A Study On The Risk Factors And Intervention Of Hypertension Among Residents In Zhenjiang City

ObjectiveTo study the risk factors,protective factors and control status of essential hypertension in Zhenjiang city by means of epidemiological investigation.Furthermore,to construct a modern management system of prevention and treatment of hypertension based on the Internet and to carry out comprehensive intervention and dynamic management for hypertensive patients,improve the control rate of hypertension in this population and reduce the incidence of hypertension complications.Contents1.To make an epidemiological survey of hypertension in the population in Zhenjiang city,and to study the new risk as well as protective factors of hypertension and the status of the medication rate and control rate in the patients with hypertension.2.By establishing a management system of hypertensive information based on the internet,to track and manage the subjects dynamically and comprehensively,and to explore a modern mode of prevention and control for hypertension.Method1.Epidemiological Investigation A cross-sectional study which investigated 3,300 local residents was conducted to collect their clinical baseline data,including blood pressure,family history,weight,waist circumference,diet,and aerobic exercise.Logistic regression analysis was used to explore the new risk factors and protective factors which closely related to the pathogenesis of hypertension,and to investigate the medication rate and control rate of hypertensive patients.2.Comprehensive Intervention and Management of Hypertension Based on Internet of Things(1)To organize a hypertension management team.(2)To collect health files of the hypertension patients.(3)To build a management information system of hypertension based on Internet of Things.(4)Comprehensive intervention and management: Three hundreds of patients with informed consent of hypertensive patients were randomly divided into comprehensive intervention group and independent treatment group for controlled study.Observation indicators: changes of the blood pressure of patients in the two groups,control rate,the incidence of acute or sub-acute hypertension and the total cost of medication.Results1.In this study,multivariate logistic regression showed that the family history of hypertension,disorder of blood glucose,dyslipidemia,high salt diet,drinking,age,waist and weight were the risk factors associated with essential hypertension in Zhenjiang residents(OR=2.911、2.199、1.737、1.401、1.223、1.052、1.030 and 1.021respectively),while OR value of physical exercise is 0.673.The medication rate of Angiotensin Converting Enzyme Inhibitor or Angiotensin Receptor Blocker(ACEI/ARB),Calcium Channel Blocker(CCB),Diuretic(D),ACEI/ARB+CCB,ACEI/ARB+CCB+D and others were 21.75%,19.78%,0.71%,13.55%,1.81% and22.83%,respectively.The total control rate of blood pressure in the people with hypertension was 50.89%.Among them,the control rates of blood pressure in hypertensive patients aged from 30 to 39 years old and those who received junior college or above were the highest.2.Compared with the independent treatment group,the blood pressure control rate in the comprehensive intervention group was significantly increased(61.49% vs 45.16%),while the systolic blood pressure,the diastolic blood pressure and the total cost of drug treatment significantly decreased compared with the independent treatment group.No complications of hypertension occurred in either group during the observation period.Conclusion1.Family history of hypertension and metabolic disorder of glucose are the most important risk factors of essential hypertension in Zhenjiang citizen.By contrast,physical exercise is the protective factor against from hypertension.The control rate of blood pressure in Zhenjiang residents suffering from hypertension were different,depending upon age and educational levels.2.The establishment of a hypertensive management system based on the Internet of Things,which can dynamically track in and comprehensively intervene patients with hypertension,is beneficial to increase the rate of blood pressure control in hypertensive patients and thus reduce the incidence of hypertension complications.