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：

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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.	国家心血管病中心. 中国心血管病报告2012[N]. 医师报, 2013-8-21(12-13).
2.	李立明, 饶克勤, 孔灵芝, 等. 中国居民2002年营养与健康状况调查[J]. 中华流行病学杂志, 2005, 26(7):478-484.
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5.	周超, 雷燕, 杨春霞, 等. 饮酒、吸烟和嗜盐等生活方式与高血压发病关联的Meta分析[J]. 现代预防医学, 2006, 33(4):488-490.
6.	中华人民共和国卫生部疾病预防控制局, 中华人民共和国卫生部心血管病防治中心,中国高血压联盟. 中国高血压防治指南(2009基层版)[J]. 中华高血压杂志, 2010, 18(1):11-30.
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8.	Gupta R. Defining hypertension in the Indian population[J]. Natl Med J India, 1997, 10(3):139-143.
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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.	赵文华, 翟屹, 胡建平, 等. 中国超重和肥胖造成相关慢性疾病的经济负担研究[J]. 中华流行病学杂志, 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.	马冠生, 朱丹红, 胡小琪, 等. 中国居民饮酒行为现况[J]. 营养学报, 2005, 27(5):16-19.
18.	杨功焕, 马杰民, 刘娜, 等. 中国人群2002年吸烟和被动吸烟的现状调查[J]. 中华流行病学杂志, 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. 国家心血管病中心. 中国心血管病报告2012[N]. 医师报, 2013-8-21(12-13).
2. 李立明, 饶克勤, 孔灵芝, 等. 中国居民2002年营养与健康状况调查[J]. 中华流行病学杂志, 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, 杨春霞, 等. 饮酒、吸烟和嗜盐等生活方式与高血压发病关联的Meta分析[J]. 现代预防医学, 2006, 33(4):488-490.
6. 中华人民共和国卫生部疾病预防控制局, 中华人民共和国卫生部心血管病防治中心,中国高血压联盟. 中国高血压防治指南(2009基层版)[J]. 中华高血压杂志, 2010, 18(1):11-30.
7. 刁节文, 熊巧丽. 成都市各城区经济综合实力分析[J]. 商业经济, 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. 赵文华, 翟屹, 胡建平, 等. 中国超重和肥胖造成相关慢性疾病的经济负担研究[J]. 中华流行病学杂志, 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. 马冠生, 朱丹红, 胡小琪, 等. 中国居民饮酒行为现况[J]. 营养学报, 2005, 27(5):16-19.
18. 杨功焕, 马杰民, 刘娜, 等. 中国人群2002年吸烟和被动吸烟的现状调查[J]. 中华流行病学杂志, 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

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