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

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.