本研究主要是探討鄉村地區老人高血壓個案的自知與生活型態改變及自我照護之關係。採追蹤研究法，利用2002年台南縣南化鄉65歲以上老人做第一次社區篩檢，於2004年時再做一次追蹤調查。採結構式問卷與面談訪視收集相關資料，其內容包括人口學資料(性別、年齡、婚姻狀況與教育程度)、生活型態(抽菸習慣、飲酒習慣與體能活動習慣)，同時測量病人身高、體重與血壓。
　　2002年有762位(73.3%)完成調查，高血壓個案有331位(43.4%)。2004年有574位(78.0%)完成追蹤，高血壓病人有233位。本研究將高血壓病患分成三組：第一組為2002年即自知有高血壓病史或曾服用降血壓藥物者，於2004年追蹤時仍都自知高血壓病史或曾服用降血壓藥者；第二組為2002年新發現血壓異常之個案，於2004年追蹤時也自知有高血壓病史或曾服用降血壓藥者；第三組為2002年新發現血壓異常之個案，於2004年追蹤時仍不自覺有高血壓者。結果顯示高血壓病患的自知率從2002年64.4%提升至2004年89.3%。三組民眾在生活型態的改變上，除第二組在體能活動比例有顯著增加之外，其餘各組間改變或各組內變化皆無差異。體重與血壓在組間的變化沒有差異，但是在組內都有上升趨勢。在服藥頻率方面，每週用藥5天以上者在第一、二組為76%及43.1%，三組間的分布達顯著差異。自我血壓測量方面，三組之間則沒有明顯差異存在。
　　利用篩檢及追蹤發現高血壓個案的自知率提昇，但是在生活型態則沒有顯著改變，雖然體重與血壓的變化沒有顯著差異，但是在各組都有上升趨勢，是值得注意的情形。因此建議公共衛生的專業人員應重視上述的結果，而且應定期追蹤高血壓的個案。

　　The purpose of the study is to understand the relationship between awareness, the change of lifestyle of hypertensive elders in a rural community. We use a follow-up design for the research. We did community-based screenings for people over 65-year-old living in Nan-Hua township, Tainan county in 2002 as the base study, and followed up them in 2004. We used a structured questionnaire to interview each participant face-to-face. The content of questionnaire included gender, age, marital status, educational level, lifestyles (smoking, alcohol drinking, and physical activities), medication, and blood pressure monitoring. We also checked body weight, body height, and blood pressure for each participant.
　　There were 762 elders in the base study and 574 of them in the follow up study. Among those 574 participants in both studies, 233 of them were hypertensive cases which served as our study subjects. We divided all subjects into 3 groups. The first group includes the cases of being aware of hypertension or having been taking anti-hypertensive drugs before 2002 (old cases, all aware). The second group includes the cases who were newly diagnosed hypertension in 2002 and were aware of hypertension or have been taking anti-hypertensive drugs after 2002 (new cases, aware). The third group includes the cases who were newly diagnosed hypertension in 2002 and were unaware of hypertension in 2004 (new cases, unaware).
　　The result of the study reveals the percentage of awareness to hypertension increased from 64.4% in 2002 to 89.3% in 2004. There is no difference in the change of smoking behaviors and alcohol drinking within groups or between groups during these two years. Only physical activities have been found increase in the second group. Also, there is no difference in the change of blood pressure or body weight among groups; however, they increase in every group. In the frequency of taking medications, there is significant differences among groups which 76% in the first group and 43.1% in the second group have been taking medications over 5 days a week. In the frequency of self blood pressure monitor, no significant difference among groups was found.
　　This study showed an increase of awareness to hypertension between base screening and follow-up period. However, no significant change was found in lifestyle change except for physical activities. Although there is no difference in the change of blood pressure or body weight, there is an increase in each group. Thus, the study suggests public health professionals be aware the above result, and focus on following up hypertensive cases regularly.

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