摘要
目的探讨数字疗法用于中国成人高血压患者自我管理的可行性及效果评估。方法纳入2021年5月1日—12月31日使用数字疗法进行自我管理的高血压患者进行回顾性分析。根据基线收缩压(SBP)值将受试者分为正常血压组(SBP<130 mm Hg)、正常高值血压组(SBP 130~139 mm Hg)、1级高血压组(SBP 140~159 mm Hg)和2级高血压组(SBP 160~179 mm Hg),采用混合效应模型分析血压管理效果。结果队列共纳入1131例,最终数据可用于分析者514例,年龄中位数(四分位间距)是51岁(42~60岁)。正常血压组共237例(46.1%),正常高值血压组共118例(23.0%),1级高血压组共96例(18.6%),2级高血压组共63例(12.3%),各组受试者在26周时SBP降幅(均数标准误)分别为2.9(0.9)、14.2(1.5)、25.9(2.1)、35.3(3.2)mm Hg。基线SBP>140 mm Hg者共159例(30.9%),在26周时血压控制率为87.4%。校正了年龄、性别、体重指数、腰围、吸烟、焦虑、高脂血症、糖尿病、冠心病、卒中、心房颤动、慢性心力衰竭、慢性肾脏病、动脉粥样硬化性心血管疾病风险和是否服用抗高血压药,数字疗法参与度更高与SBP降幅更大相关(P<0.001)。有57例患者在随访过程中出现血压异常升高(SBP≥160 mm Hg),参与度更高与更少出现血压异常升高相关(P<0.001)。结论使用数字疗法进行高血压自我管理可改善高血压的控制率,且能及时发现血压异常升高的情况并及时干预。
Objective To explore the feasibility and efficacy of digital therapeutics for self-management in Chinese adult hypertension patients.Methods A retrospective analysis was carried out on hypertension patients who used digital therapeutics for self-management from May 1 to December 31,2021.Subjects were divided into normal blood pressure group(SBP<130 mm Hg),high-normal blood pressure group(SBP 130~139 mm Hg),grade 1 hypertension group(SBP 140~159 mm Hg),and grade 2 hypertension group(SBP 160~179 mm Hg)according to the baseline SBP.A mixed model was used to analyze the effect of blood pressure management.Results A total of 1131 subjects were included in the cohort,and the final data were available for analysis in 514 subjects with a median age(inter-quartile range,IQR)of 51 years(42 to 60 years).There are 237 patients(46.1%)in the normal blood pressure group,118 patients(23.0%)in the high-normal blood pressure group,96 patients(18.6%)in the grade 1 hypertension group,and 63 patients(12.3%)in the grade 2 hypertension group.The SBP decrease(standard error of mean)of each group at week 26 was 2.9(0.9),14.2(1.5),25.9(2.1)and 35.3(3.2)mm Hg,respectively.The blood pressure control rate in 159(30.9%)subjects with baseline SBP>140 mm Hg achieved 87.4%at 26 weeks.After adjusting for age,sex,body mass index,waist circumference,smoking,anxiety,hyperlipidemia,diabetes,coronary heart disease,stroke,atrial fibrillation,chronic heart failure,chronic kidney disease,atherosclerotic cardiovascular disease risk,and whether to take antihypertensive drugs,higher engagement of digital therapeutics was associated with a greater reduction in SBP(P<0.001).57 patients were observed to have abnormally elevated blood pressure(SBP≥160 mm Hg)during follow-up,and higher engagement was associated with fewer abnormally elevated blood pressure(P<0.001).Conclusion Using digital therapeutics for self-management may help to improve the control rate of hypertension,and can timely detect and intervene the abnormal elevated blood pressure.
作者
何霁云
赵丽明
刘凯
HE Jiyun;ZHAO Liming;LIU Kai(Department of Cardiology,Chengdu Frist People’s Hospital,Chengdu 610041,Sichuan,China;Department of Cardiology,Chengdu Office Hospital of Tibet Autonomous Region People’s Government,West China Hospital,Sichuan University,Chengdu 610041,Sichuan;Department of Cardiology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan)
出处
《心血管病学进展》
CAS
2023年第3期270-276,共7页
Advances in Cardiovascular Diseases
基金
四川省科技厅重点研发项目(2022YFSO356)。
关键词
高血压
自我管理
数字疗法
控制率
参与度
Hypertension
Self-management
Digital therapeutics
Control rate
Engagement
