increased in detail management group was higher than that of the control group, the difference was statistically significant (P <0.001). Conclusion The detail management of community hypertension can not only reduce the blood pressure of hypertensive patients, but also help to reduce the risk factors of hypertension and reduce the level of cardiovascular risk stratification, which should be popularized and applied in the prevention and treatment of community hypertension.