Objective To analyze the effectiveness of community-based hypertension management after 2009 under the investment of the public health service equalization(PHSE) program in China.Methods The data stemmed from the China Health and Nutrition Survey(1991,1993,1997,2000,2004,2006,2009,2011).A sample of 10 242 participated, and 9 553 who positively responded to the survey were included in the final analysis,including 1 025 with a confirmed diagnosis of hypertension 〔1 007 of whom aged 35-84(317 were under control but other 690 were not) 〕.Trend and isometric analyses were performed to predict the effectiveness of community-based hypertension management in 2013.The risk for 10-year risk of cardiovascular and cerebrovascular diseases and ratio of people with this kind of risk were calculated,so that,long-term (10-year) effectiveness of hypertension management in China was analyzed.Results In 2013,after the social,economic factors and health services developing factors were adjusted,the predicted number of people with awareness of hypertension, people receiving antihypertensive treatment,and those with controlled hypertension was 39 132 883,32 610 735 and 28 697 447,respectively.The weighted 10-year risk of fatal and non-fatal cardiovascular and cerebrovascular diseases for people with controlled hypertension and those with uncontrolled hypertension was 6.34%,16.34%,respectively,indicating that this risk in those with controlled hypertension was lowered by 10 percentage points by hypertension control interventions.The predicted number of people with cardiovascular and cerebrovascular diseases developed from controlled and uncontrolled hypertension in 10 years was 1 819 275,4 689 995,respectively,showing that the cases of such diseases among those with controlled hypertension were decreased by 2 870 720 by hypertension control interventions.Conclusion The PHSE program contributed to the improvement of hypertension awareness,treatment and control in China.It lowered hypertensive population's 10-year risk of developing into fatal or non-fatal cardiovascular and cerebrovascular diseases.Further emphasis needs to be focused on comprehensive interventions for chronic disease patients.The study improved the evaluation of hypertension intervention in primary care,providing an evidence for long-term economic evaluations of the PHSE program in China.%目的 分析2009年后基本公共卫生服务项目投入之下,社区高血压患者健康管理的效果.方法 数据主要来源于国家营养和健康调查(CHNS)(1991、1993、1997、2000、2004、2006、2009、2011年),2009年共调查10 242人,回收有效问卷9 553份,确诊高血压患者1 025例,其中35~84岁高血压患者1 007例,根据血压控制情况分为血压控制组317例和血压未控制组690例.采用趋势分析和等比分析预测2013年高血压患者健康管理效果.计算血压控制组与血压未控制组10年心脑血管疾病发病风险及人数,分析健康管理长期效果.结果 2013年高血压知晓增量人数、治疗增量人数和控制增量人数分别为39 132 883、32 610 735、28 697 447例.血压控制组患者10年心脑血管疾病加权风险为6.34%,血压未控制组患者10年心脑血管疾病加权风险为16.34%,血压控制将10年心脑血管疾病风险降低了10个百分点.血压控制组10年心脑血管疾病发病人数为1 819 275例,血压未控制组10年心脑血管疾病发病人数为4 689 995例.血压控制减少心脑血管疾病发病2 870 720例.结论 基本公共卫生服务项目提高了高血压患者知晓率、治疗率和血压控制率,降低了10年心脑血管疾病发病风险;基层医疗卫生服务机构慢性病患者管理需要不断强化多因素综合干预;研究改进高血压患者健康管理评价方法,为长期效果评价提供依据.
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