A Community-based Study of Non-pharmaceutical Therapy in Patients with Hypertension in Chengdu_West China Medical Journal

Authors：

 HEYu , YANGZhi-yi ,  LIAOXiao-yang , DUXiu-fang

Department of General Practice, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LIAOXiao-yang, Email: liaoxiaoyang@sohu.com

Keywords：

Hypertension; Community; Non-pharmaceutical therapy; Standardized management

DOI：

10.7507/1002-0179.20140253

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effect of non-pharmaceutical therapy in patient with hypertension in Chengdu. Methods From October 2010 to October 2011, a total of 33 general practitioners from 14 community health-care centers in Chengdu were trained by 2009 "Hypertension Guideline" of China for grass-root; each practitioner was required to manage 25 hypertensive patients during one year, based on standardized project. We evaluated the effect of non-pharmaceutical therapy before and after project and the antihypertensive effects from different therapy. Results By the end of 2011, a total of 632 hypertensive patients[aged from 36 to 79 with an average of 65.72±8.55; 263 males with the mean age of (66.41±9.10) years old, 369 females with the mean age of (65.22±8.10) years old], who were eligible for criteria with complete data had been managed for one year. The non-pharmaceutical management includes quitting smoke, limiting alcohol, limiting salt diet, reducing weight and increasing regular physical activity. At the beginning of this project, the acceptance rate of such management were 75.96%, 71.43%, 99.01%, 73.28%, and 85.00%, respectively. After one year of such non-pharmaceutical management, the proportion of patient, who suffered from smoking, alcohol drinking, excess salty diet, overweight and obesity, and lack of physical exercise, decreased from 8.54%, 5.54%, 16.00%, 55.06%, and 23.73% to 3.80%, 1.42%, 2.69%, 34.43%, and 11.39%, respectively with statistical difference (P<0.001). Overweight and obesity is the main risk factor related to lifestyle. During one year management, Systolic blood pressure decreased by 25.81, 23.71, and 27.78 mm Hg (1 mm Hg=0.133 kPa) in the patients with non-pharmaceutical therapy, pharmaceutical therapy, and both, respectively; diastolic blood pressure decreased by 10.23, 3.99, and 10.46 mm Hg, respectively, in the three groups with statistical difference (P<0.05). Conclusion Through the hypertension management, strengthening the cognition of non-pharmaceutical therapy for general practitioner can reduce both high blood pressure risk and cardiovascular risk significantly and comprehensively.

Citation： HEYu, YANGZhi-yi, LIAOXiao-yang, DUXiu-fang. A Community-based Study of Non-pharmaceutical Therapy in Patients with Hypertension in Chengdu. West China Medical Journal, 2014, 29(5): 827-830. doi: 10.7507/1002-0179.20140253 Copy

1.	國家心血管病中心. 中國心血管病報告2012[N]. 醫師報, 2013-8-21(12-13).
2.	李立明, 饒克勤, 孔靈芝, 等. 中國居民2002年營養與健康狀況調查[J]. 中華流行病學雜志, 2005, 26(7):478-484.
3.	Appel LJ, Champagne CM, Harsha DW, et al. Effects of comprehensive lifestyle modification on blood pressure control:main results of the PREMIER clinical trial[J]. JAMA, 2003, 289(16):2083-2093.
4.	Appel LJ, Brands MW, Daniels SR, et al. Dietary approaches to prevent and treat hypertension:a scientific statement from the American Heart Association[J]. Hypertension, 2006, 47(2):296-308.
5.	周超, 雷燕, 楊春霞, 等. 飲酒、吸煙和嗜鹽等生活方式與高血壓發病關聯的Meta分析[J]. 現代預防醫學, 2006, 33(4):488-490.
6.	中華人民共和國衛生部疾病預防控制局, 中華人民共和國衛生部心血管病防治中心,中國高血壓聯盟. 中國高血壓防治指南(2009基層版)[J]. 中華高血壓雜志, 2010, 18(1):11-30.
7.	刁節文, 熊巧麗. 成都市各城區經濟綜合實力分析[J]. 商業經濟, 2012(15):32-34.
8.	Gupta R. Defining hypertension in the Indian population[J]. Natl Med J India, 1997, 10(3):139-143.
9.	Chobanian AV, Bakris GL, Black HR. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. The JNC 7 report[J]. ACC Curr J Rev, 2003, 12(4):31-32.
10.	Tevens VJ, Obarzanek E, Cook NR, et al. Trials for the hypertension prevention research group. Long-term weight loss and changes in blood pressure:results of the trials of hypertension prevention, phase Ⅱ[J]. Ann Intern Med, 2001, 134(1):1-11.
11.	Whelton PK, Appel LJ, Espeland MA, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons:a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group[J]. JAMA, 1998, 279(11):839-846.
12.	Listed NA. Effects of weight loss and Sodium reduction intervention on blood pressure and hypertension incidence in overweight People with high-normal blood pressure. The Trials of Hypertension Prevention, phaseⅡ. The Trials of Hypertension Prevention Collaborative Research Group[J]. Arch Intern Med, 1997, 157(6):657-667.
13.	Hsieh YC, Hung CT, Lien LM, et al. A significant decrease in blood pressure through a family-based nutrition health education programme among community residents in Taiwan[J]. Public Health Nutr, 2009, 12(4):570-577.
14.	Vennegoor MA. Salt restriction and practical aspects to improve compliance[J]. J Ren Nutr, 2009, 19(1):63-68.
15.	趙文華, 翟屹, 胡建平, 等. 中國超重和肥胖造成相關慢性疾病的經濟負擔研究[J]. 中華流行病學雜志, 2006, 26(7):555-559.
16.	Aucott L, Poobalan A, Smith WC, et al. Effects of weight loss in overweight/obese individuals and long-term hypertension outcomes:a systematic review[J]. Hypertension, 2005, 45(6):1035-1041.
17.	馬冠生, 朱丹紅, 胡小琪, 等. 中國居民飲酒行為現況[J]. 營養學報, 2005, 27(5):16-19.
18.	楊功煥, 馬杰民, 劉娜, 等. 中國人群2002年吸煙和被動吸煙的現狀調查[J]. 中華流行病學雜志, 2005, 26(2):5-11.
19.	Drevenhorn E, Kjellgren KI, Bengtson A. Outcomes following a programme for lifestyle changes with People with hypertension[J]. J Clin Nurs, 2007, 16(7B):144-151.
20.	Eriksson KM, Westborg CJ, Eliasson MC. A randomized trial of lifestyle intervention in primary healthcare for the modification of cardiovascular risk factors[J]. Scand J Public Health, 2006, 34(5):453-461.

1. 國家心血管病中心. 中國心血管病報告2012[N]. 醫師報, 2013-8-21(12-13).
2. 李立明, 饒克勤, 孔靈芝, 等. 中國居民2002年營養與健康狀況調查[J]. 中華流行病學雜志, 2005, 26(7):478-484.
3. Appel LJ, Champagne CM, Harsha DW, et al. Effects of comprehensive lifestyle modification on blood pressure control:main results of the PREMIER clinical trial[J]. JAMA, 2003, 289(16):2083-2093.
4. Appel LJ, Brands MW, Daniels SR, et al. Dietary approaches to prevent and treat hypertension:a scientific statement from the American Heart Association[J]. Hypertension, 2006, 47(2):296-308.
5. 周超, 雷燕, 楊春霞, 等. 飲酒、吸煙和嗜鹽等生活方式與高血壓發病關聯的Meta分析[J]. 現代預防醫學, 2006, 33(4):488-490.
6. 中華人民共和國衛生部疾病預防控制局, 中華人民共和國衛生部心血管病防治中心,中國高血壓聯盟. 中國高血壓防治指南(2009基層版)[J]. 中華高血壓雜志, 2010, 18(1):11-30.
7. 刁節文, 熊巧麗. 成都市各城區經濟綜合實力分析[J]. 商業經濟, 2012(15):32-34.
8. Gupta R. Defining hypertension in the Indian population[J]. Natl Med J India, 1997, 10(3):139-143.
9. Chobanian AV, Bakris GL, Black HR. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. The JNC 7 report[J]. ACC Curr J Rev, 2003, 12(4):31-32.
10. Tevens VJ, Obarzanek E, Cook NR, et al. Trials for the hypertension prevention research group. Long-term weight loss and changes in blood pressure:results of the trials of hypertension prevention, phase Ⅱ[J]. Ann Intern Med, 2001, 134(1):1-11.
11. Whelton PK, Appel LJ, Espeland MA, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons:a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group[J]. JAMA, 1998, 279(11):839-846.
12. Listed NA. Effects of weight loss and Sodium reduction intervention on blood pressure and hypertension incidence in overweight People with high-normal blood pressure. The Trials of Hypertension Prevention, phaseⅡ. The Trials of Hypertension Prevention Collaborative Research Group[J]. Arch Intern Med, 1997, 157(6):657-667.
13. Hsieh YC, Hung CT, Lien LM, et al. A significant decrease in blood pressure through a family-based nutrition health education programme among community residents in Taiwan[J]. Public Health Nutr, 2009, 12(4):570-577.
14. Vennegoor MA. Salt restriction and practical aspects to improve compliance[J]. J Ren Nutr, 2009, 19(1):63-68.
15. 趙文華, 翟屹, 胡建平, 等. 中國超重和肥胖造成相關慢性疾病的經濟負擔研究[J]. 中華流行病學雜志, 2006, 26(7):555-559.
16. Aucott L, Poobalan A, Smith WC, et al. Effects of weight loss in overweight/obese individuals and long-term hypertension outcomes:a systematic review[J]. Hypertension, 2005, 45(6):1035-1041.
17. 馬冠生, 朱丹紅, 胡小琪, 等. 中國居民飲酒行為現況[J]. 營養學報, 2005, 27(5):16-19.
18. 楊功煥, 馬杰民, 劉娜, 等. 中國人群2002年吸煙和被動吸煙的現狀調查[J]. 中華流行病學雜志, 2005, 26(2):5-11.
19. Drevenhorn E, Kjellgren KI, Bengtson A. Outcomes following a programme for lifestyle changes with People with hypertension[J]. J Clin Nurs, 2007, 16(7B):144-151.
20. Eriksson KM, Westborg CJ, Eliasson MC. A randomized trial of lifestyle intervention in primary healthcare for the modification of cardiovascular risk factors[J]. Scand J Public Health, 2006, 34(5):453-461.

West China Medical Journal

A Community-based Study of Non-pharmaceutical Therapy in Patients with Hypertension in Chengdu

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content