智慧化管理模式对老年高血压患者血压达标率的影响

The Impact of Smart Management Model on Blood Pressure Control Rate in Elderly Hypertensive Patients

摘要: 目的：评估基于“星网计划”的智慧化管理模式对老年高血压患者血压达标率的影响，并分析不同人群特征下的干预效果，为完善基层高血压智慧化管理模式提供相关参考。方法：采用前瞻性随机对照研究，共纳入179例老年高血压患者，随机分为智慧管理组(N = 92)和传统管理组(N = 87)。智慧管理组接受智能血压计远程监测、针对老年人群的个性化健康教育、互动随访管理，对照组则接受常规社区管理。随访6个月后，比较两组老年患者血压达标情况，包括血压达标率(<140/90 mmHg和<130/80 mmHg)及血压变化情况。结果：6个月随访结果显示，智慧管理组血压 < 140/90 mmHg的达标率为60.87%，显著高于传统管理组的12.64% (P < 0.001)；当设定更严格的血压标准 < 130/80 mmHg时，智慧管理组达标率(23.91%)显著高于传统管理组的4.60% (P < 0.001)。智慧管理组患者收缩压平均下降17.82 ± 11.15 mmHg，传统管理组下降2.98 ± 10.26 mmHg (P < 0.001)；舒张压方面，智慧管理组下降2.85 ± 12.14 mmHg，对照组下降0.24 ± 7.69 mmHg (P = 0.045)，舒张压下降幅度也显著大于对照组(P = 0.045)。亚组分析显示智慧化管理在不同年龄、性别、教育程度的老年患者中的控制效果均显著优于传统管理模式(P均<0.05)。结论：基于“星网计划”的智慧化管理模式显著提高了老年高血压患者的血压达标率，适合在基层医疗机构的老年人群中推广应用。

Abstract: Objective: To evaluate the impact of the smart management model based on the “star network plan” on the blood pressure compliance rate of elderly patients with hypertension and analyze the intervention effect under different population characteristics; it provides a relevant reference for improving the smart management model of grassroots hypertension. Methods: A total of 179 elderly hypertensive patients are enrolled in a prospective randomized controlled study and are randomly divided into a smart management group (N = 92) and a traditional management group (N = 87). The smart management group receives remote monitoring of intelligent blood pressure monitors, personalized health education for the elderly population and interactive follow-up management, while the control group receives routine community management. After 6 months of follow-up, the blood pressure compliance of the two groups of elderly patients is compared, including blood pressure control rate (<140/90 mmHg and <130/80 mmHg) and the changes in blood pressure. Results: The 6-month follow-up shows that the blood pressure control rate of < 140/90 mmHg in the smart management group is 60.87%, which is significantly higher than 12.64% in the traditional management group (P < 0.001). When the more stringent blood pressure standard < 130/80 mmHg is set, the blood pressure control rate of the smart management group (23.91%) is significantly higher than that of the traditional management group (4.60%) (P < 0.001). Systolic blood pressure decreases by 17.82 ± 11.15 mmHg in the smart management group and 2.98 ± 10.26 mmHg in the traditional management group (P < 0.001). Diastolic blood pressure decreases by 2.85 ± 12.14 mmHg in the smart management group and 0.24 ± 7.69 mmHg in the control group (P = 0.045), and the diastolic blood pressure decreases significantly more than that in the control group (P = 0.045). Subgroup analysis shows that the control effect of smart management in elderly patients of different ages, genders and education levels is significantly better than that of traditional management mode (P < 0.05). Conclusion: The smart management model based on the “star network plan” can significantly improve the blood pressure control rate of elderly patients with hypertension, which is suitable for promotion and application in the elderly population in primary medical institutions.