Key result
Community-based hypertension management program linked to an increase in blood pressure control to 85%.
Why the study?
Community health service centers in China play an important role in chronic disease management, but real-life blood pressure control rates and determinants in such programs were not well characterized.
Does a community health service center-based hypertension management program improve blood pressure control rates in community patients?
Cohort (n=3,191)
No
Does a community health service center-based hypertension management program improve blood pressure control rates in community patients?
Absolute Event Rate: 85% vs 32%
p-value: p=<0.001
A community health service center-based hypertension management program in China significantly improved blood pressure control rates from 32% to 85% over an average of 33 months.
May support CHSC hypertension programs for higher control; leaves open generalizability beyond this single-center observational cohort.
BACKGROUND: Community health service center (CHSC) in China is always regarded as a good facility of primary care, which plays an important role in chronic non-communicable disease management. This study aimed to investigate the blood pressure (BP) control rate in a real life CHSC-based management program and its determinants. METHODS: The study enrolled 3191 patients (mean age of 70 ± 10 years, 43% males) in a hypertension management program provided by the Yulin CHSC (Chengdu, China), which had been running for 9 years. Uncontrolled BP was defined as the systolic BP of ≥140 mmHg and/or the diastolic BP of ≥90 mmHg, and its associated factors were analyzed by using logistic regression. RESULTS: The duration of stay in the program was 33 ± 25 months. When compared with the BP at entry, the recent BP was significantly lowered (147 ± 17 vs. 133 ± 8 mmHg; 83 ± 11 vs. 75 ± 6 mmHg) and the BP control rate was dramatically increased (32 vs. 85%) (all p < 0.001). The age of >70 years [1.40 (odds ratio), 1.15-1.71 (95% confidence interval)], female gender (0.76, 0.63-0.93), longer stay of >33 months (0.77, 0.63-0.94), doctor in charge (0.97, 0.95-0.99), and the use of calcium channel blocker (1.35, 1.09-1.67) were significantly related to uncontrolled BP at the recent follow up (all p < 0.05). CONCLUSIONS: This CHSC-run hypertension program provides an ideal platform of multi-intervention management, which is effective in achieving higher BP control rate in community patient population. However, the BP control status could be affected by age, gender and adherence of the patients, as well as practice behavior of the doctors.
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Chen et al. (2014) conducted a cohort in Hypertension (n=3,191). Community health service center (CHSC)-based hypertension management program vs. Baseline (pre-intervention) was evaluated on Blood pressure control rate (SBP <140 mmHg and DBP <90 mmHg) (p=<0.001). A community health service center-based hypertension management program significantly increased the blood pressure control rate from 32% at baseline to 85% after a mean follow-up of 33 months.
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