关键词: 基本公共卫生服务, 农村, 不同病程, 高血压患者, 血压控制率, 因素分析

Abstract: Objective To analyze the current status of blood pressure control and influencing factors among hypertensive patients under community management in the Sanluo area of Shanghai, and to provide evidence-based support for hypertension prevention and treatment in this region. Methods A cross-sectional study was conducted from October to December 2021, employing a multi-stage sampling method. Hypertensive patients managed under the national basic public health services were recruited to participate in a questionnaire survey, physical measurements, and laboratory examinations. Participants were stratified into three groups based on the duration of their hypertension diagnosis: a short-duration group (≤5 years), a medium-duration group (6-<11 years), and a long-duration group (≥11 years). Univariate and multivariate logistic regression analyses were performed to identify the factors associated with blood pressure control across these different disease duration cohorts. Results A total of 2 894 hypertensive patients under management were included in the study, comprising 1 317 males and 1 577 females. The blood pressure control rates were 48.36% (295/610), 40.86% (257/629), and 39.21% (649/1 655) for the short-, medium-, and long-duration groups, respectively, with the differences among the groups being statistically significant (P<0.01). Statistically significant differences (P<0.01 or P<0.05) were also observed among the three groups with respect to age, educational attainment, marital status, history of cardiovascular and cerebrovascular diseases, history of diabetes, adherence to antihypertensive medication, and blood pressure control. Binary logistic regression analysis revealed that for the short-duration group, annual income (OR=0.553), overweight/obesity (OR=1.513), and total cholesterol (OR=1.563) were significant influencing factors. In the medium-duration group, marital status (OR=0.395) and total cholesterol (OR=1.585) were significant predictors. For the long-duration group, home blood pressure monitoring (OR=0.801) and blood glucose levels (OR=1.699) were identified as key determinants of blood pressure control. Conclusion The rates of blood pressure control among community-managed hypertensive patients with varying disease durations in the Sanluo area of Shanghai are suboptimal. Factors such as home blood pressure monitoring, overweight/obesity, total cholesterol, and blood glucose are major determinants influencing blood pressure control across different stages of hypertension. It is recommended that healthcare professionals develop targeted prevention and treatment strategies tailored to the specific disease duration of patients in order to improve population-level blood pressure control rates.

Key words: Basic public health services, Rural area, Different disease durations, Hypertensive patients, Blood pressure control rate, Factor analysis