Objective To investigate the effect of blood pressure control its influencing factors in hypertensive patients under disease management of basic public health services (BPHS) in Yunnan province for improving the patients′ blood pressure control and BPHS′ community disease management.
Methods The participants of the study were 1 521 previously diagnosed hypertension patients aged ≥ 35 years identified via questionnaire interview, physical examination, and laboratory tests conducted among 9 600 permanent adult residents recruited with multistage stratified random sampling in 8 counties/districts of Yunnan province during 2021. Of the participants, 1 011 (66.5%) were assigned into a management group (under the BPHS′s disease management confirmed by matching the participants′ identification card ID number with the records in the BPHS′s disease management information system) and 510 (33.5%) into a non management group (with the ID numbers not matched with the records of the information system). Demographic characteristics, disease management/blood pressure control (maintaining a systolic/diastolic blood pressure below 140/90 mmHg) and their associates of the participants were analyzed and compared between the two groups.
Results The observed blood control rate was significantly higher among the participants of management group than that among those of non management group (33.2% vs. 22.0%, P < 0.05). Compared to those of the non management group, the participants of management group reported significant higher proportions of having received doctors′ lifestyle guidance on decreasing salt intake (89.5% vs. 81.7%), regular physical exercise (86.9% vs. 79.2%), body weight control (84.6% vs. 77.4%), smoking cessation (83.8% vs. 78.7%), restricting alcohol consumption (84.1% vs. 78.3%), and psychological counseling (81.3% vs. 72.9%) (all P < 0.05); for all the participants having accepted the six items of lifestyle guidance mentioned above, the observed blood pressure control rates of the management group′s participants were significantly higher than those of the non management group′s participants ( 33.6% vs. 22.8%, 33.5% vs. 22.0%, 34.3% vs. 22.3%, 33.7% vs. 22.4%, 34.0% vs. 22.5%, and 33.4% vs. 21.7%, all P < 0.05). The results of multivariate logistic regression analysis showed that the participants with higher education, being urban residents, having medication according to physician′s prescription, and receiving BPHS′s disease management were more likely to have their blood pressure under control.
Conclusion In Yunnan province, the community hypertension patients under BPHS′ disease management have a better blood pressure control compared to the patients without the management, suggesting a good efficiency of the BPHS′ disease management in the province.
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