摘要
目的:研究社区综合干预对高血压前期人群血压及血管功能的影响,探索适合高血压前期人群的社区管理方案。方法:在上海江浦社区按照性别分层、系统抽样随机抽取高血压前期人群400人,并采用随机数字表法将人群分为干预组和对照组,每组200人(男100人,女100人)。干预组采取社区综合干预、多方合作、规范健康管理方案,对照组不采取任何干预措施,随访2年,比较干预前后两组人群血压水平、高血压防治知识知晓、不健康行为减少情况,同时测定干预前后血管功能损害的相关指标:一氧化氮(NO)、内皮素(ET)-1、尿微量白蛋白。结果:(1)基线时,高血压前期人群多有肥胖、不健康的生活方式或饮食习惯,高血压防治知识知晓率低。(2)干预后,干预组的高血压防治知识知晓率明显增加,不健康行为显著减少(P<0.05)。(3)与对照组相比,干预后干预组的血压(收缩压及舒张压)、高血压病检出率明显降低(P<0.01)。(4)干预后,干预组较对照组人群的NO水平上升,ET-1水平下降,尿白蛋白排泄减少(P<0.05)。结论:社区综合干预、多方合作管理是一种有效管理策略,对控制高血压前期人群的血压具有较好效果,并且可延缓或阻止其进展为临床高血压。对高血压前期人群血管功能的改善作用是其可能的分子作用基础。
Objective： To evaluate the therapeutic effect of community-based comprehensive intervention on blood pressure control and vascular function in people with prehypertension.Methods： Four hundred people with prehypertension were selected in Jiangpu community in Shanghai using gender stratification and systematic sampling.People were divided into two groups, study group and control group using random number table with each group including one hundred males and one hundred females. The study group was given comprehensive intervention including health education, lifestyle change, psychological assistance and joint management（patient, doctor and family members）, while the control group was treated with nothing.Blood pressure, hypertension awareness rate, unhealthy behavior status, and biomarkers of vascular function （nitric oxide, endothelin-1, urinary micro-albumin） were detected before and after 2 years intervention. Results： At baseline, individuals with prehypertension were more often obese or overweight clustering unhealthy lifestyle and low hypertension awareness rate. Hypertension awareness rate increased and unhealthy lifestyle rate decreased in the study group compared with the control group after intervention（P〈0.05）. Furthermore, the systolic and diastolic blood pressure, detection rate of hypertension were significantly lower and biomarkers of vascular function improved in the study group compared with the control group（P〈0.05）.Conclusion： Community-based comprehensive intervention is effective in hypertension prevention and control. Improved vascular function had possibly the important role in the hypertension prevention.
出处
《中外医学研究》
2013年第13期16-19,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
高血压前期
社区综合干预
血压控制
血管功能
Prehypertension
Community-based general intervention
Blood pressure control
Vascular function
