CAJ | 학술논문

目的了解北京市45～79岁社区脑卒中高危人群的血压干预效果.方法 2011年5月至2012年4月对北京市7604名45～79岁社区脑卒中高危人群每月随访一次,由社区医生制定个体化的随访管理方案,分析干预后血压平均水平、高血压控制率、脑卒中发病率.结果干预前高血压患病率为64.1％.干预后,收缩压、舒张压分别下降2.9、1.5 mm Hg,血压下降明显(t值分别为-20.987、-15.494,P值均为0.000)；前四次随访血压下降幅度最大；收缩压下降幅度表现为高年龄组下降幅度大(F=14.287,P=0.000),男性高于女性(t=-2.885,P=0.004),郊区人群高于城区(t=5.314,P=0.000),初中及以下文化程度者下降幅度大(t=-6.943,P=0.000)；舒张压下降幅度表现为低年龄组人群下降幅度大(F=22.864,P=0.000),男性高于女性(t=-2.259,P=0.024),初中以上文化程度者下降幅度大(t=2.428,P=0.015).干预后高血压控制率由67.7％上升到87.9％,明显升高(x2=324.595,P=0.000).脑卒中发病率为2.7‰,郊区人群明显高于城区(x2=5.293,P=0.021).结论社区干预可降低脑卒中高危人群的血压平均水平,提高高血压控制率,进而降低脑卒中发病率；以早期血压干预效果好,其中男性血压下降明显.
목적 료해북경시45～79세사구뇌졸중고위인군적혈압간예효과.방법 2011년5월지2012년4월대북경시7604명45～79세사구뇌졸중고위인군매월수방일차,유사구의생제정개체화적수방관리방안,분석간예후혈압평균수평、고혈압공제솔、뇌졸중발병솔.결과 간예전고혈압환병솔위64.1％.간예후,수축압、서장압분별하강2.9、1.5 mm Hg,혈압하강명현(t치분별위-20.987、-15.494,P치균위0.000)；전사차수방혈압하강폭도최대；수축압하강폭도표현위고년령조하강폭도대(F=14.287,P=0.000),남성고우녀성(t=-2.885,P=0.004),교구인군고우성구(t=5.314,P=0.000),초중급이하문화정도자하강폭도대(t=-6.943,P=0.000)；서장압하강폭도표현위저년령조인군하강폭도대(F=22.864,P=0.000),남성고우녀성(t=-2.259,P=0.024),초중이상문화정도자하강폭도대(t=2.428,P=0.015).간예후고혈압공제솔유67.7％상승도87.9％,명현승고(x2=324.595,P=0.000).뇌졸중발병솔위2.7‰,교구인군명현고우성구(x2=5.293,P=0.021).결론 사구간예가강저뇌졸중고위인군적혈압평균수평,제고고혈압공제솔,진이강저뇌졸중발병솔；이조기혈압간예효과호,기중남성혈압하강명현.
Objective To evaluate the effect of blood pressure intervention program on stroke among high risk population aged 45-79 at the community level,in Beijing.Methods 7604 subjects were followed and given specific advice according to the situation of each individual,every month.Data regarding average blood pressure,number of hypertension control and the incidence of stroke among people in the community,were recorded and analyzed.Results Prior to the follow-up program,the hypertension prevalence was 64.1％ but both the systolic and diastolic blood pressure showed a reduction of 2.9 and 1.5 mm Hg,respectively after the intervention program was implemented,with t value as-20.987,-15.494,respectively,and P values were both 0.000.Decrease of BP at the first four follow-up experiences was more obvious.Decrease of systolic blood pressure appeared more in elderly (F value was 14.287,and P value was 0.000),in males (t value was-2.885,P value was 0.004),people living in suburban areas (t value was 5.314,P value was 0.000) and with poorer education (t value was-6.943,P value was 0.000).However,decrease of diastolic blood pressure was seen more in younger age population (F value was 22.864,P value was 0.000),in males (t value was-2.259,P value was 0.024) and those having received better education (t value was 2.428,P value was 0.015).Rate regarding hypertension control increased from 67.7％ to 87.9％ after the intervention program was implemented (x2 value was 324.595,P value was 0.000).Incidence of stroke was 2.7‰ and seen higher in suburban area (x2 value was 5.293,P value was 0.021).Conclusion Community intervention program on hypertension could both reduce the blood pressure and the incidence rate of stroke among high-risk population.The earlier the blood pressure intervention program started,the better the effect would be seen.Reduction of blood pressure in males seemed more obvious.In order to prevent or delay the occurrence of stroke,knowledge on hypertension prevention should be improved among populations at high risk.Individualized and comprehensive follow-up management programs should be strengthened among the community health care takers.