在马来西亚雪兰莪州初级保健诊所进行家庭血压监测的高血压患者的血压控制和影响高血压控制的因素

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-09-13 DOI:10.1016/j.cegh.2025.102183

Anusha Manoharan , Beatrice Jee Ngee Ling , Hazwan Mat Din , Vengketeswara Rao Seetharaman , Noor Diana Ismail , Yew Mei Lee , Najwa Aziz

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引用次数: 0

摘要

家庭血压监测（HBPM）被认为是高血压管理的重要工具。尽管在马来西亚高血压患者中广泛采用HBPM，但血压控制率仍然不理想。本研究探讨影响雪兰莪州初级保健诊所实施HBPM的高血压患者血压失控的因素。方法于2024年3月在雪兰莪州的5个初级保健诊所进行了一项横断面调查，涉及376名接受HBPM治疗的高血压患者。收集HBPM的社会人口学、药物依从性（MAANS量表）和知识、态度和实践（KAP）数据。采用Logistic回归分析与未控制血压相关的因素。结果办公室血压失控率为44.1%，家庭血压失控率为27.1%。与年龄≥60岁的参与者相比，年龄小于40岁的参与者发生家庭血压失控的可能性是后者的6.25倍（OR = 6.25, 95% CI 2.13-16.67, p = 0.001）。同样，40-59岁的参与者与≥60岁的参与者相比，家庭血压失控的可能性高出3.23倍（OR = 3.23, 95% CI 1.27-7.69, p = 0.014）。未建议采用HBPM技术的患者出现未控制血压的几率高出2.2倍（OR = 2.2, 95% CI 1.56-3.01, p = 0.044）。无业者的办公室血压失控机率较高（OR = 1.80, 95% CI 1.10-2.92, p = 0.018）。不良HBPM行为的参与者发生办公室血压失控的几率高出1.43倍（OR = 1.43, 95% CI 1.42-1.99, p = 0.021）。结论指导和实践上的空白阻碍了HBPM的效果。通过量身定制的干预措施和结构化教育来解决知识、态度和实践问题，可以改善HBPM实践。

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Control of blood pressure and factors influencing uncontrolled hypertension in hypertensive patients practicing home blood pressure monitoring in primary care clinics in Selangor, Malaysia

Problem considered

Home Blood Pressure Monitoring (HBPM) is recognized as an important tool for hypertension management. Despite the widespread adoption of HBPM among hypertensive patients in Malaysia, blood pressure control rates remain suboptimal. This study explored factors influencing uncontrolled BP among hypertensive patients practicing HBPM in primary care clinics in Selangor.

Method

A cross-sectional survey was conducted in March 2024 across five primary care clinics in Selangor, involving 376 hypertensive patients performing HBPM. Data on sociodemographic, medication adherence (MAANS scale), and knowledge, attitudes, and practices (KAP) of HBPM were collected. Logistic regression was used to analyze factors associated with uncontrolled BP.

Results

The prevalence of uncontrolled office BP was 44.1 %, while uncontrolled home BP was 27.1 %. Participants younger than 40 years were 6.25 times more likely to have uncontrolled home BP (OR = 6.25, 95 % CI 2.13–16.67, p = 0.001) compared to those aged ≥60 years. Similarly, participants aged 40–59 years were 3.23 times more likely to have uncontrolled home BP (OR = 3.23, 95 % CI 1.27–7.69, p = 0.014) compared to those aged ≥60 years. Patients not advised on HBPM techniques had 2.2 times higher odds of uncontrolled home BP (OR = 2.2, 95 % CI 1.56–3.01, p = 0.044). Unemployed participants had higher odds of uncontrolled office BP (OR = 1.80, 95 % CI 1.10–2.92, p = 0.018). Participants with poor HBPM practices had 1.43 times higher odds of uncontrolled office BP (OR = 1.43, 95 % CI 1.42–1.99, p = 0.021).

Conclusion

Gaps in guidance and practices impede HBPM efficacy. Addressing knowledge, attitudes, and practices through tailored interventions and structured education can improve HBPM practices.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.