Abstract: Background　In China，hypertension prevalence is increasing，and hypertension-related cardiovascular and cerebrovascular diseases have become the leading causes of death.However，the rates of hypertension awareness，treatment and control are relatively low in residents.Moreover，hypertension problems have imposed great burden on the government and residents.So it is necessary to carry out efficient and inexpensive hypertension-related prevention and treatment interventions.Objective　To analyze hypertension control，antihypertensive medication status，and responses to general practice care in hypertensive patients from Haikou communities based on analyzing hypertension management data of community health centers in Haikou，providing a theoretical basis for promoting community-based prevention and treatment of hypertension in this area.Methods　Data were collected from 4 community health centers（Dayuan Community Health Center，Jinpan Community Health Center，Binhai Community Health Center，and Jinmao Community Health Center） in Haikou.And from he health records system of these centers，a simple random sample of 200 cases were selected（50 from each center） out of those who lived in the communities within the serving areas of the above-mentioned health centers during August 2017 to January 2018，with health records documenting，hypertension management and follow-up data，and without interventions from hypertension trials.They were equally randomized into test group and control group，treated with 6-month general practice-based interventions and self-management interventions，respectively.Demographic characteristics （including gender，age，education level，family history of hypertension，cardiovascular and cerebrovascular complications，medications，and approaches for medications），hypertension control，and medication type and regimen were collected.Post-intervention effect was evaluated by hypertension control，BMI，medication compliance，correction of unhealthy life habits，and satisfaction with general practice care.Results　Hypertension control status differed significantly by family history of hypertension，cardiovascular and cerebrovascular complications，medication，and administration method（P<0.05）.The most commonly used antihypertensive monotherapy was calcium channel blockers，followed by β-receptor blockers，angiotensin Ⅱreceptor blockers，compound preparations，angiotensin converting enzyme inhibitors and diuretics.For combined use，β-receptor blockers + calcium channel blockers were the primary combination，followed by angiotensin Ⅱ receptor blockers + calcium channel blockers，calcium channel blockers + angiotensin converting enzyme inhibitors.After intervention，compared with the control group，test group had higher hypertension control rate（P<0.05），lower average BMI（P=0.004），and greater improvements in correcting unhealthy habits such as heavy drinking，little exercise and high-salt diet（P<0.05）.Moreover，test group showed higher average level of satisfaction with general practice care（P<0.05），because they spent sufficient time on communicating with the physicians，based on which the physicians provided comprehensive preventive，diagnostic and/or therapeutic services（including the explanation of the purposes of examination and treatment），and were willing to listen to patients' opinions about their own regimens.Conclusion　The control rate of hypertension in the communities in Hainan is still not ideal.Rational use of antihypertensive drugs should be improved.General practice-based interventions are beneficial to controlling hypertension.

Key words: Hypertension, Health education, Community health centers, Intervention studies, General practice

摘要： 背景　我国高血压患病率日益增长，但其知晓率、治疗率、控制率偏低，与高血压相关的心脑血管疾病成为我国居民首位死亡因素。高血压已成为政府和居民的重要负担，所以开展高效、廉价的高血压防治工作是非常必要的。目的　分析海口市社区卫生服务中心对高血压管理的有关资料，了解海口市社区高血压患者的血压控制情况、用药特征，探讨全科医疗干预效果，为进一步推动海口市社区高血压防治工作提供一定的理论依据。方法　选取2017年8月—2018年1月在海口市4家社区卫生服务中心（海口市大园社区卫生服务中心、金盘社区卫生服务中心、滨海社区卫生服务中心、金茂社区卫生服务中心）居住并已建立健康档案、有高血压诊治及随访记录、未参与血压干预试验的高血压患者。采用单纯随机抽样的方法从上述4家社区卫生服务中心的高血压健康档案中抽取200例（每个社区50例）患者，并依据随机数字表法分为两组，试验组100例接受全科医疗干预，对照组100例接受自我管理，干预6个月。了解患者人口学特征（包括性别、年龄、受教育程度、高血压家族史、心脑血管合并症、用药情况、用药方式），调查患者高血压控制率以及用药种类、用药方案。比较两组患者的高血压控制率、BMI、用药依从性、不良生活习惯纠正情况及全科医疗满意度评分。结果　不同高血压家族史情况、心脑血管合并症情况、用药情况、用药方式高血压患者高血压控制率比较，差异有统计学意义（P<0.05）。社区高血压用药以钙通道阻滞剂为主，其次为β-受体阻滞剂、血管紧张素Ⅱ受体阻滞剂、复方制剂、血管紧张素转换酶抑制剂、利尿剂。联合用药情况以β-受体阻滞剂+钙通道阻滞剂为主，其次为血管紧张素Ⅱ受体阻滞剂+钙通道阻滞剂、钙通道阻滞剂+血管紧张素转换酶抑制剂等。干预后干预组血压低于对照组（P<0.05）。干预后干预组高血压控制率高于对照组（P<0.05）。干预后干预组BMI低于对照组（P=0.004）。干预组饮酒、缺乏锻炼、高盐饮食减少率高于对照组（P<0.05）。干预组与医生的沟通时间充足、医生能给出全面的诊断和治疗、医生提供了相关预防服务、医生向你说明检查和治疗的目的、你能对自己的治疗方案提出意见、你对治疗效果的满意程度得分高于对照组（P<0.05）。结论　海口市社区高血压控制率仍不太理想，降压药物合理应用仍需改进，全科医疗干预措施有利于患者控制血压。

关键词: 高血压, 健康教育, 社区卫生中心, 干预性研究, 全科医学