Abstract Aims The Risk Assessment and Management Programme for Hypertension (RAMP-HT) is a protocol-driven, risk-stratified and multidisciplinary programme supplementing usual care for patients with hypertension (HT) in primary care. This study aimed to assess the association between RAMP-HT with complications and all-cause mortality compared to usual care only over 10 years. Methods In this prospective target trial emulation, electronic health records in Hong Kong was extracted, and sequence trials were emulated for patients with HT from January 2012 to December 2018. One-to-one propensity score matching was performed. Stabilized inverse probability treatment weights and pooled logistic regression were applied to obtain the hazard ratio for cardiovascular diseases (CVD) and all-cause mortality between groups. Results 337,990 eligible person-trials (168,995 per group) were included after propensity score matching. The incidence rate (IR) (cases/1,000 person years) of RAMP-HT was lower than usual care group for CVD (RAMP-HT: IR 16.54 95% CI 16.31, 16.78; usual care: IR 18.40 95% CI 18.10, 18.69) and all-cause mortality (RAMP-HT: IR 9.41 95% CI 9.24, 9.59; usual care: IR 12.23 95% CI 12.00, 12.47). RAMP-HT participants had significantly reduced risk of CVD (HR: 0.91, 95% CI: 0.89, 0.93) and all-cause mortality (HR: 0.88, 95% CI: 0.86, 0.90) as compared with usual care patients. Conclusion RAMP-HT supplementing usual care associated with reduced relative risk of CVD and all-cause mortality risks in patients with HT by 9% and 12% respectively compared to patients receiving usual care only, supporting the integration of RAMP-HT with usual primary care in managing HT.
Wong et al. (Mon,) studied this question.
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