Managing hypertension – a community-based approach

This study investigated if a comprehensive care model (CCM) improves the management of hypertension. 

They found that a CCM improved blood pressure (BP) control and reduced the risk of cardiovascular disease (CVD). 

Hypertension or high blood pressure (BP) is a common condition. High BP can increase the risk of cardiovascular disease (CVD). CVD can lead to heart attacks, stroke or death. Managing BP levels is very important to prevent CVD. Medication and lifestyle changes can effectively manage BP. However, uncontrolled hypertension is still very common. 

Comprehensive care models (CCMs) may be an option for managing hypertension. CCMs use multiple methods to manage BP. The first step involves screening people for high BP. They take account of local factors that may affect BP management. This includes the availability of doctors and the cost of medication. Non-physician health workers (NPHW) play an important role. These may include nurses or physicians assistants.  Each CCM needs to be investigated to determine if it is feasible and improves patient care. 

This study included 1371 patients with hypertension. These patients were part of 30 communities. The CCM was used within 16 communities. Standard care (SC) was used in 727 patients. 644 patients received the CCM. The CCM was developed by the authors. NPHWs lead the CCM. Their work was supervised by a doctor. The CCM involved active CVD risk detection, cholesterol-lowering medication and support from a family member or friend to increase adherence to treatment. 

CVD risk was significantly lower in patients that took part in the CCM (by 11.17%) compared to SC (by 6.4%). Patients in the CCM had a significant reduction in total BP (by 11.45 mmHg). The level of low-density lipoproteins (LDLs) was also lower in CCM-treated patients. LDLs are an indicator of CV health. More people in the CCM program reduced their BP below 140 mmHg (69%) vs. 30% for SC-treated patients. 

The authors concluded that a CCM improved BP control and reduced the risk CVD.

Patients in the SC were also screened for hypertension. This could have changed how they managed their BP. This could have led to underestimating the effect of the CCM.

If you have any concerns regarding hypertension please consult with your physician.