在高血压下降血压的小组交付干预措施:系统性审查和元分析
Sinéad Tj McDonagh1, Charlotte Reburn1, Jane R Smith1
1Exeter Collaboration for Academic Primary Care, Department of Health and Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter.
概括
与常规护理相比,群体干预有效降低高血压患者的血压 (BP). 运动和生活方式教育显示了最显著的血压降低,突出了它们在初级保健环境中的潜力.
科学领域:
- 心血管医学 心血管医学
- 公共卫生 公共卫生
- 临床试验 临床试验
背景情况:
- 高血压是心血管疾病的主要可改变的风险因素,目前的初级保健管理往往不够理想.
- 集体交付的干预措施,包括同行支持,为管理初级保健中的高血压提供了一种潜在的有效方法.
- 对于高血压管理中的群体干预措施有效性的证据依据仍然不清楚.
研究的目的:
- 系统地评估组交付的高血压干预措施对血压 (BP) 结果的影响,与通常护理 (UC) 相比.
- 确定哪种类型的群体干预措施在降低血压方面最有效.
- 为了探索与更大的BP降低相关的因素在小组设置.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 搜索包括MEDLINE,Embase,Cochrane CENTRAL和CINAHL,时间截至2024年3月.
- 来自54项研究 (13,976名参与者) 的数据使用随机效应元分析进行了聚合,并使用元回归来确定血压降低的预测因素.
主要成果:
- 与UC相比,小组干预显著降低了缩血压7.2 mmHg (运动),4.8 mmHg (生活方式教育) 和3.6 mmHg (心理治疗干预).
- 还观察到透气压的降低:3.9 mmHg (运动),2.9 mmHg (生活方式教育) 和1.2 mmHg (心理治疗干预).
- 较高的基线血压和先前存在的心血管发病率与更大的血压降低有关.
结论:
- 群体交付的干预措施在降低高血压患者的血压方面表现出有效性.
- 运动和生活方式教育干预似乎特别有益.
- 需要进一步的研究来评估这些干预措施在初级保健中的可行性和成本效益.
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