Influence of comprehensive intervention on efficacy and safety of antihypertensive therapy in patients with hypertension in the community health service center

Abstract

Objective To explore the influence of comprehensive intervention on efficacy and safety of antihypertensive therapy in patients with hypertension in the community health service center. Methods The subjects were from patients with hypertension who visited Sun Palace Community Health Service Center, Chaoyang District, Beijing from October 2017 to October 2018. The patients who met the criteria were randomly divided into the control group and the intervention group. Patients in the control group were treated only with conventional medication, while patients in the intervention group were treated with additional comprehensive intervention of non-drugs on the basis of conventional medication. After 1 year of treatment, the patients′ blood pressure and the proportion of patients with risk factors for hypertension such as smoking, drinking excess, high salt diet, insufficient exercise, overweight, Zung self-rating anxiety scale (SAS) score >40 and/or Zung self-rating depression scale (SDS) score >40 in the 2 groups before and after treatment were compared; the treatment compliance of conventional medication (taking drugs on time), efficiency of blood pressure control (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg), incidence of adverse cardiovascular events (CAE), and incidence of adverse reactions related to antihypertensive drugs before and after treatment between the 2 groups were compared as well. Results A total of 400 patients were enrolled in the study(200 in the control group and 200 in the intervention group). There were no significant differences in gender, age, course of disease, hypertension grade, and combined diseases in patients between the 2 groups (all P>0.05). After 1 year of treatment, the systolic and diastolic blood pressures of patients both in the control group and in the intervention group were significantly lower than those before treatment (all P 40 and/or SDS score >40 in the intervention group were significantly lower than those in the control group (all P<0.05); the proportion of patients who took drugs on time and efficiency of blood pressure control in the intervention group were significantly higher than those in the control group [82.5% (165/200) vs. 64.0% (128/200), 64.0% (128/200) vs. 52.5% (105/200), both P<0.05]; the incidence of cardiovascular adverse events in patients in the intervention group was lower than that in the control group [1.0%(2/200)vs. 6.5% (13/200), P<0.05]; the incidence of adverse reactions related to antihypertensive drugs in patients in the intervention group was lower than that in the control group[4.0%(8/200) vs. 10.0% (20/200), P<0.05]. Conclusion Comprehensive intervention could significantly improve the efficacy and safety of antihypertensive therapy in patients with hypertension in community health service center. Key words: Hypertension; Community health services; Comprehensive intervention