家庭远程血压监测在社区高血压患者中的应用研究

目的 探讨家庭远程血压监测在社区高血压患者血压控制中的应用效果,以期探索社区高血压患者血压控制的有效模式。 方法 选取2014年8月-2016年6月在江阴市已确诊并建档管理的高血压患者1 372例,随机分为实验组(690例)和对照组(682例),进行两个月的干预研究。对照组进行常规社区高血压管理,实验组采用家庭远程血压监测技术实时监测血压,社区医生根据患者血压及时给予生活方式指导和调整药物治疗方案。比较两组间血压控制、高血压知识知晓率和生活方式改变情况的差异。 结果 两组入组前年龄、性别、体质指数、高血压分级、收缩压和舒张压水平相比较,差异均无统计学意义(P＞0.05)。实验组和对照组两组自身前后相比较,无论是收缩压还是舒张压水平均下降,差异有统计学意义(P＜0.001);出组时实验组收缩压水平低于对照组,差异有统计学意义(P＜0.001),而舒张压之间差异无统计学意义(P＞0.05)。出组时实验组血压控制率(42.0%)高于对照组(34.6%),差异有统计学意义(χ²=7.999,P=0.005),且实验组的收缩压达标率(50.1%)高于对照组(49.9%)(χ²=13.356,P＜0.001);经过两个月的干预,实验组的患者对高血压危险因素和治疗原则两项知识的知晓率(分别为98.8%、98.6%)优于对照组(分别为97.5%、96.2%),差异有统计学意义(P＜0.05);两组间生活方式相比较,实验组的经常锻炼人数比例(46.8%)高于对照组(43.8%,χ²=4.493,P=0.037)。 结论 家庭远程血压监测是一种有效的社区高血压管理模式,有助于提高患者的血压控制率,并能提高患者的高血压知识知晓率和改善不健康的生活方式,值得在社区推广应用。

Application of home blood pressure telemonitoring to community hypertension control

Objective To explore the application of home blood pressure telemonitoring to blood pressure control among community patients with hypertension so as to explore the effective models of community hypertension tertiary prevention. Methods Totally 1,372 hypertension patients registered and managed in Jiangyin City from August, 2014 and June, 2016 were selected and randomly divided into the experimental group (n=690) and the control group (n=682), and then a 2-month intervention was conducted. The control group was given routine management of hypertension. The experimental group received home blood pressure telemonitoring, life style guidance and medication advice from community doctors. The differences in blood pressure control, awareness rate of hypertension-related knowledge and life style changes were compared between the two groups. Results Before the intervention, no statistically significant differences were found in age, gender, body mass index (BMI), hypertension grade, systolic and diastolic blood pressure levels between the two groups (all P>0.05). After the intervention, the systolic and diastolic blood pressure levels in the experimental group and the control group were both decreased, with statistically significant differences (both P<0.001),and the systolic blood pressure level of the experimental group was lower than that of the control group (P<0.001), but diastolic blood pressure level showed no statistically significant difference (P>0.05). Moreover, the rate of blood pressure control was higher in the experimental group than in the control group (42.0% vs. 34.6%), with statistical significance (χ²=7.999, P=0.005). And the qualified-control rate of systolic blood pressure was higher in the experimental group than in the control group (50.1% vs. 49.9%, χ²=13.356, P<0.001).Besides, the awareness rates of knowledge about risk factors and treatment principles of hypertension in the experimental group were both superior to those in the control group (98.8% vs. 97.5%, 98.6% vs. 96.2%), with statistical significance (both P<0.05). As for the life style, the proportion of patients withregular exercise in the experimental group was higher than that in the control group (46.8% vs. 43.8%, χ²=4.493, P=0.037). Conclusions Home blood pressure telemonitoring is an effective community-based hypertension management model. This model is conducive to improving the patients’ blood pressure control rate, increasing the patients’ awareness rate of hypertension knowledge and eliminating unhealthy life style, and it is worth applying in the community.