关键词: 脑梗死, 高血压, 二级预防, 服药依从性, 影响因素

Abstract: Objective： To investigate the status quo and influencing factors of compliance with secondary prophylactic medication among elderly hypertension patients with cerebral infarction. Methods： A cluster sampling method was used to select 1200 retired elderly hypertensive patients with cerebral infarction from 20 communities in a certain area as the study subjects. They were followed up for 1 year. Morisky medication compliance questionnaire was used to evaluate the patients′ compliance with secondary preventive medication. Demographic information， daily behavior indicators， clinical indicators， psychological and social support factors of the two groups were collected for univariate analysis and Logistic model multivariate analysis to identify independent risk factors of secondary preventive medication compliance in retired hypertension patients with cerebral infarction. Results： Among 1145 elderly hypertensive patients with cerebral infarction， 478 cases had good compliance with secondary preventive medication， accounting for 41.75%. In addition to gender， marital status， payment type， smoking history and drinking history， there were statistically significant differences between the two groups in age， education level， living style， family monthly income， hypertension course， physical activity， chronic disease， oral drug type， nerve defect degree， depression and social support (P<0.05). Multivariate analysis by Logistic regression model showed that the independent risk factor affecting the compliance of retired hypertension patients with cerebral infarction with secondary preventive medication was family monthly income (<3 000 yuan) (OR： 1.559； 95%CI： 1.196-2.031)， duration of hypertension (≥10 years) (OR：1.324； 95%CI： 1.002-1.751)， physical activity (lack) (OR：1.368； 95%CI： 1.050-1.782)， degree of nerve defect (severe) (OR： 1.880； 95%CI：1.433-2.466)， social support (low) (OR：2.568； 95%CI：1.985-3.321). Conclusion： The current situation of compliance with secondary preventive medication of elderly hypertension patients with cerebral infarction in a community in a certain area is not optimistic. Individualized intervention strategies should be developed for low-income families， patients with long disease course， lack of physical activity， severe neurological deficits and low social support， so as to improve the compliance with secondary preventive medication.

Key words: Cerebral infarction, High blood pressure, Secondary prevention, Medication compliance, Influencing factor