高血压患者血压控制情况现状及相关因素分析  

Analysis of current situation and influencing factors of blood pressure control in patients with hypertension

作　　者：胡琳 廖如珺[3] 唐梓桓 吉克春农 朱天宇 曹彧恒 于洁 朱文辉 张华东[4] 廖强[2] 张韬 HU Lin;LIAO Ru-jun;TANG Zi-huan;JIKE Chun-nong;ZHU Tian-yu;CAO Yu-heng;YU Jie;ZHU Wen-hui;ZHANG Hua-dong;LIAO Qiang;ZHANG Tao(West China School of Public Health/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院,四川成都610041 [2]凉山州疾病预防控制中心,四川凉山615050 [3]四川省疾病预防控制中心 [4]重庆市疾病预防控制中心

出　　处：《现代预防医学》2023年第11期2101-2106,共6页Modern Preventive Medicine

基　　金：四川省卫健委项目(20PJ092);四川省科技厅项目(2020YFS0091);重庆市科技局项目(cstc2020jscx-cylhX0003);成都市科技局项目(2021-YF05-01585-SN);凉山州社区诊断项目(H210322)。

摘　　要：目的了解西南某地高血压患者血压控制情况现状及相关因素,为制定高血压有效干预措施提供科学的参考依据。方法以西南某地446名高血压患者作为研究对象,使用完整数据集分析、多重插补法处理缺失数据,构建基于频率logistic回归的血压控制情况模型,探索血压控制相关因素。此外,使用贝叶斯的方法进一步优化研究结果。结果2020年该地高血压患者血压控制率54.32%。多因素分析结果显示,经济中等县(OR=0.189,95%CI:0.123~0.291)、经济较不发达县(OR=0.590,95%CI:0.383~0.910)、日均食盐摄入量≥6g(OR=0.722,95%CI:0.535~0.974)是血压控制达标的危险因素。年龄不小于55岁(与年龄<55岁相比,55~<70岁OR=1.806,95%CI:1.225~2.662;≥70岁OR=2.016,95%CI:1.305~3.115)、规则服药(OR=3.604,95%CI:2.314~5.612)、接受健康教育和指导(OR=2.716,95%CI:1.703~4.330)、接受心肺听诊检查(OR=1.464,95%CI:1.063~2.015)是血压控制达标的保护因素。结论与世界平均水平相比,该地血压控制率较高。有必要对高血压患者定期展开高血压知识普及与指导,促进其规则服药,控制食盐摄入量,在随访或体检时进行心肺听诊检查,从而控制血压,减少高血压带来的重大疾病负担。本研究结果可以为其它欠发达地区制定高血压防治措施提供参考,推动健康事业发展。Objective To understand the current situation of blood pressure control and influencing factors in patients with hypertension in southwest China,so as to provide scientific reference for the formulation of effective intervention measures for hypertension.Methods Using complete data set analysis and multiple interpolation to deal with the missing data,a blood pressure control model based on frequency logistic regression was constructed to explore the influencing factors of blood pressure control.In addition,Bayesian method was used to further optimize the research results.Results In 2020,the blood pressure control rate of hypertensive patients in this area was 54.32%.The results of multivariate analysis showed that moderate economic counties(OR=0.189,95%CI:0.123-0.291),less economically developed counties(OR=0.590,95%CI:0.383-0.910),and average daily salt intake≥6g(OR=0.722,95%CI:0.535-0.974)were risk factors for blood pressure control.The age not less than 55 years old(compared with the age<55 years old,55 to<70 years old:OR=1.806,95%CI:1.225-2.662;≥70 years old:OR=2.016,95%CI:1.305-3.115),regular medication(OR=3.604,95%CI:2.314-5.612),health education and guidance(OR=2.716,95%CI:1.703-4.330),and cardiopulmonary auscultation examination(OR=1.464,95%CI:1.063-2.015)were protective factors for blood pressure control.Conclusion Compared with the global average,the blood pressure control rate in this area is higher.It is necessary to popularize hypertension knowledge and guide patients on regular medication,control salt intake,and take cardiopulmonary auscultation examination during follow-up or physical examination,so as to control blood pressure and reduce the major disease burden caused by hypertension.This study provides reference for other underdeveloped areas to formulate measures for the prevention and treatment of hypertension and promote health.

关 键 词：高血压 血压控制 社区健康管理 贝叶斯logistic回归 

分 类 号：R544.1[医药卫生—心血管疾病] R181.2[医药卫生—内科学]