RESUMO
Objective:To understand the epidemiological characteristics of high-risk population of hypertension in Shanghai， and to provide references for health management and targeted lifestyle intervention of the high-risk population in community. Methods:The data from the 2013 Shanghai Non-communicable and Chronic Diseases Surveillance were used. The subjects who met the criteria of high-risk population of hypertension were included， and 11 753 subjects were finally identified， to analyze the distribution and level of risk characteristics. Result:Among six high-risk characteristics of hypertension， the detection rate of high salt in diet was the highest （55.3%）， followed by overweight/obesity （44.0%）， family history of hypertension （41.6%）， and blood pressure level of （130-139）/（85-89） mmHg （31.7%）. The detection rate of excessive drinking was the lowest （5.0%）. The percentage of population with one or two high-risk characteristics was higher than that with three or more high-risk characteristics （76.9% vs. 23.1%）. Systolic blood pressure， diastolic blood pressure， fasting plasma glucose level， and body mass index in the male high-risk group were higher than those in the female group， and the differences were statistically significant （P<0.05）. Systolic blood pressure， diastolic blood pressure， fasting plasma glucose level， body mass index and daily salt intake were different between different age groups， educational level and occupational types （P<0.05）. Systolic blood pressure， diastolic blood pressure， body mass index and daily salt intake were significantly different among high-risk groups with different marital status （P<0.05）. The daily salt intake and systolic blood pressure levels of high-risk population in different areas were significantly different （P<0.05）. Conclusion:We should identify high-risk groups of hypertension as early as possible and actively carry out community health management and targeted lifestyle interventions. The focus should be on the groups and individuals with high-risk characteristics such as dietary high salt and overweight/obesity， male， middle-aged and low-educated groups. In this way， we can reduce the level of high-risk characteristics， prevent and delay the occurrence of hypertension.
RESUMO
Objective To understand the status of community-based management of hypertensive patients aged thirty-five or above in Shanghai . Methods Data from Shanghai Chronic Disease and Risk Factors Surveillance carried out in 2013 were used to analyze the community-based management and treat-ment and control of blood pressure of hypertensive patients aged thirty-five or above in Shanghai .Sample was weighted according to complex sampling scheme and post-stratification to calculate the rates with95 %confidence intervals ( CI) for the subgroups according to different characteristics .The Rao-Scottχ2 test was performed to test for the differences of the rates of the subgroups . Results There were 10 510 hyperten-sion patients were included in the study among which 7 343 patients were aware of their diagnosis , and a total of 3 815 patients had been under management in communities .After being weighted the rate of management of hypertensive patients in communities was 49.74%(95%CI:45.66%-53.83%).There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ2 =68 .120 , P=0 .002 ) , the rate of management among the patients aged sixty-five or above was 55.49%(95%CI:51.58%-59.32%), while among the patients aged thirty-five to forty-four was only 41.20% (95%CI: 30.73% -52.54%).The rate of management among females was 51.12%(95%CI:47.17%-55.05%), while males was 48.46% (95%CI:43.34%-53.61%), with no statistical significance (χ2 =5.194, P =0.216 ).The rates of management in urban areas , sub-urban areas and rural areas were 47 .66% ( 95%CI: 42 .55%-52 .82%) , 52 .92% ( 95%CI:43.41% -62.24%), 52.84% ( 95%CI: 44.96% -60.58%), respectively, with no statistical significance (χ2 =19 .281 , P =0 .432 ) . The follow-up rate in patients with hypertension under standardized management in communities was 21 .97%( 95%CI: 18 .61% -25 .74%) .There was a significant difference between different genders (χ2 =65.048, P =0.000 ).The rate of females was 27.42%(95%CI:227.7 %-32.61%), which was higher than the rate of males (16.61%,95%CI:13 .02%-209.3 %) .There were no significant differences among different age groups (χ2 =2 .017 , P=0 .834 ) and regions (χ2 =21 .244 , P=0 .111 ) .The treatment rate was 95 .47% ( 95%CI: 94 .08% -96 .54%) .There was a significant difference among different age groups (χ2 =403.46 , P=0 .006 ) .The treatment rate among the patients aged sixty-five or above was 96 .90% ( 95%CI:95 .39%-97 .93%) , while among the patients aged thirty-five to forty-four was 89.31%(95%CI:77.94% -95.19%).There were no significant differences among gender (χ2 =7.983 , P=0.055 ) and regions (χ2 =0.881, P=0 .807 ) .The control rate of hypertensive patients managed in communities was 38 .98% ( 95%CI:35 .55%-42 .51%) , There were no significant differences among different age groups (χ2 =23 .188 ,P=0.103), gender(χ2 =1.050,P =0.468) and regions( χ2 =0.529,P =0.938). Conclusion We should further expand the coverage of the standardized management of hypertension patients in the community , and make personalized intervention plan , so as to improve blood pressure control rates of hypertension patients in the community .