Risk Factors Analysis And Intervention Management Of Hypertension In Rural Residents In Northern Jiangsu Province

Background: Hypertension,a common and high-risk chronic disease,can induce important organ diseases such as coronary heart disease,stroke,and kidney disease,seriously affecting the quality of patients' life,and has become a major disease threatening the health of our residents.The prevention and control of hypertension requires long-term and systematic management.In rural areas of China,due to differences in regions,customs,lifestyles,and economic development levels,there are certain differences in the risk factors for hypertension,and the intervention measures are uneven.According to the different conditions of the region,systematically analyzing the risk factors of local hypertension and formulating corresponding intervention strategies and programs,will help to improve the level of prevention and control of chronic hypertension in rural areas,enhance residents' awareness of hypertension prevention and control,improve the quality of life and reduces medical costs.Objective: To provide a scientific basis for the prevention and control of hypertension in rural areas of northern Jiangsu,by studying the risk factors of hypertension in farmers in northern Jiangsu and the evaluation of the effects of interventions.Methods: This study was divided into two parts.The first part was a case-control study.For Shuyang County in the northern part of Jiangsu Province,stratified random sampling was used to randomly select 3 townships.Each township was randomly selected from an administrative village with 3 administrative villages.According to the "Guidelines for the Prevention and Treatment of Hypertension in China"(revised edition of 2010),the case group and the control group were set up by group matching method,and a case-control study was conducted through questionnaire survey to analyze the risk factors of hypertension in the region.A Hypertension risk prediction model was constructed to precisely predict the incidence of hypertension.The second part is the community intervention trial.Using the PRECEDE-PROCEED MODEL health promotion model,combined with local actual conditions,community intervention trials were conducted to promote the study subjects' awareness of hypertension and strengthen self-management and control of hypertension,from June 2018 to May 2018.The comprehensive evaluation of the intervention effect is used to explore the standardized management mode of hypertension management in rural areas,and provide reference for the policy formulation of the health administrative department.Results:Case-control study results: Univariate analysis showed overweight or obesity in the study area(OR=2.501,P<0.001),high-salt diet(OR=3.103,P<0.001),high oil diet(OR=1.806,P=0.008),family history(OR=3.005,P<0.001),physical exercise(OR=0.182,P<0.001),smoking(OR=4.536,P<0.001)and other factors related to hypertension has statistical significance.Multivariate analysis showed that overweight or obesity(OR=2.666,P<0.001),family history(OR=3.269,P<0.001),high-salt diet(OR=2.646,P<0.001),smoking(OR=4.983,P<0.001)is risk factors for hypertension in the study area,and physical exercise(OR=0.165,P<0.001)is a protect factor.Results of community intervention trials: After intervention,the systolic blood pressure level of the intervention group was significantly lower than that of the control group,the difference was statistically significant(P<0.001);the normal blood pressure value of the intervention group,the frequency of blood pressure measurement,concurrent stroke,and concurrency,The awareness rate of normal salt intake and other indicators was higher than that of the control group,the difference was statistically significant(P<0.05).The intervention group needs to take the medicine for life,the drug can be stopped after normal blood pressure,no discomfort or no medication,and other firm belief index is higher than the control group,the difference was statistically significant(P<0.05).The intervention group's measures to control blood pressure,blood pressure control by medication and other indicators were higher than the control group,the difference was statistically significant(P <0.05).The mean compliance of medication was higher than that of the control group,and the difference was statistically significant(P=0.013).The self-behavior of the intervention group,such as intake of edible oil,high oil diet,intake of edible salt,physical exercise were lower than the control group,the difference was statistically significant(P<0.05).The mean mental health status score and quality of life score of the intervention group were higher than the control group,and the difference was statistically significant(P<0.05).The number of days that the intervention group could not work due to hypertension was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Although residents of the region have a certain understanding of the knowledge of hypertension,they have relatively poor knowledge,belief,and behavior about hypertension,and have weak self-management ability for hypertension.Systematic interventions effectively improve the knowledge,belief,and behavior of hypertension in the residents,promote the control of hypertension,and reduce the burden of hypertension.The analysis of the risk factors of hypertension,the comprehensive and systematic scheme of hypertension intervention management based on Green's model,have positive significance for the prevention and control of hypertension in rural residents.