Effect of pharmaceutical intensive intervention for community hypertensive patients and prevention of ischemic stroke
Objective To investigate the effect of pharmaceutical intensive intervention for community hypertensive patients and to predict the risk of ischemic stroke in 10 years.Methods A total of 180 patients with hypertension treated at Community Health Service Center of Dongdajie,Zhengzhou from October 2021 to July 2022 were selected for the randomized controlled trial,and were divided into a control group and an intervention group by the random number table method,with 90 cases in each group.There were 39 females and 51 males in the control group;they were(63.17±4.27)years old.There were 41 females and 49 males in the intervention group;they were(63.49±4.05)years old.The control group took routine clinical intervention;in addition,the intervention group took pharmaceutical intensive intervention.The systolic and diastolic blood pressures and levels of fasting blood glucose,glycated hemoglobin,total triglyceride,total cholesterol,and low density lipoprotein before and after the intervention were compared between the two groups.The Modified Flamingham Stroke Scale was used to predict the 10-year stroke risk of the two groups.The Chinese version of Depression-Anxiety-Stress Scale(DASS-21),Medical Coping Style Questionnaire(MCMQ),Self-care Ability Scale(ESCA),and Morisky Medication Compliance Scale(MMAS-8)were used to evaluate all the patients.x2 test,t test and rank sum test were used.Results After the intervention,the systolic and diastolic blood pressures in the intervention group were lower than those in the control group[(118.63±7.15)mmHg(1 mmHg=0.133 kPa)vs.(130.56±10.53)mmHg and(80.71±8.25)mmHg vs.(93.11±9.34)mmHg],with statistical differences(t=8.892 and 9.440;both P＜0.001).The levels of fasting blood glucose,total triglyceride,glycated hemoglobin,total cholesterol,and low density lipoprotein in the intervention group were lower than those in the control group[(5.23±0.65)mmol/L vs.(5.79±0.74)mmol/L,(1.38±0.14)mmol/L vs.(1.51±0.16)mmol/L,(5.72±0.56)％vs.(6.18±0.69)％,(4.80±0.34)mmol/L vs.(5.11±0.41)mmol/L,and(2.37±0.34)mmol/L vs.(2.69±0.41)mmol/L],with statistical differences(t=5.394,5.801,4.911,5.521,and 5.700;all P＜0.001).After the intervention,the 10-year risk of stroke in the intervention group was lower than that in the control group[low risk:38.89％(35/90)vs.23.33％(21/90);middle risk:44.44％(40/90)vs.45.56％(41/90);high risk:16.67％(15/90)vs.31.11％(28/90)],with a statistical difference(Z=2.523,P＜0.001).The score of DASS-21 in the intervention group was lower than that in the control group[(16.13±3.04)vs.(23.23±6.07);t=9.922;P＜0.001].The scores of MCMQ,ESCA,and MMAS-8 in the intervention group were higher than those in the control group[(70.11±9.09)vs.(58.34±8.95),(102.05±21.01)vs.(75.14±15.19),and(14.25±4.24)vs.(11.12±3.20)],with statistical differences(t=8.753,9.847,and 5.590;all P＜0.001).Conclusion Pharmaceutical intensive intervention for community hypertensive patients can improve their blood pressures,regulate their blood lipids and blood glucose,reduce the risk of stroke in 10 years,relieve their anxiety,and increase their self-management ability,treatment enthusiasm,and medication compliance.
HypertensionCommunityPharmaceutical intensive interventionRisk of stroke in 10 yearsAnxietySelf-management abilityMedication compliance
万方数据
维普
