Analysis on management of patients with hypertension in communities in Shanghai

Objective To understand the status of community-based management of hypertensive patients aged thirty-five or above in Shanghai. Methods Data from Shanghai Chronic Disease and Risk Factors Surveillance carried out in 2013 were used to analyze the community-based management and treatment and control of blood pressure of hypertensive patients aged thirty-five or above in Shanghai. Sample was weighted according to complex sampling scheme and post-stratification to calculate the rates with 95% confidence intervals (CI) for the subgroups according to different characteristics. The Rao-Scott χ² test was performed to test for the differences of the rates of the subgroups. Results There were 10 510 hypertension patients were included in the study among which 7 343 patients were aware of their diagnosis, and a total of 3 815 patients had been under management in communities. After being weighted the rate of management of hypertensive patients in communities was 49.74% (95%CI:45.66%-53.83%). There was a significant difference in the proportion of patients receiving management services when comparing different age groups (χ²=68.120, P=0.002), the rate of management among the patients aged sixty-five or above was 55.49%(95%CI:51.58%-59.32%), while among the patients aged thirty-five to forty-four was only 41.20% (95%CI:30.73%-52.54%). The rate of management among females was 51.12% (95%CI:47.17%-55.05%), while males was 48.46% (95%CI:43.34%-53.61%), with no statistical significance (χ²=5.194, P=0.216). The rates of management in urban areas, sub-urban areas and rural areas were 47.66% (95%CI:42.55%-52.82%), 52.92% (95%CI:43.41%-62.24%), 52.84% (95%CI:44.96%-60.58%), respectively, with no statistical significance (χ²=19.281, P=0.432). The follow-up rate in patients with hypertension under standardized management in communities was 21.97%(95%CI:18.61%-25.74%). There was a significant difference between different genders (χ²=65.048, P=0.000). The rate of females was 27.42% (95%CI:22.77%-32.61%), which was higher than the rate of males (16.61%,95%CI:13.02%-20.93%). There were no significant differences among different age groups (χ²=2.017, P=0.834) and regions (χ²=21.244, P=0.111). The treatment rate was 95.47% (95%CI:94.08%-96.54%). There was a significant difference among different age groups (χ²=40.346, P=0.006). The treatment rate among the patients aged sixty-five or above was 96.90% (95%CI:95.39%-97.93%), while among the patients aged thirty-five to forty-four was 89.31% (95%CI:77.94%-95.19%). There were no significant differences among gender (χ²=7.983, P=0.055) and regions (χ²=0.881, P=0.807). The control rate of hypertensive patients managed in communities was 38.98% (95%CI:35.55%-42.51%), There were no significant differences among different age groups (χ²=23.188,P=0.103), gender(χ²=1.050,P=0.468) and regions(χ²=0.529,P=0.938). Conclusion We should further expand the coverage of the standardized management of hypertension patients in the community, and make personalized intervention plan, so as to improve blood pressure control rates of hypertension patients in the community.