GOVERNMENT EXPERT JOINT TWO YEARS INTERVENTION FOR HYPERTENSION AT A MULTI-ETHNIC RESOURCE-CONSTRICTION COUNTY NORTHWEST CHINA IS RELATED TO DECREASED STROKE MORTALITY

Abstract

Objective: Hypertension is common worldwide. Patterns of hypertension may vary in remote less developed areas. Xinjiang Northwest China is a multi-ethnic province with low income, low education and medical resource-constriction background, where hypertension is affecting up to 54.6% of adults of 30 years and older, characterized by lower treatment and control rates and higher prevalence and mortality of stroke. Therefore, we selected Emin county, a typical of above condition, to implement a government-expert joint comprehensive intervention for hypertension between January 2014 to December 2016. The aim is to raise awareness, treatment and control of hypertension, improve access to screening, and to decrease hospital admission and mortality to hypertension, cardiovascular diseases and stroke. Design and method: Efforts were orchestrated from government, hypertension professionals, and general public. Medical staff education and door to door screening and education of population, establishment of hypertension department and BP measuring points, and an evidence- and condition-based 5 step anti-hypertensive treatment algorithm, and systemic management of hypertensive population were the main methods. Medical staff and public education was performed in four languages and materials were prepared in four language. Intervention outcome was evaluated by analyzing the data generated in 2014 and 2016. Results: Cross-sectoral committee organized 102 seminars and training programs for medical staff and and 540 times for population. 1 hypertension department and 184 BP measurement points were founded. Simultaneously with the intervention, 59405 subjects 15 years and older were invited to be screened, and 49497 subjects participated, with a 83 3% response rate. Awareness (64 4% vs 58%, P < 0.001), treatment (44 6% vs 39%, P < 0.001), and control (14 7% vs 10%, P < 0.001) of hypertension were improved at 2016. Hospital admission rates due to hypertension (10 14 vs 8 39%), CVD (4 02 vs 2 60%) and stroke (3 72 vs 3 10%) were decreased. More importantly, mortality due to stroke (23 0 vs 14 0%) was decreased after two years of intervention. Conclusions: With government-expert joint effort, it was possible to achieve higher hypertension awareness and treatment, to decrease hospital admission due to hypertension, CVD and stroke and mortality due to stroke within a short time in resource-constriction area.