浙江省社区高血压综合防治研究

目的 通过以社区为基础对一般人群、高危人群和高血压现患人群进行5年的高血压及相关危险因素的综合干预，降低高血压和心血管急性事件的发生率和死亡率。探讨以社区为基础的高血压综合防治模式。方法 选择嘉兴、丽水、绍兴三地区分别代表农村、城镇社区、城市，每个地区均设有干预区和对照区。在干预区内对一般人群进行健康促进，对高危人群进行强化干预，对患病人群进行系统管理。结果 通过社区综合干预，(1)提高了人群高血压知识知晓率、服药率(44．65％)和血压控制率(11．78％)；(2)多种高血压危险因素得到进一步控制；(3)高血压患者收缩压下降2．69mmHg．舒张压下降了3．22mmHg；(4)心血管急性事件的发生率和死亡率逐年降低。结论 以社区为基础的高血压综合干预措施对减少人群的高血压危险因素水平，增加高血压患者的治疗率和血压控制率，降低心血管急性事件的发生率和死亡率不仅有效，而且是切实可行的。

The Community-based Comprehensive Prevention and Control for Hypertension in Zhejiang Province

Objective Through the comprehensive interventions on community-based in the general and the high risk population and hypertensive patients for 5 years, to reduce the incidence and mortality rates of hypertension and cardiovascular disease, and to explore the proper pattern of community-based comprehensive prevention and control for hypertension. Methods Selecting the Jiaxin, Shaoxin and Lishui areas as country, city and town communities, and each community was divided into intervention and control area. We carried out health promotion in general population, gave an intensified intervention to the high risk population and established systemic management and treatment on hypertension cases in each prevention area. Results The preventive effects of community-based interventions on hypertension were revealed:(1)The rates of hypertension awareness, taking medicine and blood pressure control in people of prevention areas; (2)Many risk factors for hypertension were controlled. (3)Means of systolic and diastolic blood pressure were significantly decreased (2.69/3.22 mm Hg, respectively) in patients with hypertension; (4)The incidence and mortality rates of hypertension and cardiovascular acute incidents had been reduced year by year. Conclusions The results showed that the community-based comprehensive interventions for hypertension was not only effective to the decrease of the risk factors for hypertension, the increase the rates of treatment and control of hypertension, and the decrease of prevalence and mortality of hypertension and cardiovascular acute incidents, but also practical to them.