Objective To evaluate the effect of community - based detailed hypertension management on control of blood pressure and incidence of stroke in hypertensive patients. Methods Data from the hypertension management database of a community health center in Shanghai between January 2008 and January 2012 were used. A total of 360 cases of hypertensive patients were selected using health screening. They were randomly and evenly divided into two groups after informed consent from each subject were obtained. The patients in the study group were given detailed hypertension management, and the patients in the control group were given chronic disease routine management. Results Mean systolic blood pressure, mean diastolic blood pressure, and mean pulse pressure were significantly different before and after management in both groups ( P <0. 01 ). The decreases in mean systolic blood pressure, mean diastolic blood pressure, and mean pulse pressure in the detailed management group were significantly larger than those of the routine management group ( P <0. 05 ). The stroke incidence rate in the detailed management group ( 15. 56% ) was significantly lower than that in the routine management group ( 28. 89% ) ( P <0. 01 ). Conclusion The community - based detailed hypertension management is more effective than the chronic disease routine management in blood pressure control and stroke prevention in hypertensive patients.%目的 评价社区高血压细节管理对高血压患者血压控制的效果,探索高血压疾病细节管理对高血压患者并发脑卒中的影响.方法 资料来源于上海市某社区卫生服务中心2008年1月-2012年1月社区高血压管理数据库.在社区以健康筛查方法选取360例符合研究要求的高血压患者,经知情同意后,采用随机数字表法分成两组,每组180例患者,分别实施慢性病日常管理和高血压疾病细节管理.结果 细节管理组管理前后平均收缩压(SBP)、舒张压(DBP)、脉压(PP)比较差异均有统计学意义(t值分别为17.09、13.08、5.69,P＜0.01);日常管理组管理前后平均SBP、DBP、PP比较差异亦有统计学意义(t值分别为9.56、4.91、2.88,P＜0.01).管理后,细节管理组患者的平均SBP、DBP和PP净变化差值分别为(7±13)mm Hg、(3±11)mm Hg和(7±16)mm Hg,日常管理组分别为(3±10)mm Hg、(1±6)mm Hg、(3±10)mm Hg,两组比较差异有统计学意义(t值分别为2.99、2.42、2.71,P＜0.05).细节管理组脑卒中发病28例(15.56%),日常管理组脑卒中发病52例(28.89%),两组发病率间差异有统计学意义(χ2=9.26,P＜0.01).结论 高血压疾病细节管理在社区高血压管理中的作用明显,不仅可以更有效地降低高血压患者的血压水平,而且可以减少高血压患者脑卒中的发生.
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