摘要
目的 监测凉山州高血压患者血压控制达标情况及影响因素,为改进高血压患者管理策略提供依据.方法 通过分层整群随机抽样的方法,于2023年抽取凉山州盐源县、德昌县对基本公共卫生服务项目纳入管理的原发性高血压患者进行血压控制达标情况和影响因素调查.数据均使用例数和百分比进行描述,组间差异的比较使用x2检验,多组比较且总体差异有统计学意义时,使用Bonferroni法进行两两比较,α'=α/[k*(k-1)/2];分组变量为有序分类变量时,组间差异的比较采用趋势x2检验.高血压患者血压达标情况的危险因素分析使用Logistic回归.统计分析使用SPSS 18.0,以P＜0.05为差异有统计学意义.结果 共调查盐源县、德昌县原发性高血压患者517人,血压总体控制达标率为44.29％,收缩压控制达标率为53.19％,舒张压控制达标率为61.51％.地区、年龄、民族、吸烟情况、是否定期测量血压、单次购药量、剩余降压药量、服药依从性达标情况、是否服用钙通道阻滞剂、是否服用血管紧张素受体2拮抗剂、是否服用2种及以上降压药对血压控制达标有影响,组间差异均有统计学意义(P均＜0.05).多因素Logistic回归分析分析结果显示,德昌县、年龄为65岁及以上的凉山州在管高血压患者血压控制达标率高,OR及其95％CI分别为:3.33(2.04～5.26)和2.27(1.47～3.45).结论 凉山州德昌县、年龄为65岁及以上的高血压患者血压控制达标率高,应对于不同的高血压群体,针对性的开展对应内容的宣传和入户讲解,加强不良生活方式管理、不良服药行为和遵医嘱服药行为干预、血压监测行为促成、烟酒嗜好干预等服药依从性教育.
Abstract
Objective To monitor the blood pressure control compliance and influencing factors of hypertensive patients in Liangshan Prefecture,and to provide basis for improving the management strategy of hypertensive patients.Methods The stratified cluster random sampling method was used to select primary hypertension patients who were included in the management of basic public health service projects in Yanyuan County and Dechang County of Liangshan Prefecture in 2023,to conduct an investigation on blood pressure control compliance and influencing factors.Number of cases and percentage were used to describe the data,and differences between groups were compared by x2 test.When multiple groups were compared and overall differences were statistically significant,the Bonferroni method was used for pairwise comparison,α'=α/[k*(k-1)/2].When the grouping variable was an ordered categorical variable,the difference between groups was tested by trend x2 test.Logistic regression was used to analyze the risk factors of blood pressure control compliance in hypertensive patients.Statistical analysis was conducted by SPSS 18.0,and P＜0.05 was considered statistically significant.Results A total of 517 patients with primary hypertension in Yanyuan County and Dechang County were investigated,with an overall blood pressure control compliance rate of 44.29％,a systolic blood pressure control compliance rate of 53.19％,and a diastolic blood pressure control compliance rate of 61.51％.Region,age,ethnicity,smoking status,whether blood pressure was regularly measured,single dose of medication,remaining antihypertensive medication,compliance with medication standards,whether calcium channel blockers were taken,whether angiotensin receptor 2 antagonists were taken,and whether two or more antihypertensive drugs were taken had an impact on achieving blood pressure control standards.The differences among groups were statistically significant(all P＜0.05).The results of multivariate Logistic regression analysis showed that,located in Dechang and aged 65 years and above had a higher rate of achieving blood pressure control standards in patients with hypertension.The odds ratio(OR)and 95％confidence interval(CI)were 3.33(2.04-5.26)and 2.27(1.47-3.45),respectively.Conclusions The blood pressure control compliance rate was high in hypertensive patients aged 65 years and above in Dechang County of Liangshan Prefecture.Targeted publicity and door-to-door explanations should be carried out for different groups of hypertensive patients,and medication compliance education should be strengthened,including management of unhealthy lifestyles,medication behavior and adherence to medical advice,promotion of blood pressure monitoring behavior,and intervention of smoking and drinking habits.
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