Abstract
BackgroundCommunity-based blood pressure (BP) monitoring plays an important role in national hypertension management in China. However, the utilisation of this service, together with its associations on hypertension treatment and BP control has not been fully investigated.MethodsThe study population was from the China Health and Retirement Longitudinal Study (CHARLS) in 2015. Cross-sectional data of 2487 hypertensive persons were included as subjects. Stratified sample households were selected from 450 villages or communities of 150 counties from 28 provinces. Finally, 21,097 individuals were interviewed successfully. The main outcome was hypertension control (having average BP under 140-90 mmHg). The main independent variable was utilisation of community-based BP monitoring service (having BP examination once a season or more). The mediators were hypertension treatment (currently taking any antihypertensive medicine) and lifestyle factors (alcohol intake, physical activity, smoke). We performed chi-square and binary logistic regression to analyse associations of BP monitoring with hypertension treatment and blood pressure control. The mediation model was examined by the Sobel test.ResultsMean age of the population was 64.2 (0.24). The percentage of males was 42.8%. Prevalence of community-based BP monitoring was 32.1%. Patients who used this service had higher odds of hypertension treatment (β = 1.259, P < 0.01, OR = 3.52, CI = 2.467–5.030), and BP control (β = 0.220, P < 0.05, OR = 1.246, CI = 1.035–1.499). Medication treatment played a complete mediating role between monitoring and hypertension control in this study (t = 4.51, P < 0.001). Those who underwent BP monitoring tended to be those who did not finish primary school education (χ2 = 30.300, P < 0.001), had poorer household income (χ2 = 18.298, P < 0.05), and lived in rural areas rather than in urban areas (χ2 = 40.369, P < 0.001).ConclusionsAlthough the use of BP monitoring service had no direct effect on BP control, it had a positive effect on BP control through the full mediation effect of hypertension treatment. Termly BP monitoring by community-based health expertise among hypertensive persons, for instance, once a season, can be recommended to public health policymakers for BP control through instructions on medication treatment and health behaviours.
Highlights
Community-based blood pressure (BP) monitoring plays an important role in national hypertension management in China
Supported by previous study reports, our hypothesis is that community-based BP monitoring has a positive effect on hypertension control through medication treatment and healthy lifestyle establishment. (Fig. 1) this study aims to provide an overall estimate of national-level utilisation of community-based BP monitoring service among hypertensive persons and to explore its association with blood pressure control
32.1% of subjects had BP monitored by the community or village doctors. 28.0% of subjects were uneducated. 80.0% of them lived with a spouse or cohabitated. 52.8% of them were from rural areas and 54% had a job. 94% of them were insured. 77.9% of hypertensive persons seldom drank
Summary
Community-based blood pressure (BP) monitoring plays an important role in national hypertension management in China. Hypertension is associated with higher risks of cardiovascular diseases (CVD) accounting for 17 million deaths in 2013 worldwide [1]. It results in other NCDs such as diabetes and chronic kidney diseases. The prevalence of hypertension has been rising in decades in both developed and developing countries [2,3,4,5,6,7]. In China, hypertension prevalence is rising as the population grows older. According to a recent study, the prevalence of hypertension among people in the age group of 35–75 is 44.7, 92.6% of whom were above 45 years old [9]
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