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.