The effect of community hypertension management on blood pressure control and its determinants in southwest China

Int Health. 2020 May 1;12(3):203-212. doi: 10.1093/inthealth/ihaa002.

Abstract

Background: Hypertension is a leading cause of cardiovascular disease (CVD). The purpose of this study was to examine the effectiveness of community healthcare in controlling blood pressure (BP) and mitigating related risk factors after 5 y of follow-up.

Methods: Hierarchical clustering sampling was employed to choose a representative sample of 10 rural and 10 urban community populations (N=4235). The 5y prospective cohort study was completed by the medical group in the community clinical centre.

Results: The study included 4235 patients, median age 69 y (range 61-76), with hypertension in 2009; 2533 (59.81%) were female. The rate of BP control increased from 28.33% in 2009 to 64.05% in 2014. The BP control rate was higher in patients with CVD and kidney disease and lower in those with obesity than in those without. Comparing 2009 and 2014 values, the intervention resulted in median systolic BP and diastolic BP reductions of 7.0 mmHg and 6.5 mmHg, respectively. Age, medication treatment, antihypertensive agents, BP at baseline and follow-up, complications of diabetes, CVD, obesity and kidney disease, the aspartate aminotransferase:aminotransferase ratio and smoking were identified as risk factors for BP control.

Conclusions: Community management of hypertension by general practitioners achieved significant BP control over 5 y of intervention.

Keywords: blood pressure control; hypertension; prospective cohort study; risk factor.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ambulatory Care Facilities
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure*
  • Cardiovascular Diseases / etiology
  • China
  • Community Health Services*
  • Delivery of Health Care / methods*
  • Diabetes Mellitus
  • Female
  • General Practitioners
  • Humans
  • Hypertension / complications
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Kidney Diseases / complications
  • Male
  • Middle Aged
  • Obesity / complications
  • Program Evaluation*
  • Prospective Studies
  • Risk Factors
  • Rural Population
  • Smoking / adverse effects
  • Transaminases / blood
  • Urban Population

Substances

  • Antihypertensive Agents
  • Transaminases