Objective To evaluate the therapeutic and economic effect of community - based comprehensive intervention of Grade 1 hypertension. Methods A total of 200 patients with Grade 1 hypertension were selected in a community in Jinan using gender stratification and systematic sampling. The patients were divided into a study group and a control group using random number table, each group having 50 males and 50 females. The study group was given comprehensive intervention including health education, lifestyle change, psychological assistance and joint management ( patient, doctor, and family members ), while the control group was treated with conventional drug therapy. Blood pressure, blood lipid and blood glucose were measured before and after 3 years of intervention. Hypertension awareness rate, healthy behavior formation rate, and medical costs were also compared between the two groups after 3 years of intervention. Results The cholesterol and physical fitness index were significantly different, but the systolic and diastolic blood pressure, and fasting blood glucose were not significantly different between patients in the two groups after intervention. The hypertension awareness rates were not significantly different between the study group ( 27. 0% ) and the control group ( 29. 0% ) before the intervention ( x2 =0. 099, P =0. 753 ), but after the intervention, hypertension awareness rate in the study group ( 98. 0% ) was significantly higher than that in the control group ( 83. 0% ) ( X2= 12. 767 , P =0. 001 ). Healthy behavior formation rate in the study group ( 96. 9% ) was significantly higher than that in the control group ( 80. 0% ) after the intervention ( x2= 13.832, P < 0. 01 ) . Conclusion Community - based comprehensive intervention is effective in hypertension prevention and control. The intervention improves the awareness rate of hypertension and healthy behavior formation rate, and reduces the medical costs.%目的 通过社区综合干预对1级高血压人群血压影响的研究,了解其对血压和医药费用等方面的控制效果,进一步规范高血压患者的管理,探索1级高血压人群社区绿色防治方法.方法 在济南市天桥区北村街道办事处某社区按照性别分层、系统抽样随机抽取1级高血压人群200人,并采用随机数字表法分为干预组和对照组,每组100人(男50人,女50人).干预组采取社区综合干预、多方合作、规范健康管理方案,对照组采取常规药物治疗方案,随访3年血压、血脂、血糖等生物学指标.另外,分析人群高血压防治知识知晓率及健康行为形成率的变化,并分析医药费用控制情况.结果 (1)干预后两组的收缩压、舒张压和空腹血糖间差异无统计学意义(P＞0.05),但胆固醇和体质指数间差异有统计学意义(P＜0.05).(2)干预前干预组和对照组的高血压相关知识知晓率分别为27.0%和29.0%,二者间差异无统计学意义(χ2=0.099,P=0.753);干预后两组高血压相关知识知晓率分别上升为98.0%和83.0%,二者间差异有统计学意义(χ2=12.767,P=0.001).(3)干预后两组健康行为形成率分别为96.9%(95/98)和80.0%(80/100),干预组高于对照组,差异有统计学意义(χ2=13.832,P＜0.01).结论 社区综合干预、多方合作管理是一种绿色防治方法,对1级高血压的预防和控制有良好效果,并可明显提高社区居民高血压相关知识知晓率和健康行为形成率,而且大大降低了患者的医药费用.
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