Study Of Community-based Comprehensive Intervention For Hypertension In Changsha City

Objective:To research the changes of the awareness rates of health knowledge and bad behaviors about hypertension in Changsha after community comprehensive intervention, and evaluate the effects of community comprehensive intervention. And it’s also analysis the influencing factors of the awareness rates of health knowledge about hypertension, risk behaviors and effect of blood pressure control.Methods:Using multi-stage stratified cluster random sampling method. First, a township was selected from each of nine counties in Changsha City, then from the pits of each township randomly selected three villages, finally30residents above18-year-old were selected from the every village (they are hypertension patients, high-risk population and healthy population. Each group has10subjects). Respondents will be tracked survey in the followed three years.The questionnaire includes social demographic characteristics, health knowledge about hypertension, risk factors, physical and laboratory examination, follow-up, taking medicine, and so on.Epidata3.1is adopted to establish the database. SPSS18.0is used to analysis data. Ratio, χ2test, multiple independent samples non-parametric test, binary classification logistic regression and other methods are used to describe and analyze the data.Results:In2010-2012,2430questionnaires were distributed and recycled later. The recovery rate is100.00%and the total effective response rate is97.65%.In patients and high risk population, the differences of awareness rates of blood pressure, blood glucose, blood lipids and body weight in three years are statistically significant; there is no difference within years in awareness rates of diagnostic criteria of hypertension. In healthy population, the difference of awareness rates of health knowledge about hypertension in three years has statistical significance.In patients, the differences of drinking frequently (χ2=20.99,P0.00), excessive salt intake (χ2=8.08, P=0.02) and great life stress (χ2=28.91, P=0.00) in three years have statistical significance. In high risk population, only the difference of lack of exercise (χ2=8.39, P=0.02) is statistically significant. In healthy population, lack of exercise and great life stress in different years are statistically significant.In patients, there are differences within years in over standard rates of SBP (and/or DBP)(χ2=17.13, P=0.00), TC (χ2=12.59, P=0.00) and TG (χ2=7.93, P=0.02). Those in high risk population aren’t statistically significant. In healthy population, only the difference of over standard rates of TC among three years was statistically significant.There are significant significance in medication regularity (H=7.04, P=0.03) and the control effects of blood pressure (H=9.60, P=0.01) in Patients among three years.The influence factors of awareness rates of blood pressure in patients are profession (OR profession=in-service=2.72, OR profession=retired=6.22) and years (OR year=2012-4.61). Those in high risk population are gender (OR=1.50), age (OR=0.81), profession (OR profession=in-service=2.41, OR profession=retired=2.77) and years (OR year=2012=2.00). Those in healthy people are age (OR=1.25), profession (OR profession=in-service=3.06) and years (OR year=2011=1.85, OR year=2012=2.18). The influence factors of awareness rates of blood glucose in patients are gender (OR=0.66), age (OR=1.33), level of education (OR=1.38), marital status (OR marital status=unmarried=0.06, marital status=divorce or spouse=0.38), profession (OR profession=in-service=2.11, OR profession=retired=1.66)and years(OR year=2012=3.22).Those in high risk population are profession(OR profession=in=serice=2.06, OR prfession=retired=3.31) and years(OR year=2012:3.49).Those in healthy people are marital status (OR marital status=unmarried=0.21),profession(OR profession=in-service=2.20, OR profession=retired=2.86)and years(OR year=2012=3.50).The influence factors of awareness rates of blood lipids in patients are gender(OR=0.67), profession(OR profession=in-service=1.68,OR profession=retired=2.11)and years (OR yera=2012=2.44).Those in high risk population are age(OR=0.75), profession(OR profession=in-service=2.00,OR proession=retired=3.65)and years (OR year=2012=2.21).Those in healthy people are age(OR=1.38),level of education(OR=2.22),marital status(OR marital stutus=unmarried=0.17), profession(OR profession=in-service=1.83,OR proession=retired=2.84) and years (OR year=2011=1.49,OR year=2012=3.08).The influence factors of awareness rates of diagnostic criteria of hypertension in patients are gender (OR=0.61),age(OR=1.25)marital status(OR proession=retired=0.09, OR marital status=divorce of spouse=0.28) and profession (ORprofession=in-service=1.80, OR proession=retired=3.01).Those in high risk population are profession (OR profession=in-service=3.15,OR proession=retired=3.02)and years (OR year=2012=1.62).Those in healthy people are age(OR=1.25),level of education (OR=1.73),profession (OR proession=in-service=2.93, OR proession=retired=4.76) and years (OR=year=2012=2.00).The influence factors of awareness rates of weight in patients are level of education (OR=1.53), profession (OR proession=retired=2.76) and years (OR year=2012=2.01).Those in high risk population are age (OR=0.64),level of education((OR=1.56),profession (OR proession=in-service=3.61, OR proession=retired=3.93)and years(OR year=2011=0.49).Those in healthy people are level of education (OR=1.50), profession (OR profession=in-service=2.86) and years (OR year=2011=0.50).The influence factors of smoking in patients are gender (OR=15.72), age (OR=1.34), level of education (OR=1.38) and profession (OR profession=retired=2.08). Those in high risk population are gender (OR=13.92), age (OR=1.23) and profession (OR profession=in-service=1.86, OR profession=retired=3.81). Those in healthy people are gender (OR=22.61) and profession (OR profession=in-service=1.94). The influence factors of drinking in patients are gender (OR=5.60), marital status (OR marital status=unmarried=0.09), level of education (OR=0.40) and years (OR year=2011=2.96, OR year=2012=5.51). Those in high risk population are gender (OR=21.05) and age (OR=1.35). The influence factors of salt intake in patients are gender (OR=1.59), profession (OR profession=in-service=1.68, OR profession=retired=2.27) and years (OR year=2012=0.68). This in high risk population is profession (OR profession=in-service=2.08, OR profession=retired=3.11). Those in healthy people are gender (OR=2.45), age (OR=1.41), marital status (OR marital status=divorce or spouse=2.69), and level of education (OR=1.64). The influence factors of physical activity in patients are age (OR=1.62) and profession (OR profession=retired=1.75). Those in high risk population are age (OR=1.43), level of education (OR=0.70) and years (OR year=2012=1.75). Those in healthy people are level of education (OR=0.60), marital status (OR marital status=unmarried=4.51) and years (OR year=2012=1.72). The influence factor of mental pressure in patients is years (OR year=2012=8.12). Those in high risk population are gender (OR=0.55) and age (OR=1.72). Those in healthy people are profession and years.The influence factors of effects of blood pressure control are profession (OR profession=retired=1.98) and years (OR year=2011=1.70, OR year=2012=2.07). Conclusions:Community management and intervention of high blood pressure have acquired certain effects.After the intervention, awareness rates of blood pressure、diagnostic criteria of hypertension, blood glucose, blood lipids and weight are higher than that of before.After the intervention, Exposure rates of smoking, often drinking, great life stress in patients, and smoking, lack of exercise and great life stress in high risk population, and smoking, drinking frequently, excessive salt intake and lack of exercise in healthy people are declining.After the intervention, the over standard rates of SBP (and/or DBP), TC and TG in patients are lower than that of before.After the intervention, medication regularity and the control effect in patients are better than that of before. Year and profession are the influencing factors of effectiveness of blood pressure control.It is the key point of improving the awareness rates of health knowledge about hypertension to enhance behavioral intervention and health education in the population of female, elderly, unmarried, unemployed and low education. It is the key point of reducing the incidence of hypertension related risk behaviors to enhance behavioral intervention and health education in the population of men, young, and unemployed. Both awareness rates and incidence of hypertension related risk behaviors can be improved through prolonging the time of intervention.