Follow-up And Intervention Study On High Risk Population Of Cardiovascular Disease In Rural Residents Of Southern Jiangxi Province

Objective:In this study,we conducted multiple follow-ups and interventions on high-risk groups of 35-75 year old Cardiovascular Desease(CVD),to understand the high-risk characteristics of high-risk CVD population in rural areas of Gannan,and to study and evaluate the intervention effect of CVD high-risk population.To explore the factors influencing the intervention effect of high-risk populations of CVD,and to construct an intervention evaluation model to provide reference and basis for cardiovascular disease prevention and treatment evaluation.Methods:Randomly selected rural residents aged 35-75 in a county of Ganzhou were screened for high-risk CVD population.2246 cases of high-risk CVD were screened for follow-up and comprehensive intervention management.The intervention included lifestyle recommendations and cardiovascular disease.Level and secondary prevention.The evaluation indicators include blood pressure,body weight,blood sugar,blood lipids,smoking,drinking,physical activity,dietary status,and health-related quality of life.Through the principal component analysis,the cumulative contribution of more than 70%of the principal component indicators and the corresponding scores,establish a comprehensive evaluation model for the intervention effect of CVD high-risk groups.Results:1.The detection rate of high-risk CVD in rural areas of Gannan was 23.13%.The high-risk detection rates of four high-risk types of high blood pressure,dyslipidemia,high risk,and cardiovascular history were 17.07%,7.27%,4.78%and 0.66%,respectively.2.Single-factor repeated measurement of smoking,frequent drinking,amateur non-exercise,and obesity in high-risk populations of CVD were different(P<0.001).Before the intervention,compared with the intervention for 2 years,the OR values of smoking,regular drinking and obesity were 1.704,2.716 and 2.110,respectively,which were statistically significant(P<0.001),suggesting that smoking,regular drinking and obesity were significantly lower than before intervention.The OR value before amateur non-exercise intervention was1.076(P>0.05).3.Single factor repeated measurement of CVD high-risk groups often eat mixed grains,often eat meat,often eat fresh vegetables,and often eat pickled vegetables behavior changes(P<0.001).Before the intervention and the intervention for 2 years,the OR values of cereals,meat,and pickled vegetables were 0.635,3.194,and 2.371,respectively,which were statistically significant(P<0.01),suggesting that the behavior of frequent cereals was increased;The behavior of pickled vegetables decreased.The OR value of the fresh vegetables before the intervention was 1.131(P>0.05),suggesting that often eat fresh vegetables behavior has no obvious change.4.After 2 years of comprehensive intervention,,BMI,systolic blood pressure,diastolic blood pressure and heart rate of the high-risk group were decreased by 0.727 cm,1.306 kgr/m2,22.189 mmHg,6.857 mmHg and 4.00 4times per minute,respectively(P<0.01);the waist circumference were decreased by 0.727 cm(P>0.05).5.After comprehensive intervention,the laboratory test indicators of CVD high-risk groups changed significantly.The values of TC,LDL-C and FPG decreased year by year.The intervention for 2 years decreased by 0.554mmol/L,0.288mmol/L and 1.151mmollL,respectively.The decrease was significant.The intervention of HDL-C and TG values increased by 0.043mmol/L and 0.147mmol/L respectively(P<0.01).6.After 2 years of comprehensive intervention,the health-related quality of life of CVD high-risk groups:the ability of action and daily living ability increased by 0.02 points compared with the intervention,and the paim/discomfort and anxiety/depression scores increased by 0.13 points and 0.07 points respectively.The difference was statistically significant(P<0.001);there was no change in self-care ability score(P>0.05).7.Principal component analysis was carried out on 15 intervention evaluation indicators to construct a comprehensive intervention effect evaluation model for CVD high-risk groups:Fi=?1 X1+?2 X2+?3 X3+...+?jXj(j=1,2,3,4...)F = ?1F1 + ?2F2 + ?3F3 +...?jFj(j= 1,2,3,4,...)·Conclusions:1.The detection rate of high-risk CVD in rural areas of Gannan was 23.13%,among which the high blood pressure detection rate(17.07%)was the highest,followed by dyslipidemia(7.27%),high risk(4.78%)and cardiovascular history(0.66%),residents should pay more attention to their blood pressure and blood lipid changes.2.Individualized comprehensive intervention can change the bad habits and behaviors of CVD high-risk groups,reduce the risk of smoking?regular drinking and obesity,increase the regular consumption of miscellaneous grains and reduce the frequent eating of meat and pickled vegetables.3.Individualized comprehensive intervention can effectively improve the self-management ability of CVD high-risk groups,improve their lifestyle and reduce the waist circumference,BMI,systolic blood pressure,diastolic blood pressure,heart rate,TC,LDL-C,FPG values and increase HDL-C value of high-risk groups,gradually reaching one Stable and ideal state.4.Individualized interventions in high-risk populations of CVD can significantly improve their health-related quality of life and improve their pain/discomfort and anxiety/depression.5.In view of the low cultural level of high-risk objects in rural areas of Gannan,the high proportion of the elderly,the lack of self-management awareness,the active participation in physical exercise and the unreasonable diet,it is very necessary to take individualized and targeted interventions.Significantly improve the intervention and control effects of CVD risk factors.6.Prolonged intervention time and increased number of interventions can achieve better intervention results.7.A comprehensive evaluation model of intervention effect of CVD high-risk population based on principal component analysis was constructed,and the intervention effect could be evaluated by comprehensive score.