The Analysis Of Integrated Prevention And Treatment Of Hypertension Training And Follow-up Survey Of Hypertension In Community

Abstract The study is divided into two sections, first section of the contents is thebasic situation of community physicians and Related issues of hypertension preventionand treatment technical training, second section is Subproject series of research ofNational Center for Cardiovascular Health industry in Anhui province--“cardiovasculardisease monitoring and diagnosis and treatment and prevention warning technologyapplication research-hypertension standardization management”,which is a study ofgiving standardized treatment and follow-up to city functional community hypertensionpatients.Objective1. Investigate the basic situation of community physicians and analyzeexisting problems in the prevention and treatment of hypertension;2. analyze thegeneral situation of functional communities and residential community in hypertensivepatients and follow-up after standardized treatment, to provide evidences forstandardized management mode of chronic diseases.Methods (1)A questionnaire survey about hypertension prevention and trentment wasconducted in1158physicians from5districts or communities of Anhui province from2005to2012,(2) we follow up hypertensive patients from seven functionalcommunities and three residential according to the criterion of hypertensionstandardization management by National Center for Cardiovascular Health industry inHefei countryside area from April2010to December2010. We used the surveymethodology and questionnaire which was made by National Center for CardiovascularDisease. The survey included: the general situation, physical examination, biochemical index of blood examination, diet behavior and treatment of status indicators. The datawas managed and inputted by EpiData3.1. All statistics were analyzed via the SPSS19.0Results1. The study included1158physicians from Anhui district or communityhospitals,(1) community doctors basic situation: community doctors have a similarproportion of men and women, the rates are47%and53%, Most of them were recordedby junior college with the percentage of46%,64%staff had passed the nationalmedical licensure examination, and44%were resident physicians,(2) Hypertensionwas one of the common diseases in community with the percentage of85.7%，andconsidered as a disease which had got an efective treatment, related issues ofHypertension and other chronic disease prevention and treatment: Poor living conditionwas one of main problems which Influence the effects of prevention and treatment ofhypertension, the measures of51.5%increasing funding,70.3%learning hypertensionknowledge training scale were considered to enhance the prevention and treatment ofhypertension．2.167patients from functional communities and91patients from residentialcommunities were followed up in this study, the rates of follow-up were77.3%and81.9%, which had no difference. The results after one year standardized treatmentperiod:(1) physical examination: the two groups in body mass index (BMI), andaverage heart rate have no significant difference, the systolic blood pressure control offunctional community is higher than residential community, the rate of hypertensioncontrol in functional community is40.9%, which is lower than the residentialcommunities group (76.9%), the difference is statistically significant (P <0.05).(2)biochemical indexes: there were no significant differences in triglyceride (TG),high-density lipoprotein cholesterol (HDL-C), fasting glucose, creatinine (CRE) and leftventricular hypertrophy between Functional communities and residential communities,total cholesterol (TCH), the rate of total cholesterol (TCH) in the normal level in functional community group is42.1%, which is lower than residential communities group;(3) lifestyle: the differences of the tastes, history of smoking and drinking history werenot statistically significant between the two groups (P>0.05); residential communitygroup is more limit the intake of high fat foods than the functional community group,the difference was statistically significant (P <0.05);50.0%functional communitygroup per week exercise three to five times more than the residential community, thedifference is statistically significant (P <0.05);(4) Risk stratification:20.2%functionalcommunity group dangerous tiered for high risk, functional community group is lessthan residential community group, the differences were statistically significant (P<0.05);(5)drug using:21.6%functional community group prefer non-drug antihypertensivetreatment, which is higher than residential community, the difference was statisticallysignificant (P <0.05); there is significant difference in antihypertensive scheme betweentwo groups (P＜0.05);27.3%functional communities group hypertensive patientsprevently used aspirin when they combined with other cardiovascular andcerebrovascular factors, which is lower than residential community group, thedifference is statistically significant (P <0.05).Conclusion (1) The staff and educational structure of community doctors is still at alow level;（2）it is necessary to popularize knowledge and technique of hypertesionprevention and treatment for optimizing the primary health service agencies, in whichstandard training is significant;(3) There were no significant differences in most of thebiochemical parameters both in the two group during follow-up period, we shouldimprove the community hypertension intervention on lifestyle awareness, pay attentionto health education of hypertension patients in functional communities;(4)Implementing standardized management to hypertension patients in community notonly lower blood pressure level, but also improve hypertension control rate, but stillneeds to be strengthened.