血压晨峰现象的社区干预措施探讨与实践

目的探讨血压晨峰现象的社区干预措施。方法对入选132位的晨峰高血压患者随机分为干预组和非干预组。其中非干预组64例,予以一般的高血压管理,干预组68例,予以一般的高血压管理以外,并予以我们慢性病管理组牵头的全科团队模式下的社区综合干预措施包括生活方式的调整、心理干预、药物调整、血脂血糖管理等多层面的干预。两组都进行为期3年的随访。结果干预组24小时的平均收缩压、白昼平均收缩压、夜间平均收缩压、收缩压晨峰变异幅度与非干预组相比有显著差异(P<0.01),并且心脑血管事件的发生率也有明显的差异(P<0.01)。结论经过我们慢性病管理组牵头的全科团队模式下的社区综合干预,血压的晨峰现象完全可以得到良好控制,从而减少和避免心脑血管并发症的发生。

Exploration and Practice of Community Intervention in Morning Blood Pressure Surge

Objective To explore and practice community intervention in morning blood pressure surge (MBPS). Methods 132 hypertensive patients with morning peak were randomly divided into intervention group and non-intervention group. The non-intervention group (64 cases) received general management of hypertension, while the intervention group (68 cases) received general management of hypertension and community comprehensive intervention under general practitioner team model. Community intervention was multidimensional intervention launched by our chronic disease management professional group, including lifestyle adjustment, psychological intervention, medication adjustment, blood lipid and blood glucose management. Both groups were followed up for 3 years. Results The 24-hour average systolic blood pressure, mean daytime systolic blood pressure, nighttime average systolic blood pressure, systolic blood pressure variation rate of the morning peak in intervention group had significant difference compared with non-intervention group (P<0.01), while the cardiovascular event rate was also significantly different (P<0.01). Conclusions With the comprehensive community intervention under the mode of general practitioners team launched by our chronic disease management team, the morning blood pressure surge has been controlled well, and the cardiovascular and cerebrovascular complications have been reduced or avoided.