Higher blood pressure control rate in a real life management program provided by the community health service center in China

Purpose: To develop and pilot test the efficacy of a culturally and linguistically sensitive, community health coach (CHC)-based intervention in Chinese immigrants in improving blood pressure control and medication adherence. Design: This study was conducted in 2017 with a cross-sectional design (n = 23). A CHC intervention was implemented using one 25-minute group educational presentation plus one 10-minute question and answer session at baseline, followed by four, 10-minute bi-weekly group question-and-answer sessions. Findings: There was a significant reduction in both systolic and diastolic blood pressure from baseline to week 8: Systolic BP −17.33 (±11.32) (p < 0.005) and diastolic BP −9.58 (±6.57) (p < 0.005). The mean score for medica- tion adherence was 10.56 (±3.24) (possible range 3–15) at baseline and there was no significant change at week 8 (mean 10.89 ± 3.95) (p = 0.86). Conclusion: The CHC-based hypertension management program showed significant reductions in both systolic and diastolic blood pressures in Chinese immigrants. Since the proposed CHC-based hypertension management program is low cost and easy to establish, further investigation is recommended to generate more results for comparison. Practice Implications: There is potential for the CHC intervention to be implemented in clinical settings to help Chinese immigrants at large achieve optimal blood pressure control.

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Combined Management can Decrease Blood Pressure: A Health-seeking Behaviors Investigation among Hypertensive Patients in Urban Communities in China

10.21203/rs.3.rs-154409/v1 ◽

2021 ◽

Author(s):

Si Wang ◽

Kai Liu ◽

Xin Zhang ◽

Qingtao Meng ◽

Xinran Li ◽

...

Keyword(s):

Blood Pressure ◽

Health Service ◽

Community Health ◽

Urban Communities ◽

Community Health Service ◽

Service Center ◽

Health Seeking ◽

Hypertensive Patients ◽

Health Seeking Behaviors ◽

Medical Facilities

Abstract Background: Hypertensive patients can freely choose the informal medical facilities such as pharmacies, community health service centers, and cardiology clinics in secondary or tertiary hospitals, as the routine places for medical treatment in China at present. It is not clear the proportion, influencing factors and the effects on blood pressure (BP) of different health-seeking behaviors among hypertensive patients in urban communities. The aim of the study is to investigate the health-seeking behaviors and the effect on BP of different health-seeking behaviors among hypertensive patients in urban communities in China.Methods: A cross-sectional survey of hypertension was conducted in urban communities in Chengdu. 437 hypertensive patients seeking medical help regularly were sequentially enrolled to fill out the questionnaire on health-seeking behaviors.Results: The average age was 67.1±7.5 years. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 144.2±17.9 mmHg and 75.4±10.4 mmHg, respectively, and the control rate of BP was 41.0%. Among the hypertensive patients investigated, 5.2% of which chose the informal medical facilities, 62.8% chose the community health service center, 21.5% chose the cardiology clinics in secondary or tertiary hospitals, and 10.5% chose both community health service center and cardiology clinics as the usual places for medical treatment. There were statistical differences in education levels, proportions of home BP monitoring, establishing chronic disease archives in community, medication compliance and side effects of drugs among the four groups. The SBP was 150.9 ±19.8, 145.1±18.0, 143.8±17.5 and 136.3±15.1 mmHg (P=0.007) in the four groups respectively and it was significantly lower in the combined management group than in the other three groups. The control rate of BP was 23.8%, 39.4%, 43.0% and 54.8% (P=0.100), respectively. Compared with patients choosing the informal medical facilities, patients in the combined management group had significant higher BP control rate (OR = 3.679, P = 0.035).Conclusions: Combined management with both community health service center and higher-level hospitals can decrease BP.

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Determinants of blood pressure control in hypertensive patients receiving a disease management program provided by a community health center in China

European Heart Journal ◽

10.1093/eurheartj/eht309.p3352 ◽

2013 ◽

Vol 34 (suppl 1) ◽

pp. P3352-P3352

Author(s):

Q. Zhang ◽

X. L. Gao ◽

X. J. Chen ◽

J. Jiang ◽

G. Y. You ◽

...

Keyword(s):

Blood Pressure ◽

Disease Management ◽

Community Health ◽

Health Center ◽

Blood Pressure Control ◽

Disease Management Program ◽

Community Health Center ◽

Pressure Control ◽

Management Program ◽

Hypertensive Patients

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Analysis of the Effect of Nine Consecutive Years’ Intensive Management and Number of Times Achieving the Target Control on Endpoint Events in T2DM Patients in Sanlitun Community Health Service Center in Beijing

International Journal of Endocrinology ◽

10.1155/2020/3646342 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Chen-Mei Zhao ◽

Xue-Li Cui ◽

Gang Wan ◽

Yu-Zhe Lu ◽

Yu-Qin Niu ◽

...

Keyword(s):

Blood Pressure ◽

Health Service ◽

Community Health ◽

Microvascular Complications ◽

Community Health Service ◽

Intensive Management ◽

Service Center ◽

Management Group ◽

Standard Management ◽

Target Control

Objective. To investigate the effect of intensive management and achieving the target control more than 3 times on endpoint events during 9 consecutive years’ annual assessment in type 2 diabetes (T2DM) patients in the Sanlitun Community Health Service Center in Beijing, including blood glucose, blood pressure, lipids profiles, and the joint target control. Methods. In Beijing Community Diabetes Study (BCDS), 224 patients with T2DM from the Sanlitun Community Health Service Center were enrolled in 2008. All patients were randomly assigned to the intensive management group (n = 113) and the standard management group (n = 111). All patients were followed up for nine consecutive years from January 2009 to December 2017. Systolic blood pressure (SBP), diastolic blood pressure (DBP), glycosylated hemoglobin (HbA1c), and low-density lipoprotein cholesterol (LDL-C) were detected as the main indexes, and the endpoint events were also carried out at the same time. The endpoint events were analyzed by using survival analysis (Kaplan–Meier method) based on management grouping and whether achieving the target control more than 3 times or not. Results. During the nine-year follow-up, the abscission number was 35 (14.29%), among which 14 (12.39%) was in the intensive management group and 21 (18.92%) was in the standard management group. The incidence of diabetic retinopathy (6 cases, 5.41%) and diabetic nephropathy (13 cases, 11.71%) in the standard management group was significantly higher than that in the intensive management group (1 case, 0.88%; 5 cases, 4.42%), respectively (P<0.05). However, there were no significant differences on the other endpoint events between the two groups (P>0.05). All-cause death was 23 cases, in which patients who achieved the target control (HbA1c and LDL-C) and the joint target control more than 3 times were significantly lower than that of less than 3 times (P<0.05). As far as death caused by cardiovascular events, cerebrovascular events, and newly onset coronary heart disease are concerned, there were no significant differences on the aforementioned endpoint events between the two groups based on target control more than 3 times or not (P>0.05). There were less incidence of new onset cerebrovascular events, stenosis or occlusion of large arteries, and diabetic microvascular complications in patients who achieved target control (HbA1c and LDL-C) and the joint target control more than 3 times than those with target control less than 3 times (P<0.05). Conclusions. The intensive management can effectively reduce the occurrence of microvascular complications. The incidence of all-cause death and the other endpoint events decreased in T2DM patients who achieved the joint target control more than 3 times during the nine-year management, which improved survival time and life quality. This trial is registered with ChiCTR-TRC-13003978 and ChiCTR-OOC-15006090.

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The Factors Correlated With the Blood Pressure Control Among the Elderly Hypertension in Hangzhou

American Journal of Hypertension ◽

10.1093/ajh/hpab075 ◽

2021 ◽

Vol 34 (12) ◽

pp. 1336-1336

Author(s):

Shi-jun Liu ◽

Qing-min Liu ◽

Hua Ding ◽

Jun Luo ◽

Xin Qiu

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Confidence Interval ◽

Community Health ◽

Blood Pressure Control ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Health Management ◽

Pressure Control ◽

Blood Pressure Control Rate

Abstract Background To evaluate the effectiveness of community health management of elderly hypertension, and to describe the status and related risk factors of blood pressure control. Methods This was a cross-sectional study. Hypertensive patients aged 60 years and above who took part in community health management in Hangzhou were selected. Data on lifestyle, obesity, blood lipids, fasting plasma glucose, and blood pressure were collected. Systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 mm Hg were used to calculate the blood pressure control rate. Results There were 209,768 subjects with mean age (70.7 ± 7.1) years in the present study. The mean value of systolic and diastolic blood pressures was (141.4 ± 16.9) and (80.2 ± 10.0) mm Hg, respectively. The blood pressure control rate was 48.39%. The rate of the subjects with unhealthy lifestyles, obesity (or central obesity), dyslipidemia, and abnormal fasting plasma glucose was 86.27%, 38.20%, 58.16%, and 14.72%, respectively. The unhealthy lifestyle, obesity, abnormal fasting plasma glucose, and dyslipidemia, affected blood pressure control rate, with an odds ratio (95% confidence interval) of 1.18 (1.15–1.21), 1.23 (1.21–1.25), 1.44 (1.40–1.48), and 1.10 (1.09–1.11), respectively. When 4 risk factors were combined, odds ratio (95% confidence interval) was 1.96 (95% confidence interval 1.83–2.09) for poor blood pressure control. Overall, the percentage of isolated systolic hypertension was 34.87% and increased with age. Conclusions The blood pressure control rate of the elderly hypertension patients in the community health management by national essential public health service was 48.39%. Obesity, unhealthy lifestyle, abnormal fasting blood glucose, and dyslipidemia are risk factors of poor blood pressure control and have cumulative effects.

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