Evaluate effects of the National Essential Public Health Service Program on hypertension control of Chinese community-dwelling people during the COVID-19 epidemic: a population-based multi-centre retrospective longitudinal study.

Abstract

Background: The National Essential Public Health Service Program was launched in 2009 to improve hypertension control of Chinese adults in primary care settings. Current research evidence regarding effectiveness of the National Essential Public Health Service Program on hypertension control during the COVID-19 epidemic was limited. To fulfil the research gap, this study aimed to evaluate hypertension control of the National Essential Public Health Service Program during the COVID-19 epidemic. It was anticipated that our study findings could demonstrated whether the National Essential Public Health Service Program was effective on hypertension control during the COVID-19 epidemic, which could provide policy making guidance on whether strategies to improve hypertension control of the National Essential Public Health Service Program during epidemics were necessary.

Method: This study was designed as a retrospective longitudinal study. People registering with the NEPHSP as hypertensive patients and consistently accepted hypertension care services of the NEPHSP between January 1, 2019 to January 8, 2023 were included in this study. The participants were included from 1393 primary care settings in 14 districts. The study outcomes included clinical, lifestyle, and anti-hypertensive treatment indicators. The study data were extracted from the structural patient information recorded in the Residence Health Record System. Using Generalized Estimating Equations model, we evaluated the hypertension control of the National Essential Public Health Service Program during the COVID-19 epidemic.

Results: 411183 participants were included. Systolic blood pressure and diastolic blood pressure mean values increased by 1.83 mm Hg (95% CI, 1.78 to 1.88, P < 0.001) and 0.04 mm Hg (95% CI, 0.01 to 0.07, P < 0.001) during the COVID-19 epidemic. Systolic blood pressure and diastolic blood pressure control rates decreased by 7.92% (-0.35, 95% CI, -0.36 to -0.34, P < 0.001) and 8.27% (-0.31, 95% CI, -0.33 to -0.30, P < 0.001). Cardiovascular and cerebrovascular diseases diagnosis increased 8.04% (0.60, 95% CI, 0.58 to 0.61, P < 0.001) and 6.24% and (0.69, 95% CI, 0.68 to 0.71, P < 0.001) during the COVID-19 epidemic.

Conclusion: Hypertension control of the National Essential Public Health Service Program declined during the COVID-19 epidemic. Structural telemedicine systems should be predefined to ensure efficient delivery of hypertension care services during epidemics. Strategies for ensuring timely referral and mental health interventions should be performed during epidemics.