Study On Lifestyle Group Intervention Among People With Prehypertension In Communities

Background:Hypertension as the most common 'rich disease',causes about 7.1 million deaths each year,seriously endangering people's lives and health,while increasing the economic burden of families and society.Therefore,the prevention and control of hypertension disease is imminent.In recent years,people gradually turn preventing the cause of hypertension to preventing risk factors of hypertension.In May 2003 in the United States Hypertension Prevention,Diagnosis,Evaluation and Treatment of the Joint Committee formally put forward the "prehypertension" concept for the first time.Prehypertension is a transitional stage of progression to hypertension.China's mainland region over the past decade adult prevalence of prehypertension was 37%.Numerous studies have shown that gender,overweight or obesity,central obesity,smoking,drinking,and high-salt diet are prehypertensive risk factors.Most of these risk factors can be controlled by exercise,eating habits and other lifestyle changes,and thus to delay or prevent the rise of blood pressure.Experience at home and abroad shows that community intervention is the most effective way to control hypertension.At present,there is a relative shortage of community health resources,lack of compliance with patients and limited to health education in China's hypertension community intervention.The group intervention is a disease management model in which individuals with the same or different diseases are organized together and then their health education,skills training and individual diagnosis and treatment are implemented by health service personnel.Which can solve the problem of increasing of patients and the relative lack of community management doctors in current Chinese community,and poor patient compliance and other issues.In this study,we conducted a baseline survey of the health status of community residents to understand the distribution of prehypertensive population and its risk factors,construct lifestyle group intervention among people with prehypertension in communitie,implement comprehensive intervention measures and evaluate the effect of intervention,to provide a scientific basis for exploring the group intervention model of prehypertension,which is mainly to change unhealthy lifestyle and suitable for the reality of community in our country.Objectives:1.To understand the distribution characteristics and risk factors of prehypertension in residents in the area,and to provide scientific basis for the development of community prehypertension lifestyle group intervention model and its evaluation.2.To explore the construction of community prehypertension lifestyle group ntervention model,and to provide the basis for the community prehypertension lifestyle group intervention.3.To carry out community prehypertension lifestyle group intervention study,compare the changes of physical examination indexes and lifestyle before and after intervention,and evaluate the effect of intervention.And through the intervention to intervene in the prevention and treatment of hypertension core knowledge,improve the health awareness of residents,reduce health risk behavior.Methods:1.A group survey was conducted on the residents of Liangxi County,Wuxi City and Sheyang County,Yancheng City.The subjects were divided into normal blood pressure group,prehypertensive group and hypertension group according to the diagnostic criteria of hypertension and prehypertension.Use t test,?2 test,multi-factor logistic regression to get the distribution of hypertension and prehypertension and its risk factors.2.The prehypertensive patients were randomly divided into intervention group and control group.The community prehypertensive lifestyle group intervention model was constructed and implemented.The intervention mainly included health education of general knowledge of hypertension,general management skills training,group discussions and individual health education,the entire intervention activities are divided into intensive care and intervention and follow-up management.The subjects in the control group were only routinely followed to maintain the current lifestyle.3.The follow-up questionnaire and physical examination were used to evaluate the data collected before the intervention,when intervention for half a year and one year,and compared the changes of the physical examination index and the lifestyle index of the intervention group and the control group,evaluate the effect of intervention.Results:1.The prevalence of hypertension in community residents was 10.14%,and prehypertension prevalence rate was 53.78%in Jiangsu Province.Non-conditional multivariate logistic regression analysis showed that gender,age,educational level,urban and rural,BMI,central obesity and family history of hypertension were influential factors of early hypertension.2.After one years of intervention or management,the systolic and diastolic blood pressure of the two groups decreased,and the effect of the intervention group was more obvious than the control group,the difference was statistically significant(P<0.05).With the prolongation of intervention time,the intervention effect was more significant,the difference was statistically significant(P<0.05).3.After one year of intervention or management,the BMI and waist circumference of the control group increased with the passage of time,while the BMI and waist circumference of the intervention group were good,the difference was statistically significant(P<0.05).With the prolongation of intervention time,the effect of intervention was more significant,the difference was statistically significant(P<0.05).4.After one year of intervention,the amount of smoking and alcohol intake in the intervention group and the control group showed a decreasing trend(P<0.05).The reduction in smoking and alcohol intake between the two groups was not related to the intervention activity,the difference was not statistically significant(P>0.05).5.Before and after the intervention,the daily intake of salt,the daily intake of edible oil and the number of days were improved,and the difference between the two groups was statistically significant(P<0.05).6.The outcome rate of hypertension in the intervention group was 2.78%,which was lower than that of the control group,and the difference was statistically significant(P<0.05).The success rate of the prehypertensive group in the intervention group was 24.44%,which was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:1.Subjects had a higher prevalence of prehypertension and had become an important issue affecting the health of community residents.Sex,age,educational level,urban and rural,BMI,central obesity and family history of hypertension are prehypertensive factors,many of which can be controlled by lifestyle intervention,should be given enough attention.2.To construct the health education,general management skills training,group discussion and individual health education as the main intervention content,to focus on intensive intervention and home follow-up management as the intervention channel of community prehypertension lifestyle group intervention model,reflecting the effect of good,saving time,high efficiency,set follow-up,management in one of the characteristics.3.Community prehypertensive lifestyle group intervention model has a certain effect to improve the community residents to improve the physical indicators and change unhealthy lifestyle.