The status and influencing factors of hypertension control under the family doctor system
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摘要: 目的 了解上海市闵行区H社区高血压病控制现状及相关影响因素,为进一步完善家庭医生制度下的社区高血压病管理提供科学依据。 方法 采取整群抽样方法,抽取2016年5—7月上海市H社区28个家庭医生管理满1年的高血压患者5 558例,进行问卷调查、体格检查与血生化检查,判别血压控制是否达标以及分析影响血压控制达标的相关因素。 结果 高血压病患者的血压控制率为56.37%。单因素Logistic回归分析显示,性别、高血压分级、高血压管理年数、BMI指数、HDL-C为血压控制是否达标的影响因素;多因素非条件Logistic回归分析显示,性别、管理年数、BMI是影响本社区高血压患者血压控制的主要因素。女性患者比男性患者血压控制更好(OR=0.853,95% CI:0.765~0.951),管理时间未满5年的患者比已管理5年以上的患者血压控制要好(OR=1.274,95%CI:1.134~1.431),BMI指数过轻、标准的高血压患者比超重、肥胖的患者血压控制更好(OR过轻=1.918,95%CI过轻:1.080~3.406;OR标准=1.278,95%CI标准:1.070~1.528)。 结论 家庭医生制度下开展社区高血压管理工作已取得一定成效,在今后的社区高血压病防制工作中应重视对男性、肥胖或超重或患病时间长患者的综合干预。Abstract: Objective To understand the status and influencing factors of hypertension control in H community in Minhang District, Shanghai, and to provide scientific basis for further improvement of community hypertension management under the family doctor system. Methods With the cluster sampling method, 5 558 cases of hypertension patients from managed for 1 years by 29 family doctors in H community in Shanghai were selected to get questionnaire survey, physical examination and blood biochemical tests to determine whether blood pressure were under control, and to analyze the influencing factors. Results There were 56. 37% of patients whose blood pressure were under control. Single factor Logistic regression analysis showed that gender, hypertension, hypertension management, BMI index, HDL-C for blood pressure control were the main impact factors; and unconditional Logistic regression analysis showed that gender, years of management, and BMI were the main factors for patients in our community to control blood pressure. Female patients could control blood pressure better than male (OR=0. 853, 95% CI:0. 765-0. 951); time management under the age of 5 years control was better than that over 5 years (OR=1. 274, 95% CI:1. 134-1. 431), BMI index of too light or standard control better than the overweight and obesity (ORtoo light)=1. 918, 95% CI too light):1. 080-3. 406; ORstandard=1. 278, 95% CI标准:1. 070-1. 528). Conclusion Community hypertension management in the family doctor system has certain impacts, and the community hypertension prevention work should pay more attention to the male, obesity or overweight in long term management.
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Key words:
- Family doctors /
- Hypertension /
- Influencing factors
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