A16395 Hypertension Management and Effect Analysis on Treatment Flow Path in the Uncontrolled Blood Pressure Patients of Community Health Center

Objectives: To explore hypertension management and effect analysis on treatment flow path in the uncontrolled blood pressure (BP) patients of community health center (CHC). Methods: Hypertensive patients in CHC used simple antihypertension flow path, the preferred medicine was calcium channel blockers (C), angiotensin converting enzyme inhibitors or angiotensin receptor blockers (known as A). BP did not target in 2–4 weeks, general practitioners (GPs) prescribed C and A, or A and diuretic (D) to treat 1 month at least. Bp did not reach the target yet, the patients were referral to department of hypertension. Under the guidance of experts in tertiary hospitals (THs), GPs adjusted treatment protocol, strengthened management, made BP reach the target. The uncontrolled BP patients were referral to THs to make etiological diagnosis, after BP reached the target, they were back to the community to follow-up. Results: Among 307 uncontrolled BP patients, the average age of 157 males were 65.0 ± 8.6 years. Moderate and severe hypertension was 80.0%, 14.3% accompanied by diabetes, and 20.5% merged with clinical diseases. High risk and extremely high-risk patients were 85.0%. Through 3.97 ± 1.21 months intensive management, systolic BP decreased significantly from 167.56 ± 16.73mmHg in the baseline to 132.79 ± 11.24 mmHg, and diastolic BP from 95.34 ± 12.59 mmHg to 79.11 ± 7.85 mmHg (P < 0.0001), BP control rate was 75.6%. 42 patients were referral to superior hospital, the referral rate was 13.7%.6 patients were diagnosed as secondary hypertension. Conclusion: GPs implemented intensive management and made BP reach the target under the guidance of experts were effective management pattern of chronic disease. The uncontrolled BP patients in the communities used simple treatment flow path (C + A or A + D) earlier, the BP control rate was higher.