| Objective To investigate the status of outpatient blood pressure control in patients with hypertension and diabetes mellitus in Chongqing area and to explore the factors that may affect the effect of blood pressure control.Methods 9 hospitals in the main urban areas and surrounding areas of Chongqing were selected as the survey subjects before May 2018.A questionnaire survey was conducted(demographic characteristics,lifestyle,past medical history,family history and medication status),physical examination(height,waist circumference,hip circumference,body mass index and blood pressure).Data were analyzed by SPSS 23 statistical software.According to data type,t test or chi-square test were used for comparison between groups,and multivariate logistic regression analysis was used to explore the influencing factors.Results The study included a total of 1004 patients with hypertension and diabetes.There were 242 people whose blood pressure reached the control standard <130 / 80 mmHg and the control rate was 24.1%.Single factor analysis showed that thesystolic blood pressure of the peripheral area was 145.43 + 19.55 mmHg,higher than that of the main urban area(138.23 + 19.48mmHg)(p=0.000),and the systolic blood pressure of those without heart failure was higher than that of the combined group(139.99 + 19.60 vs 135.06 + 20.23,p=0.042).Patients without special diseases insurance had higher systolic blood pressure(145.51 + 2.34 vs 133.15 + 1.96/138.77 + 1.82/140.47 +0.73,p=0.001)than those with special diseases insurance.Patients aged<65 years had higher diastolic blood pressure than those aged 65 years or older(82.57 + 11.80 vs 76.23 76.23 11.17,p=0.000),and patients in the peripheral area had higher diastolic blood pressure(81.42,11.13 11.13 vs11.13,p=0.000)than those in the main urban area.Patients with no special disease insurance had higher diastolic pressure than those with special diseases insurance(84.09 + 1.46 vs 78.44 + 1.36/78.33 + 1.06/76.86 + 0.42,p=0.000).The diastolic blood pressure of patients with diabetes duration less than 5 years was higher than that of patients with more than 5 years’ duration(80.17 + 12 vs 76.43,11.5,p=0.000),and the differences were statistically significant(P <0.05).The blood pressure control rate of the patients from the main urban area was significantly higher than that of the peripheral area(26.9% vs 16%,p=0.000);the blood pressure control rate of the patients who spent more than 500 yuan in the treatment month was higher than those who spent less than 500 yuan(28.7% vs 21.9%,p=0.019);the blood pressure control rate of the patients with central obesity waslower than that of the patients without central obesity(22% vs 31.9%,p=0.002).The blood pressure control rate of patients with regular exercise was higher than that of non exercisers(28.5% vs 19.5%,p=0.001);the blood pressure control rate of smokers was lower than that of non smokers(15.7% vs 26.3%,p=0.001);in concomitant diseases and complications,the control rate of patients with coronary heart disease(29% vs 20.5%,p=0.002)and cardiac failure patients(34.7% vs 23.3%,p=0.029)was higher than those without corresponding diseases.The rate of blood pressure control in patients with diabetes mellitus over 5 years was higher than that in patients with shorter duration(26.8% vs 18.5%,p=0.004).In terms of special disease insurance,the lowest blood pressure control rate was 11.6% without special disease insurance,and the highest blood pressure control rate was only in patients with hypertension special disease,which was 32.1%,higher than those with only diabetes specific insurance(25.7%).Multivariate logistic regression analysis showed that from the main urban area(OR=1.79,95% CI:1.20-2.65,P=0.004),with special disease insurance of hypertension(OR=3.16,95%CI:1.27-7.89,P=0.014),Duration of diabetes within 5 years at least(OR=1.76,95% CI:1.20-2.59,P=0.004)were the protective factors affecting blood pressure control rate;Central obesity(OR=0.58,95%CI:0.41-0.83,P=0.002),Not often Exercise(OR=0.55,95%CI:0.40-0.75,P=0.000),Smoking(OR=0.54,95%CI:0.35-0.82,P=0.004),Complicated with coronary heart disease(OR=0.66,95% CI:0.48-0.91,P=0.011)were the risk factors that affects the blood pressure control rate.Conclusion The blood pressure control rate of outpatients with hypertension and diabetes in Chongqing is relatively low,so we should increase publicity and education on chronic diseases such as hypertension and diabetes in the peripheral areas.According to different influencing factors,targeted interventions should be formulated.Patients with combined or concomitant diseases should strengthen comprehensive management to reduce the overall risk.The state should also increase investment in medical care and reduce the burden of patients,thereby improving blood pressure control rate and reducing the risk of cardiovascular and cerebrovascular events. |
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