LAUSR

Objectives: To explore the appropriate and applicable techniques for screening and control of refractory hypertension in community level. Methods: Random sampling method was used to recruit 4535 hypertension patients from four project sites managed by Zhejiang Hospital, Beijing Chaoyang Hospital, 301 Hospital and Zhengzhou University. Among them, 97 cases were defined as refractory hypertension patients with application of Three-steps-flow Method and then given individualized intervention and guidance. Results: Among 97 patients with refractory hypertension, 15.5% standardized combination medicine treatment rate, 50.7%compliance rate, 14.4% smoking rate, 18.6% excessive drinking, 78.4% sedentary exercise rate, 37.1% high salt / high calorie diet and 24.7% obesity patients cases. There are 2 cases with thyroid disease history, 48 cases with snoring history and 1 OSAS case. The life style intervention and standardized medication guidance for the patients with refractory hypertension were given. A year later, the results show that the life style of patients with refractory hypertension made remarkable changes. 83.5% and 52.6% of the patients carried out home blood pressure measurement and 24 hour ambulatory blood pressure monitoring during the last one year and medical treatment compliance increased from 50.5% to 88.7%, the average systolic blood pressure and diastolic blood pressure levels were decreased 20.3mmHg and 15.3mmHg and the blood pressure control rate increased from 18.6% to 76.3% Conclusion: With application of the refractory hypertension screening and control technique, blood pressure measurement and hypertension diagnosis could be standardized.With the improvement of physicians’ assessment capacity in terms of refractory hypertension diagnosis and medication,it improves treatment and control rate