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The Integrated Management of Hypertension in General Hospitals and Community Hospitals

PURPOSE: We sought to investigate and improve the integrated management of hypertension in general and community hospitals in China. PATIENTS AND METHODS: We carried out a cross-sectional study in 90 centers from 15 cities in China from 2017 to 2018. Patients with primary hypertension were included....

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Autores principales: Xie, Kun, Gao, Xiufang, Bao, Liwen, Shan, Ying, Shi, Haiming, Li, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8219293/
https://www.ncbi.nlm.nih.gov/pubmed/34177280
http://dx.doi.org/10.2147/RMHP.S306735
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author Xie, Kun
Gao, Xiufang
Bao, Liwen
Shan, Ying
Shi, Haiming
Li, Yong
author_facet Xie, Kun
Gao, Xiufang
Bao, Liwen
Shan, Ying
Shi, Haiming
Li, Yong
author_sort Xie, Kun
collection PubMed
description PURPOSE: We sought to investigate and improve the integrated management of hypertension in general and community hospitals in China. PATIENTS AND METHODS: We carried out a cross-sectional study in 90 centers from 15 cities in China from 2017 to 2018. Patients with primary hypertension were included. RESULTS: Of the total 4286 patients included, 43.2% of them controlled blood pressure (BP) below 140/90 mmHg while only 11.5% controlled BP below 130/80 mmHg. The control rate of low-density lipoprotein-C (LDL-C) in patients with concomitant coronary artery disease (CAD), diabetes (DM), and chronic kidney disease (CKD) was 24.7%, 49.4%, and 40.6%, respectively. Thirty-one percent of the DM patients had HbA1c levels greater than 8% while 21.7% of the non-DM patients had HbA1c≥6.5%. The control rate of body mass index (BMI) was 54.4% in men and 59.8% in women. As compared to patients from community hospitals, patients from general hospitals had poorer control of BP<140/90 mmHg (OR 0.63, 95% CI 0.55–0.73, p<0.001), comparatively better attainment of LDL-C, particularly <1.8 mmol/L in CAD (OR 3.25, 95% CI 2.02–5.24, p<0.001), similar control of HbA1c < 8.0% in diabetes (OR 0.64, 95% CI 0.41–1.00, p=0.052) and comparatively worse achievement of BMI<25 kg/m(2) (OR 0.72, 95% CI 0.63–0.83, p<0.001). CONCLUSION: The integrated management of hypertension needs to be improved. Besides LDL-C, the management of BP, blood glucose (BG), and BMI need to be strengthened in not only community hospitals but also general hospitals.
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spelling pubmed-82192932021-06-24 The Integrated Management of Hypertension in General Hospitals and Community Hospitals Xie, Kun Gao, Xiufang Bao, Liwen Shan, Ying Shi, Haiming Li, Yong Risk Manag Healthc Policy Original Research PURPOSE: We sought to investigate and improve the integrated management of hypertension in general and community hospitals in China. PATIENTS AND METHODS: We carried out a cross-sectional study in 90 centers from 15 cities in China from 2017 to 2018. Patients with primary hypertension were included. RESULTS: Of the total 4286 patients included, 43.2% of them controlled blood pressure (BP) below 140/90 mmHg while only 11.5% controlled BP below 130/80 mmHg. The control rate of low-density lipoprotein-C (LDL-C) in patients with concomitant coronary artery disease (CAD), diabetes (DM), and chronic kidney disease (CKD) was 24.7%, 49.4%, and 40.6%, respectively. Thirty-one percent of the DM patients had HbA1c levels greater than 8% while 21.7% of the non-DM patients had HbA1c≥6.5%. The control rate of body mass index (BMI) was 54.4% in men and 59.8% in women. As compared to patients from community hospitals, patients from general hospitals had poorer control of BP<140/90 mmHg (OR 0.63, 95% CI 0.55–0.73, p<0.001), comparatively better attainment of LDL-C, particularly <1.8 mmol/L in CAD (OR 3.25, 95% CI 2.02–5.24, p<0.001), similar control of HbA1c < 8.0% in diabetes (OR 0.64, 95% CI 0.41–1.00, p=0.052) and comparatively worse achievement of BMI<25 kg/m(2) (OR 0.72, 95% CI 0.63–0.83, p<0.001). CONCLUSION: The integrated management of hypertension needs to be improved. Besides LDL-C, the management of BP, blood glucose (BG), and BMI need to be strengthened in not only community hospitals but also general hospitals. Dove 2021-06-18 /pmc/articles/PMC8219293/ /pubmed/34177280 http://dx.doi.org/10.2147/RMHP.S306735 Text en © 2021 Xie et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Xie, Kun
Gao, Xiufang
Bao, Liwen
Shan, Ying
Shi, Haiming
Li, Yong
The Integrated Management of Hypertension in General Hospitals and Community Hospitals
title The Integrated Management of Hypertension in General Hospitals and Community Hospitals
title_full The Integrated Management of Hypertension in General Hospitals and Community Hospitals
title_fullStr The Integrated Management of Hypertension in General Hospitals and Community Hospitals
title_full_unstemmed The Integrated Management of Hypertension in General Hospitals and Community Hospitals
title_short The Integrated Management of Hypertension in General Hospitals and Community Hospitals
title_sort integrated management of hypertension in general hospitals and community hospitals
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8219293/
https://www.ncbi.nlm.nih.gov/pubmed/34177280
http://dx.doi.org/10.2147/RMHP.S306735
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