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目的 评估系统性强化健康教育对社区老年高血压人群干预效果.方法 采取整群抽样的方法选取太原市西峪社区的2个居委会社区,地理位置相距8 km,根据纳入、排除标准将该社区所有已确诊的老年高血压患者随机分为干预组和对照组.干预组314例,对照组319例.干预组给予为期1年的系统性强化健康教育,对照组仅给予1年的常规健康教育.1年后对两组患者的血压值、体质指数、空腹血糖、血脂水平、不良生活行为的改变情况进行评价.结果 经过1年的随访,干预组收缩压从干预前的(136.75±14.62)mmHg(1 mmHg=0.133 kPa)下降至干预后的(131.11±7.71)mmHg,舒张压从(81.22±7.71)mmHg下降至(80.45±5.12)mmHg,体质指数、空腹血糖、总胆固醇、低密度脂蛋白胆固醇分别从(25.02±3.09)kg/m2、(5.85±1.50)mmol/L、(5.23±0.99)mmol/L、(2.98±1.07)mmol/L下降至(24.22±2.73)kg/m2、(5.23±1.50)mmol/L、(4.42±1.31)mmol/L、(2.73±0.95)mmol,干预前后差异具有统计学意义(P<0.05或0.01).对照组收缩压从干预前的(137.83±13.83)mmHg下降至干预后的(133.14±7.69)mmHg,舒张压从(82.04±7.62)mmHg下降至(81.22±5.29)mmHg,空腹血糖、总胆固醇分别从(5.67±1.49)mmol/L、(5.27±1.02)mmol/L下降至(5.47±1.53)mmol/L、(4.70±1.25)mmol/L,干预前后差异具有统计学意义(P<0.05或0.01).两组在收缩压、体质指数、空腹血糖、总胆固醇方面的差异具有统计学意义(P<0.05或0.01).不良生活方式改变方面:两组干预前后在戒烟、规律体育锻炼、低盐饮食、控制体重等方面的差异具有统计学意义(P<0.01).结论 系统性强化健康教育对社区老年高血压患者的血压控制及不良生活方式的改善有效.

Objective This study evaluated the effects of a systematic intensive health education intervention in community-dwelling elderly individuals with hypertension. Methods Using a cluster sampling method,we selected two neighborhoods in the Taiyuan Xiyu community,which were located 8 km apart.We randomly assigned all elderly community residents who were diagnosed with hypertension to one of two groups according to the inclusion and exclusion criteria:the intervention group(n=314)or the control group (n=319). The intervention group received a 1-year systematic intervention of intensive health education, whereas the control group only received 1 year of routine health education. After 1 year, blood pressure, body mass index, fasting blood glucose, blood lipid levels, and changes in poor health behaviors were evaluated in both groups. Results The systolic blood pressure of hypertensive patients in the intervention group decreased from(136.75±14.62)mmHg(1 mmHg=0.133 kPa)before the intervention to (131.11 ± 7.71) mmHg after the intervention. The diastolic blood pressure of hypertensive patients in the intervention group decreased from(81.22±7.71)mmHg before the intervention to(80.45±5.12)mmHg after the intervention. Body mass index, fasting blood glucose, total cholesterol, and low-density lipoprotein cholesterol decreased from(25.02±3.09)kg/m2,(5.85±1.50)mmol/L,(5.23±0.99)mmol/L,and(2.98±1.07) mmol/L before the intervention to(24.22±2.73)kg/m2,(5.23±1.50)mmol/L,(4.42±1.31)mmol/L,and(2.73±0.95)mmol/L after the intervention in the intervention group,respectively.The differences before and after the intervention were significant (P<0.05, P<0.01). The systolic blood pressure of hypertensive patients in the control group decreased from (137.83 ± 13.83) mmHg before the intervention to (133.14 ± 7.69) mmHg after the intervention. The diastolic blood pressure of hypertensive patients in the intervention group decreased from (82.04 ± 7.62) mmHg before the intervention to (81.22 ± 5.29) mmHg after the intervention. Fasting blood glucose and total cholesterol of hypertensive patients in the control group decreased from (5.67±1.49)mmol/L and(5.27±1.02)mmol/L before the intervention to(5.47±1.53)mmol/L and(4.70±1.25) mmol/L after the intervention,respectively.The differences before and after the intervention were significant (P<0.05,P<0.01).The difference between the two groups in systolic blood pressure,body mass index,fasting blood glucose, and total cholesterol were statistically significant (P<0.05, P<0.01). After the intervention, both groups showed statistically significant behavioral changes in smoking cessation, physical exercise, low-sodium diets, and weight control (P<0.01). Conclusion A systematically intensive health education intervention was effective in improving blood pressure and unhealthy lifestyles for community-dwelling elderly patients with hypertension.