智慧化高血压诊疗中心管理模式对老年高血压患者血压控制的影响

Effects of iHEC management model on blood pressure control in elderly hypertensive patients

中文关键词: 老年  高血压  智慧化高血压诊疗中心  管理  血压达标率  血压达标时间比

英文关键词: elderly  hypertension  intelligent hypertension excellence center  management  blood pressure control rate  time in target range

中文摘要:

      目的 探讨智慧化高血压诊疗中心(iHEC)管理模式对老年高血压患者血压控制的影响.方法 前瞻性选取2022年1月—2024年2月复旦大学附属静安区中心医院心内科门诊确诊的200例老年高血压患者,随机分为iHEC组(n=100)和常规组(n=100),iHEC组通过智能终端每日监测血压并实时干预,常规组行传统门诊随访.主要终点为12个月的动态血压达标率,次要终点包括血压降幅以及血压达标时间比(TTR).结果 入选时,2组患者基线资料以及动态血压水平差异无统计学意义(P＞0.05).12个月后随访结果显示,iHEC组清晨平均收缩压低于常规组[(127.96±17.80)mmHg vs(133.87±17.82)mmHg,P=0.024],清晨平均血压达标率高于常规组(65.9％vs 48.7％,P=0.007);iHEC组白天平均收缩压、白天平均舒张压以及清晨平均舒张压降幅均大于常规组(P＜0.05),iHEC组24 h、白天、夜间、清晨平均舒张压均与TTR呈负相关(P＜0.05).结论 iHEC管理模式通过连续动态监测与实时智能反馈,能显著提升患者血压管理的及时性与精准性,尤其有助于改善清晨血压达标率并提高TTR,为高血压的智能化、精细化慢病管理提供实践依据.

英文摘要:

      Objective To investigate the effects of an intelligent hypertension excellence center(iHEC)management model on blood pressure(BP)control in elderly hypertensive patients.Methods 200 elderly patients with hypertension diag-nosed in Outpatient Department of Cardiology of Jing'an District Central Hospital Affiliated to Fudan University from January 2022 to February 2024 were prospectively selected and randomly divided into iHEC group(n=100)and conventional group(n=100).The iHEC group received daily BP monitoring through intelligent terminals coupled with real-time intervention,while the conventional group received traditional outpatient follow-up.The primary endpoint was the 12-month dynamic blood pressure compliance rate,while the secondary endpoints include blood pressure reduction and time in therapeutic range(TTR).Results At baseline,there were no significant differences in demographic characteristics and ambulatory BP levels between the two groups(P＞0.05).After 12 months of follow-up,the morning systolic blood pressure in the iHEC group was significantly lower than that in the conventional group[(127.96±17.80)mmHg vs(133.87±17.82)mmHg,P=0.024],and the con-trol rate of morning blood pressure in the iHEC group was higher than that in the conventional group(65.9％vs 48.7％,P=0.007).The reductions in daytime mean systolic BP,daytime mean diastolic BP,and morning mean diastolic BP in the iHEC group was significantly greater than that in the conventional group(P＜0.05).Conclusion The iHEC management model can significantly improve the timeliness and precision of patients' blood pressure management through continuous dynamic monito-ring and real-time intelligent feedback.It is particularly helpful to improve the morning blood pressure control rate and increase the TTR.It provides a practical basis for intelligent and refined chronic disease management of hypertension.