Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Aug 26, 2024
Open Peer Review Period: Aug 26, 2024 - Oct 21, 2024
Date Accepted: Dec 19, 2024
(closed for review but you can still tweet)
The impact of the National Essential Public Health Service Packages on blood pressure control in Chinese people with hypertension: retrospective population-based longitudinal study
ABSTRACT
Background:
The National Essential Public Health Service Package was launched in 2009 to tackle poor blood pressure control of Chinese people with hypertension. However, effect of The National Essential Public Health Service Package on blood pressure control is still unclear.
Objective:
In a retrospective population-based retrospective longitudinal study, we aimed to evaluate effect of the National Essential Public Health Service Package on blood pressure control.
Methods:
A total of 516777 patients registered in the National Essential Public Health Service Package were included in this study. The blood pressure control data was assessed based on the Residence Health Record System dataset. We longitudinally evaluated effects of the NEPHSP on blood pressure control by analyzing changes of blood pressures measured via regular follow-ups that were quarterly conducted. Both of level and trend (slope) of the blood pressure outcome changes were analyzed. We conducted stratified analysis to explore blood pressure control effects of the NEPHSP among subgroup participants with specific characteristics.
Results:
The baseline mean (SD) values of SBP and DBP were 147.12(19.88) mm/Hg and 85.11(11.79) mm/Hg. The control rates of baseline SBP and DBP were 39.79% and 69.21%. SBP mean values quarterly decreased by 5.06 mm Hg (95% CI, -5.11 to -5.00, P<0.001), 6.69 mm Hg (95% CI, -6.74 to -6.63, P<0.001), 10.30 mm Hg (95% CI, -10.34 to -10.23, P<0.001), 6.63 mm Hg (95% CI, -6.68 to -6.57, P<0.001). SBP control rates quarterly increased to 53.12% (0.60, 95% CI, 0.59 to 0.61, P<0.001), 56.61% (0.76, 95% CI, 0.75 to 0.77, P<0.001), 63.40% (1.08, 95% CI, 1.07 to 1.09, P<0.001), 55.09% (0.69, 95% CI, 0.68 to 0.70, P<0.001). DBP mean value quarterly decreased by 1.75 mm Hg (95% CI, -1.79 to -1.72, P<0.001), 2.64 mm Hg (95% CI, -2.68 to -2.61, P<0.001), 4.20 mm Hg (95% CI, -4.23 to -4.16, P<0.001), 2.64 mm Hg (95% CI, -2.68 to -2.61, P<0.001). DBP control rates quarterly increased to 78.11% (0.52, 95% CI, 0.51 to 0.53, P<0.001), 80.32% (0.67, 95% CI, 0.66 to 0.68, P<0.001), 83.17% (0.89, 95% CI, 0.88 to 0.90, P<0.001), 79.47% (0.61, 95% CI, 0.60 to 0.62, P<0.001). Older age group a larger decrease in SBP mean values (0.87, 95% CI, 0.85 to 0. 90, P<0.001) and a larger increase in SBP control rates (0.054, 95% CI, 0.051 to 0.058, P<0.001). The participants with CVD had smaller decrease in SBP mean values (-0.38, 95% CI, -0.41 to -0.35, P<0.001) and smaller increase in SBP control rates (-0.041, 95% CI, -0.045 to -0.037, P<0.001) than the blood pressures outcomes of participants without CVD.
Conclusions:
The NEPHSP was effective on improving blood pressure control of Chinese people with hypertension. Blood pressure control of the older and participants with CVD need to be intensified.
Citation
The author of this paper has made a PDF available, but requires the user to login, or create an account.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.