Six-community Hypertension Intervention Trial in Taiwan: Epidemiological Characteristics and Treatment Compliance

台灣地區社區高血壓防治實驗計畫：I．流行病學特徵與治療順從性

陳建仁(Chien-Jen Chen) ； 曾文賓(Wen-Ping Tseng) ； 潘碧珍(Bi-Jen Pan) ； 林淑華(Shu-Hwa Lin) ； 莊雅倩(Ya-Chien Chuang) ； 譚素貞(Shue-Jane Tan) ； 鄭淑姿(Sock-Chee Tay) ； 江弘基(Hung-Cu Chiang)

《中華民國公共衛生學會雜誌》 8卷4期 (1988/12) Pp. 255-269

https://doi.org/10.6288/JNPHARC1988-08-04-05

摘要

本研究之目的在於瞭解台灣地區居民之高血壓流行病學特徵及危險因子，評估高血壓患者之治療順從性，以及探討社區高血壓防治工作之可行性。本研究自台北市、高雄市和台灣省分別選取了南港區、楠梓區、大園鄕、大樹鄕、竹南鎭和斗南鎭作爲研究地區，以隨機抽樣選取了4056名男性和3899名女性居民爲研究對象。根據世界衛生組織推薦之標準方法，由特別調訓之衛生所醫師及護士，進行高血壓調查和治療之工作。同時在六個衛生所成立高血壓特別門診，進行免費之階段治療。研究結果發現，台灣地區居民之性別、年齡別平均收縮壓與舒張壓，與世界各國並無明顯差異。高血壓盛行率隨著年齡增加而增加，女性自30歲以下的1.0%增加至70歲以上的37.4%，男性則自15%增加至34.2%；在五十歲以下的年齡層男性高於女性，五十歲以上則女性高於男性。複迴歸分析顯示鄉鎮居民之盛行率高於市區居民，而且肥胖度、喝酒頻率、喝茶頻率、鹹食攝取頻率及父母高血壓史與高血壓呈現正向的劑量效應關係，而活動量則與高血壓呈負相關。心臟血管疾病與糖尿病旣往史也與高血壓有密切相關。防治實驗也顯示轉介至高血壓特別門診的患者，其治療順從性高達80.6%；而轉介至其他門診的患者，其順從性只達50.6%。高血壓患者中斷治療的主要原因是「不再感覺到有不舒服」以及「沒有時間看病」。

並列摘要

In order to examine epidemiological characteristics and risk factors of hypertension, to assess the treatment compliance of hypertensives, and to evaluate the feasibility of community-based hypertension control programs in Taiwan, a Six-Community Hypertension. Intervention Project (SCHIP) was conducted, involving the survey and follow-up of 7,955 men and women. Experienced public health physicians and nurses were employed to conduct cardiovascular surveys and laboratory examinations according to standard protocols, and special hypertension clinics were established for the step-care of hypertensives.
The Chinese population in Taiwan is under an extraordinarily higher risk of developing cerebrovascular accidents than other populations around the world; however, age-sex-specific mean systolic and diastolic blood pressure levels were quite similar between Taiwan citizens and people elsewhere around the world. The prevalence rate of hypertension was found to increase with age in both sexes, with males having a higher hypertension prevalence before the age of 50 years and a lower prevalence after the age of 50 than females. Multiple regression analysis showed that age, sex, location of residence, obesity, low levels of physical activity, family histories of hypertension, and previous histories of cardiovascular diseases and diabetes were significantly associated with hypertension. The treatment compliance rate of patients referred to SCHIP clinics was as high as 81.6%, while the rate of patients referred to health insurance clinics was only 50.6%. The major reasons given by patients for discontinuing treatment were ”feeling better and/or no more symptoms or signs” and ”too busy lo see doctors”.

並列關鍵字

hypertension ； prevalence ； risk factors ； treatment compliance