[Status of home blood pressure monitoring and influencing factors of regular home blood pressure monitoring among elderly uncontrolled hypertensive patients in Central and Western China].

Objective: To describe the prevalence of home blood pressure monitoring and analyze the factors influencing regular blood pressure monitoring among elderly uncontrolled hypertensive patients in Central and Western China. Methods: It was a cross-sectional study, which enrolled hypertensive patients aged over 60 years with office blood pressure ≥140/90 mmHg (1 mmHg=0.133 kPa) from September 2019 to July 2020 in 72 hospitals in Central and Western China. Patients completed the electronic questionnaires, and were divided into regular and irregular home blood pressure monitoring groups. The proportion of patients using different types of sphygmomanometers and the percentage of patients with regular home blood pressure monitoring (at least weekly) were explored. The generalized linear mixed model was used to define the influencing factors of regular home blood pressure monitoring. Results: A total of 3 857 patients were included in this study. Age was 67(64,71) years old and there were 2 163 males (56.1%). Overall, sphygmomanometer was available at home for 3 044(78.9%) patients, 2 168(56.2%) patients conducted regular home blood pressure monitoring. Among the patients with a sphygmomanometer at home, 2 370(77.9%) of the sphygmomanometers were upper arm electronic device. Older age, higher income, longer history of hypertension, multiple antihypertensive medications and awareness of diagnostic criteria of hypertension and hypertension complications were associated with a higher prevalence of regular home blood pressure monitoring (all P<0.05). Conclusions: Among the elderly hypertensive patients with uncontrolled blood pressure in Central and Western China, there is a relatively high prevalence of home sphygmomanometer ownership and regular monitoring. Age, family income, history of hypertension, number of antihypertensive drugs and knowledge of hypertension are the influencing factors of regular home blood pressure monitoring in this population.

[Awareness, treatment and control of hypertension in 640 000 adults in eastern China].

Objective: To understand the awareness, treatment, and control of hypertension in residents aged 35-75 years in eastern China, analyze the treatment mode for antihypertensive agents while identifying those factors affecting awareness, treatment and control. Methods: The data collected in eastern China from the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project were used to obtain the information about the awareness, treatment and control of hypertension in the residents and the antihypertensive medication treatment mode in this area. Multilevel mixed-effects model was used to explore the association of the demographic characteristics of hypertension patients with the rates of awareness, treatment and control of hypertension. Results: A total of 640 539 participants aged 35-75 years, mean age (56.9±9.6) years, were included in the analysis, women accounted for 59.7% and 318 741 (49.8%) of the participants suffered from hypertension. Among those hypertensive patients, 46.5% were aware of their condition, 38.1% were taking prescribed antihypertensive medications, and 11.1% had achieved the control of hypertension, the differences were significant among provinces, between urban area and rural area and among different demographical groups. Calcium-channel blockers was the most commonly used medication (45.1%), and 78 735 hypertension patients (86.2%) took only one type of medication. Older age, higher household income, higher level of education, and histories of myocardial infarction, stroke and diabetes were associated with higher awareness, treatment and control of hypertension (P<0.05). Conclusions: The rates of awareness, treatment and control of hypertension were low in residents in eastern China. The differences in hypertension management were significant among provinces and between urban area and rural area. Further efforts are needed to enhance the system of hypertension prevention, screening, diagnosis and treatment.

[Percutaneous coronary intervention in eastern urban China: 2001-2011].

OBJECTIVE: We aimed to assess trends in clinical characteristics, treatment, and outcomes for hospitalized patients undergoing percutaneous coronary intervention (PCI) in eastern urban China from 2001 to 2011. METHOD: We analyzed a Chinese eastern representative sample of hospital admissions for PCI identified in China PEACE-retrospective CathPCI study using a two-stage random sampling design and calculated the weighted data of clinical information in each year. RESULTS: We included 3 308 admissions for PCI in 29 urban hospitals.Between 2001 and 2011, rates of hospitalizations for PCI increased by 15 fold.Compared with 2001, the patients undergoing PCI were more likely to be female, older than 70 years, and to have history of diabetes, hypertension, dyslipidemia and PCI in 2011.The proportion of trans radial PCIs was increased from 3.5% in 2001 to 72.6% in 2011 (Statistic=-28.95, Ptrend<0.000 1); the proportion of drug eluting stents (DES) among all the implanted stents was increased from 18.2%in 2001 to 98.4% in 2011(Statistic=-40.82, Ptrend<0.000 1), largely due to increased use of domestic DES.Less than 10% of medical records of patients undergoing primary PCI documented door time and balloon time.The median length of stay decreased from 13 days in 2001 to 10 days in 2011 (Statistic=-0.11, Ptrend<0.001). In-hospital mortality did not change significantly, but both any bleeding (Statistic= 2.66, Ptrend< 0.01) and access bleeding were decreased significantly (Statistic= 5.55, Ptrend< 0.000 1). CONCLUSIONS: During 2001 and 2011 in eastern urban China, there has been a rapid increase in the number and significant change in treatment patterns of PCI.Quality gaps are identified that represent opportunities to improve care.