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A4597 Effect of three-grade management on the blood pressure control rate in community hypertensive patients under the West China Hospital urban medical service alliance

Objectives: To investigate the effect of three-grade management on the BP control rate in community hypertensive patients under the West China Hospital urban medical service alliance. Methods: For patients with hypertension in the community, we created a three-grade management model composed of West China Hospital-community health service center-hypertensive patients in the Shuangqiaozi health service center as a pilot. After the preliminary preparation works, we sequentially enrolled newly added hypertensive patients receiving chronic disease management with follow-up records in the community from April to July, 2017, to evaluate the effect of three-grade management on the blood pressure control rate in community hypertensive patients. Results: In the 155 newly added hypertensive patients, 37 patients prescribed in the community with outpatient specific diseases were identified through the Easy Access in our hospital, 58 patients were transferred from other hospitals, other 60 patients were only followed up and were not prescribed in the community. Baseline BP was 150.3/83.4, 129.9/75.3 and 139.4/79.6 mmHg (P < 0.001, P = 0.003) in the three groups, respectively, and the BP control rate was 32.4%, 81% and 60% (P < 0.001) in the baseline. After an average durations of 1.7, 1.8 and 2.3 months (P = 0.006) follow-up, the blood pressure was 133.5/77.0, 128.6/75.0 and 132.2/77.7 mmHg (P = 0.015, P = 0.110), the blood pressure control rate was 75.7%, 91.4% and 86.7% (P = 0.099), and the reductions of blood pressure was 16.7/6.3, 1.3/0.24 and 7.2/1.95 mmHg (P < 0.001, P = 0.012) in the three groups, respectively. Conclusion: The three-grade management of hypertension under the West China Hospital urban medical service alliance plays a positive role in improving the blood pressure control rate in hypertensive patients in the community.