Multicomponent Intervention Linked to Greater Drop in BP
TUESDAY, Sept. 19, 2017 -- A multicomponent intervention is associated with greater reduction in systolic and diastolic blood pressure (BP) than usual care over 18 months, according to a study published in the Sept. 19 issue of the Journal of the American Medical Association.
Jiang He, M.D., Ph.D., from Tulane University School of Public Health and Tropical Medicine in New Orleans, and colleagues randomized nine health care centers with 743 low-income adults in Argentina with uncontrolled hypertension to the multicomponent intervention, which included a community health worker-led home intervention, a physician intervention, and a text messaging intervention over 18 months, and nine centers with 689 patients to usual care.
The researchers found that from baseline to 18 months, there was a decrease of 19.3 and 12.7 mm Hg in the intervention and usual-care groups, respectively (difference, 6.6 mm Hg; 95 percent confidence interval, 4.6 to 8.6 mm Hg; P < 0.001). Diastolic BP decreased by 12.2 and 6.9 mm Hg, respectively, with a difference of 5.4 mm Hg (95 percent confidence interval, 4.0 to 6.8 mm Hg; P < 0.001). In the intervention and usual-care groups, the proportion of patients with controlled hypertension increased from 17.0 to 72.9 percent and from 17.6 to 52.2 percent, respectively (difference, 20.6 percent; 95 percent confidence interval, 15.4 to 25.9 percent; P < 0.001).
"Further research is needed to assess generalizability and cost-effectiveness of this intervention and to understand which components may have contributed most to the outcome," the authors write.
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Posted: September 2017