Current status and future direction of community-based management of hypertension in China

Sun, Yingxian; Sun, Guozhe; Ye, Chang

doi:10.2478/jtim-2021-0022

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…Primary health care institutions (including community health centers and stations in urban areas, and township health centers and village clinics in rural areas) have been proven to play an important role in the management of hypertension. [5][6][7] Although a series of policies and measures have been taken to improve the effect of hypertension management, 8 it is still challenging since hypertension control is a complex public issue that needs multidisciplinary knowledge and methods. Research shows that the effect of hypertension management is affected by various individual factors including physiological (eg, dyslipidemia, amnesia), psychological (eg, anxiety, depression), and social factors (eg, socioeconomic status, health insurance).…”

Section: Introductionmentioning

confidence: 99%

Utilizing Group Model Building to Identify Barriers and Facilitators of Hypertension Management in Primary Health Care, China

Qin,

Li,

Qiao

et al. 2024

RMHP

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Group Model Building (GMB) is a qualitative method that refers to a participatory process. This project aims to identify barriers and facilitators of hypertension management in primary health care in China, through which, the leverage point for intervention may be found. Methods:The GMB was used to identify the factors influencing hypertension management. Graphs over time and causal loop diagram (CLD) were main tools of GMB. To propose the influencing factors, key stakeholders were invited to participate in a workshop. During the workshop, stakeholders were encouraged to plot the graphs over time of the variables about research issues and give a descriptive explanation. And based on this, a CLD was initially developed to establish a model of the interaction of factors. After the workshop, the research group further improved the CLD through repeated mutual discussions, and gave feedback to the participants. The Vensim PLE 9.0 software package was used to build CLD. Results: A total of 14 key stakeholders were invited to participate in the workshop. Finally, 26 influencing factors were identified, which were divided into three dimensions, including the institutional, the community health workers (CHWs), and the patient level. And 5 reinforcing loops and 4 balancing loops were formed in the CLD. Promoting the building of the Medical Community/Regional Medical Association, implementing the family doctor contract service (FDCS), and enhancing the motivation of CHWs may be potential leverage points for hypertension management in China. Conclusion: By using GMB, we have identified key factors in the management of hypertension in primary health care and provided comprehensive suggestions to overcome the obstacles.

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Section: Introductionmentioning

confidence: 99%

Utilizing Group Model Building to Identify Barriers and Facilitators of Hypertension Management in Primary Health Care, China

Qin,

Li,

Qiao

et al. 2024

RMHP

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“…Cardiovascular and metabolic diseases (CVMDs) and cancer are the top two causes of death worldwide. [ 1 , 2 , 3 , 4 ] There is growing concern regarding the impact of CVMDs on the long-term prognosis of cancer patients, as the incidence of CVMDs has been reported to be increasing in cancer patients. [ 5 , 6 , 7 ] In 2020, esophageal and gastric cancer-related deaths accounted for more than one-tenth of cancer-related deaths, becoming the sixth and third leading causes of cancer-related deaths worldwide, respectively.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of esophageal and gastric cancer patients with cardiovascular and metabolic diseases: A two-center propensity score-matched cohort study

Zhou,

Wang,

Dou

et al. 2023

Journal of Translational Internal Medicine

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Background and Objectives An increased risk of cardiovascular and metabolic diseases (CVMDs) among patients with cancer suggests a potential link between CVMD and cancer. The impact of CVMD on the survival time of patients with esophageal and gastric cancer remains unknown. We aimed to determine the incidence of CVMD and its impact on the longterm outcomes in esophageal and gastric cancer patients. Methods A total of 2074 cancer patients were enrolled from January 1, 2007 to December 31, 2017 in two hospitals, including 1205 cases of esophageal cancer and 869 cases of gastric cancer, who were followed up for a median of 79.8 and 79.3 months, respectively. Survival time was analyzed using the Kaplan–Meier method before and after propensity score matching. Results The incidence of CVMD in patients with esophageal and gastric cancer was 34.1% (411/1205) and 34.3% (298/869), respectively. The effects of hypertension, diabetes, and stroke on the long-term survival of esophageal and gastric cancer patients were not significant (all P > 0.05). The survival time was significantly longer in esophageal cancer patients without ischemic heart disease than in patients with ischemic heart disease, both before matching (36.5 vs. 29.1 months, P = 0.027) and after matching (37.4 vs. 27.9 months, P = 0.011). The survival time in gastric cancer patients without ischemic heart disease was significantly longer than in patients with ischemic heart disease, both before (28.4 vs.17.5 months, P = 0.032) and after matching (29.5 vs.17.5 months, P = 0.02). Conclusion The survival time of esophageal and gastric cancer patients with ischemic heart disease was significantly reduced compared to that of esophageal and gastric cancer patients without ischemic heart disease.

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“…Many studies have been conducted on the problem of hypertension with frailty. However, in China there is an increasing number of elderly patients with hypertension living in the community, and the health management of the elderly population with hypertension is a priority for the community health services; however, frailty is still not among the physical conditions routinely screened for in this population [12]. The management effect of hypertension in the community directly impacts the future development trend of cardio-cerebrovascular diseases in China.…”

Section: Introductionmentioning

confidence: 99%

Interaction between hypertension and frailty and its impact on the death risk among the elderly: a follow-up study

Tao

Chen

Zhou

et al. 2023

Preprint

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Background Hypertension and frailty are often occur together and are becoming more prevalent among elderly patients .Our study analyzed the frailty status in the elderly with hypertension and the impact of its interaction on the death risk. Method Frailty index (FI) model was used to assess the frailty status in the elderly based on the baseline data conducted in 2009; and death as outcome variables collected in 2020 were analyzed. The effects of hypertension prevalence on the frailty of the elderly with age and on the mortality of were analyzed. Cox regression and Kaplan-Meier curves were applied to evaluate the influence on the risk of death. Results Ultimately, 1197 elderly people were included in the analysis, and by 2020, there were 443 deaths, with a mortality rate of 37.0% (443/1197); 593 of them had hypertension, with a prevalence rate of 49.5% (593/1197). At any age, the FI values were higher and the mortality rate was higher in the elderly with hypertension than in those without hypertension. Cox regression analysis showed that the death risk was highest in the elderly with hypertension and frailty compared to those without hypertension and frailty (HR = 1.792, P = 0.000), followed by those without hypertension but with frailty (HR = 1.484, P = 0.000), and finally those with hypertension but without frailty (HR = 1.406, P = 0.005). The results of the survival time analysis showed that the median survival time of the elderly with hypertension and frailty was the shortest at 38.98 (95%CI: 35.64–42.32) months, which was lower than that of 52.94 (95%CI: 46.61–59.27) months in those without hypertension but with frailty, 102.71 (95%CI: 98.65-106.78) months in those with hypertension but without frailty, and 127.90 (95%CI: 113.54-134.69) months in those without hypertension and frailty (Log-rank = 999.686, P = 0.000). Conclusion Frailty is common among elderly patients suffering from hypertension, and there is an increased risk of poor health outcomes among elderly patients suffering from hypertension and frailty. For elderly patients with hypertension, attention should be paid to screening and assessing frailty in hopes of identifying it early so that appropriate measures of intervention can be taken to avoid or delay the resulting adverse effects.

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Current status and future direction of community-based management of hypertension in China

Cited by 7 publications

References 16 publications

Utilizing Group Model Building to Identify Barriers and Facilitators of Hypertension Management in Primary Health Care, China

Utilizing Group Model Building to Identify Barriers and Facilitators of Hypertension Management in Primary Health Care, China

Long-term outcomes of esophageal and gastric cancer patients with cardiovascular and metabolic diseases: A two-center propensity score-matched cohort study

Interaction between hypertension and frailty and its impact on the death risk among the elderly: a follow-up study

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