Thực trạng tăng huyết áp và hiệu quả của mô hình quản lý điều trị tại huyện Văn Yên, tỉnh Yên Bái ttta

1 MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY TRẦN LAN ANH HYPERTENTION STATUS AND EFFICIENCY OF MODEL FOR TREATMENT MANAGEMENT IN VĂN YÊN DISTRICT, YEN BAI PROVINCE[.]

1 MINISTRY OF EDUCATION AND TRAINING MINISTRY OF HEALTH HANOI MEDICAL UNIVERSITY TRẦN LAN ANH HYPERTENTION STATUS AND EFFICIENCY OF MODEL FOR TREATMENT MANAGEMENT IN VĂN YÊN DISTRICT, YEN BAI PROVINCE Specialism Code : Public Health : 62720301 SUMMARY OF PHD PUBLIC HEALTH DISSERTATION HANOI - 2021 THESIS HAS BEEN COMPLETED IN: HANOI MEDICAL UNIVERSITY Supervisor: Asscociat Prof Nguyen Minh Son, Hanoi Medical University 2.Prof.Nguyen Quang Tuan, Hanoi Medical University Reviewer 1: Reviewer 2: Reviewer 3: Thesis will be defended at University level Doctoral thesis assessment committee in Ha Noi Medical University At…… Date: Thesis can be found at: - National Library of Viet Nam - Library of Hanoi Medical University INTRODUCTION Justification of study issues Hypertension is a chronic disease and is one of the major risk factors for stroke, myocardial infarction and aneurysms1, Studies show that hypertension is very common with 25% to 30% People in the community infected, the disease can be found in all countries of the world, including developed countries as well as developing countries The disease is the leading cause of disability and death in the elderly and has a significant impact on the quality of life of patients 3,4,5 In Yen Bai province, the hypertensive program has been implemented from 2010 to present 42 and has been managed and treated in a number of communes, however, there has not been a comprehensive assessment of the status of hypertension How is the management and treatment of hypertension in the community done, which model is appropriate to strengthen the management of hypertension in the locality? Is it possible to promote the role of health linkages from the district to the village, hamlet and residential group to improve the effectiveness of hypertension treatment management in the community? For the above reasons, we conduct the study “Hypertension status and efficiency of model for treatment management in Văn Yên district, Yen Bai province” with two objectives: Description of hypertenstion and some related factors of people over 40 years old and the management, treatment of hypertension in two districts of Van Yen and Luc Yen, Yen Bai province in 2015 Evaluating the effectiveness of intervention models in the management and treatment of hypertension for people aged 40 years and older in the community of Van Yen district, Yen Bai province in 2016-2017 New contribution from PhD thesis For the health sector in Yen Bai and especially in Van Yen district, this is valuable and factual information The research results provide suggestions for the local health sector about solutions in directing the grassroots health care levels to better perform the task of managing hypertension in particular, and through this can also apply pressure used for the management of non-communicable diseases in general in the area Scientific value and practical value of the topic are shown through 29 tables, 05 figures and 25 charts The results obtained from the study show that the prevalence of hypertension is quite high among ethnic minorities aged 40 years and older in mountainous districts, increasing with age, sedentary groups, eating salty foods, drinking alcohol tend to be higher The topic is highly practical, mentioning the shortcomings both in terms of expertise and in terms of management, administration and direction of a specific activity in the district The results of the intervention model have been effective, reducing risk and reducing systolic blood pressure by an average of mmHg and diastolic blood pressure by an average of 1.8 mmHg The percentage of people controlling blood pressure to the target in the intervention group decreased by 21.3% (from 100% to 78m8%) was still low The research results also give the health sector of the country information and reference lessons on the implementation of non-communicable disease control at the grassroots level What has not been successful during the intervention period is also a lesson and a task for the Yen Bai health sector in the coming time Structure of the thesis The thesis consists of 140 pages, in which the introduction section is 03 pages, the literature review section is 36 pages, the methodology section is 17 pages, the result section is 52 pages, the discussion section is 25 pages, the conclusion section is 02 page and the recommendation section is 01 page There were 29 tables, 25 figures and 05 graphs in the thesis The thesis has 116 references (50 Vietnamese and 66 English documents) CHAPTER LITERATURE REVIEW 1.1 Overview and definition of hypertension 1.1.1 Definition of hypertension The World Health Organization - International Society of Hypertension (WHO ISH) have agreed to diagnose high blood pressure (THA) when the mean value over at least two measurements of systolic blood pressure (SBP) ≥ 140 mmHg and/or mean diastolic blood pressure (DBP) ≥ 90 mmHg, on at least two consecutive visits 43 1.1.2 Classify of hypertension In Vietnam, hypertension is classified as followed 44: Table 1 Classify of hypertension in Vietnam Classify Blood pressure (mmHg) Systolic Diastolic Optimal pressure < 120 < 80 Normal pressure 120 – 129 80 – 84 Normal – high pressure 130 – 139 85 – 89 Hypertension level (light) 140 – 159 90 – 99 Hypertension level (medium) 160 – 179 100 – 109 Hypertension level (severe) ≥ 180 ≥ 110 Hypertension single systolic ≥ 140 < 90 Source: Decision No 3192/QĐ-BYT dated 31 August 2010 The above criteria apply only to people who are not currently taking antihypertensive drugs and are not in an acute condition45 1.1.4 Treatment of hypertension at grassroots medical level In Vietnam, currently, the treatment of hypertension is carried out according to the guidance of the Ministry of Health in Decision No 3192/QD-BYT dated August 31, 2010 of the Minister of Health on Guidelines for the diagnosis and treatment of hypertension 42 * General principles: - High blood pressure is a chronic disease, so it needs regular monitoring, proper and sufficient daily treatment, and long-term treatment - The goal of treatment is to achieve “target blood pressure” and minimize “cardiovascular risk” - “Target blood pressure” should be < 140/90 mmHg and lower if the patient can tolerate it If cardiovascular risk is high to very high, the target blood pressure should be