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目的研究生活方式干预措施对社区高血压前期和高血压患者的影响,为高血压社区防治工作提供依据。方法选取浙江省嘉兴市和绍兴市社区的高血压前期及高血压患者448例为研究对象,将其分为对照组与干预组。对照组患者不给予个体化干预措施,维持目前生活方式。干预组患者给予为期1年的健康生活方式干预、技能培训和习惯培养,干预内容包括膳食管理、运动管理和戒烟限酒、心理平衡健康教育。结果经过12个月的个体化膳食管理和运动管理干预,随访研究结果显示,干预组患者摄油重和饮酒不良生活方式较对照组显著下降(4.31%︰12.78%,P<0.01;26.79%︰35.84%,P<0.05),收缩压较对照组仍然升高[(122.31±9.28)mm Hg︰(118.72±14.94)mm Hg,P<0.05]。干预组患者6分钟步行距离和健康状况自评较对照组显著上升[(551.09±9.46)m︰(489.63±4.48)m,(91.24±6.88)分︰(88.56±7.82)分,P<0.01]。干预组与对照组12个月与基线相关指标的差值进行比较,提示干预组患者体质指数(BMI)和腰围较干预前轻度下降,对照组升高,两组变化情况比较有显著差异[(-0.47±2.94)kg/m2︰(3.25±4.19)kg/m2,(-0.41±7.82)cm︰(1.31±3.87)cm,P<0.01]。两组收缩压和舒张压较干预前均下降,但干预组患者血压下降程度较对照组显著[(-6.61±7.74)mm Hg︰(-3.62±7.54)mm Hg,(-4.74±9.93)mm Hg︰(-3.99±9.60)mm Hg,P<0.01]。干预组患者血压知晓率、知晓正常高值血压范围、知晓高血压前期相关疾病、知晓有效治疗高血压前期的有效方法的人数构成比均较对照组高(P<0.05)。结论开展社区健康教育能够有效提高高血压前期和高血压患者防治知识水平,个体化生活方式干预能够有效控制体重,降低收缩压和舒张压水平,同时改善患者生活质量。
Objective To study the influence of lifestyle intervention on prehypertension and hypertension in community and provide the basis for prevention and control of hypertension in community. Methods A total of 448 prehypertensive and hypertensive patients from Jiaxing City and Shaoxing City of Zhejiang Province were selected as the study subjects, which were divided into control group and intervention group. Patients in the control group were not given individualized interventions to maintain the current lifestyle. Patients in the intervention group were given a one-year health lifestyle intervention, skill training and habit training. The intervention included dietary management, exercise management, smoking cessation and alcohol restriction, and psychological balance health education. Results After 12 months of individualized dietary management and exercise management interventions, follow-up results showed that patients in the intervention group had significantly lower intake of unhealthy oil and drinking alcohol than those in the control group (4.31%: 12.78%, P <0.01; 26.79% 35.84%, P <0.05). The systolic blood pressure was still higher than that of the control group [(122.31 ± 9.28) mm Hg: (118.72 ± 14.94) mm Hg, P <0.05]. Patients in the intervention group showed a significant increase in 6-minute walking distance and health status compared with the control group [(551.09 ± 9.46) m: (489.63 ± 4.48) m, (91.24 ± 6.88): 88.56 ± 7.82, P <0.01] . Comparing the differences between the intervention group and the control group at 12 months and the baseline related indicators, suggesting that the body mass index (BMI) and waist circumference of the intervention group decreased slightly compared with those before the intervention and the control group increased, the changes of the two groups were significantly different [ (-0.47 ± 2.94) kg / m2: (3.25 ± 4.19) kg / m2, (-0.41 ± 7.82) cm: (1.31 ± 3.87) cm, P <0.01. Systolic blood pressure and diastolic blood pressure in both groups were lower than those before intervention, but the blood pressure in the intervention group was significantly lower than that in the control group [(-6.61 ± 7.74) mm Hg: (-3.62 ± 7.54) mmHg, (-474 ± 9.93) mm Hg: (-3.99 ± 9.60) mm Hg, P <0.01]. Intervention group of patients awareness of blood pressure, awareness of high blood pressure range, known prehypertensive disease, known effective treatment of prehypertensive effective number of people than the control group were higher (P <0.05). Conclusion Community health education can effectively improve the prevention and treatment knowledge of patients with prehypertension and hypertension. Individualized lifestyle intervention can effectively control body weight, reduce the systolic and diastolic blood pressure levels, and improve the quality of life of patients.