The study of management of hypertensive people aged 35 and over in communities in China / 中华预防医学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the community-based management status of hypertensive patients aged 35 or over in China and provide basic data for evaluation by investigating the hypertensive patients managed in communities.</p><p><b>METHODS</b>The subjects in this study were recruited from the individuals of the 2010 China Non-communicable and Chronic Diseases. In September 2011, flow-up survey and a cross-section analysis has been done during the same people interviewed in 2010. Clustering sampling method was used to select 11 977 samples aged 35 or over and diagnosed by doctors from community level or above hospitals to be interviewed. A face to face questionnaire survey was carried out to collect information on general demographic characteristics, the treatment and control of blood pressure and risk factors of the hypertensive patients of community management.Sample was weighted according to complex sampling scheme and post-stratification to represent the population of Chinese hypertensive patients aged 35 or over and the rates with 95% confidence intervals (CI) were calculated for the subgroups according to different characteristics. The Rao-scott χ(2) test was performed to test for the differences of the rates of the subgroups.</p><p><b>RESULTS</b>In the survey, there were 11 977 patients aged 35 or over diagnosed as hypertension by doctors, and among them, a total of 5120 hypertensive patients had been under management in communities. After being weighted the rate of management of hypertensive patients in communities was 43.99% (95%CI38.17%-49.81%). There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ(2) = 21.98, P < 0.01) and sex (χ(2) = 4.18, P < 0.05), the rate of management among the patients aged 65 or over was 46.97% (95%CI40.44%-53.50%), while among the patients aged 35 to 44 was only 37.72% (31.78%-43.65%). The rate of management was higher among females (45.37%, 95%CI39.24%-51.50%) than males (42.50%, 95%CI36.71%-48.30%). The overall rate of standardized management of hypertensive patients managed in communities was 35.30% (95%CI31.78%-38.81%). The research also found differences in the proportions of patients receiving standardized management services when comparing different age groups (χ(2) = 28.66, P < 0.05), gender (χ(2) = 235.85, P < 0.01), and regions (χ(2) = 9.29, P < 0.05). The rate of receiving standardized management services among the patients aged 65 or over was 40.52% (95%CI36.21%-44.82%), while among the patients aged 35 to 44 was only 26.18% (95%CI20.07%-32.29%), the rate was lower among males (16.78%, 95%CI14.13%-19.42%) than females(51.29%, 95%CI46.41%-56.16%) , the rate of patients living in urban areas (38.53%, 95%CI34.34%-42.72%) was higher than patients living in rural areas (33.36%, 95%CI28.17%-38.55%) . The differences of the treatment rates of hypertensive patients managed in communities were found among different age groups (χ(2) = 26.39, P < 0.01), gender (χ(2) = 13.91, P < 0.01), and regions (χ(2) = 4.27, P < 0.05), the rate of treatment was 94.67% (93.41%-95.93%) among the patients aged 65 or over , while 86.47% (95%CI81.05%-91.89%) among patients aged 35 to 44, the rate of treatment was higher among females (94.35%, 95%CI93.15%-95.55%) than among males (90.84%, 95%CI88.99%-92.70%), and it was also higher among patients living in urban regions (94.17%, 95%CI92.62%-95.71%) than among patients living in rural regions (91.86%, 95%CI90.20%-93.52%). The rate of control of hypertensive patients managed in communities was 33.13% (95%CI29.50%-36.76%) and the rate was higher among the subjects living in the urban areas (45.09%, 95%CI38.73%-51.45%) than in rural areas (25.96%, 95%CI21.63%-30.30%) (χ(2) = 22.40, P < 0.01).</p><p><b>CONCLUSION</b>Results from our study showed that community management of hypertension had been popularized across the country. And it could significantly improve the program on the treatment and control of hypertension at the community level in China.</p>