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目的评价高血压社区综合干预对育龄女性高血压控制的效果。方法在江苏省太仓市沙溪镇和如东县马塘镇对1932年7月1日以后出生的已婚女性人群进行基线调查,对观察人群实施避孕药使用的知情选择等高血压防治综合干预措施,然后进行终点调查,评估干预效果。结果 (1)干预效果显著,高血压控制率由2.04%上升至22.84%(P<0.001),育龄高血压女性收缩压和舒张压分别下降5.19(95%CI:3.85～6.54)mmHg和6.45(95%CI:5.74～7.15)mmHg;干预效果地区差异明显,太仓市女性高血压收缩压下降达6.53 mmHg,高于如东县女性(3.78 mmHg)(P<0.05)。(2)育龄高血压女性降压药物使用率显著升高,由7.70%上升至55.62%(P<0.001)。(3)育龄高血压女性收缩压随口服避孕药(oral contraceptives,OC)使用时间的增加逐渐升高,呈剂量效应关系(P<0.001);干预后OC累积使用时间与收缩压/舒张压的剂量效应曲线均显著低于干预前(P<0.001)。结论育龄女性高血压社区综合干预效果显著,高血压患者降血压药物使用率显著升高,高血压控制率显著升高,OC累积使用时间与收缩压/舒张压的剂量效应曲线均显著下降。
Objective To evaluate the effect of community-based hypertension intervention on the control of hypertension in women of childbearing age. Methods A baseline survey of married women born after July 1, 1932 in Shaxi Town, Taicang City, Jiangsu Province and Matang Town, Rudong County was conducted to investigate the comprehensive prevention and treatment of hypertension Measure, then carry on the terminal investigation, evaluate the effect of the intervention. Results (1) The effect of intervention was significant. The control rate of hypertension increased from 2.04% to 22.84% (P <0.001), and the systolic and diastolic blood pressure of women of childbearing age decreased 5.19 (95% CI: 3.85-6.54) mmHg and 6.45 95% CI: 5.74 ~ 7.15) mmHg. There were significant differences in the intervention effect areas. The systolic blood pressure of female patients in Taicang City dropped 6.53 mmHg, which was higher than that of women in Rudong County (3.78 mmHg) (P <0.05). (2) The use rate of antihypertensive drugs in women of child-bearing age was significantly increased from 7.70% to 55.62% (P <0.001). (3) The systolic blood pressure in women of childbearing age and hypertension increased gradually with the increase of the oral contraceptives (OC), and the dose-response relationship was observed (P <0.001). After the intervention, the cumulative time of OC and systolic / diastolic pressure Dose-response curves were significantly lower than before intervention (P <0.001). Conclusions The community-wide intervention for women with child-bearing age has a significant effect of comprehensive intervention. Hypertension patients have a marked increase in the use of antihypertensive drugs, a significant increase in the rate of hypertension control, and a dose-response curve of OC cumulative systolic blood pressure and diastolic blood pressure.