北京房山社区人群心血管病综合防治研究

目的探索我国农村人群心血管病综合防治经验，初步总结一套有推广价值的综合防治方案。方法采用全人群与高危人群结合的防治策略，研究社区范围包括５个乡，１０万以上人口。干预方式和主要措施：（１）在卫生保健服务和社区组织体系基础上建立健全三级防治网。（２）健康教育和健康促进。（３）基层心血管病防治人员的培训。（４）高血压检出、随访和管理。结果基线调查和复查分别于１９９１～１９９２年度和１９９５年完成，通过３年干预，干预区人群知识、态度和行为得分明显高于对照区，干预区人群态度和行为向有利于心血管病防治方向改变。干预区高血压患者血压测量率和管理率分别明显高于对照区（Ｐ＜０．０１）。与对照区相比，干预区人群收缩压净下降１．２ｍｍＨｇ（Ｐ＜０．０５），但体重和体重指数略有升高。干预区脑卒中发病率下降１３．５％（Ｐ＜０．０１）；脑卒中死亡率下降了１２．９％（Ｐ＜０．０１）。对照区正相反，脑卒中发病率和死亡率均有所上升。结论心血管病综合防治方法与措施可行，初步取得预防和降低脑卒中发病和死亡的效果。

The Beijing Fanshan cardiovascular prevention program

Objective The Beijing Fangshan cardiovascular prevention program (BFCP) is a comprehensive community trial which was launched in 1991 and will be completed in the year of 2000 in five communities including three as intervention communities (IC) and two as control communities (CC) in Fangshan, Beijing suburb. BFCP was directed towards creating a basis for application of preventive measures against cardiovascular diseases and designed to be a demonstration program for wider application in rural area of China. Total population covered more than 100 000 residents.Methods The comprehensive intervention combined population with high risk individuals consisting of the following main components:(1) network setup in terms of integrating the program activities with the preexisting service structure and commuity organization; (2) health education; (3) health professional training; (4) detection and management of hypertension.Results A baseline survey was carried out in 1991 1992 and the midterm cross sectional survey in 1995. After a 3 year intervention, the scores of knowledge, attitude and behavior of CVD prevention were improved in the IC versus CC. Proportions of hypertension management with drug and non drug therapy, and the medically controlled hypertensives were higher in the IC than in CC. Systolic blood pressure was 1.2 mmHg net decline in the IC versus CC ( P <0.05)after intervention. Morbidity and mortality of stroke significantly declined by 13.5% and 12.9% respectively (all P <0.01) in the IC versus CC. Conclusion BFCP is feasible and results in significant decrease of the morbidity and mortality of stroke but not of coronary heart disease.