Community physician-led intervention increased blood pressure control rate from 19.7% to 36.3% and significantly reduced median SBP from 132 to 130 mmHg and DBP from 78 to 76 mmHg after 12 months in hypertensive patients with high-normal BP.
Does a 12-month community physician-led health management intervention improve blood pressure control and lifestyle habits in hypertensive patients with high-normal blood pressure?
A 12-month community physician-led health management intervention significantly improves blood pressure control and promotes healthy lifestyle modifications in patients with high-normal blood pressure.
Effect estimate: OR 3.222 for poor medication adherence due to adverse reactions as risk for uncontrolled BP (95% CI 1.169–8.878)
Absolute Event Rate: 36.3% vs 19.7%
p-value: p=<0.05
Introduction Among patients with hypertension, maintaining blood pressure within the high-normal range is a common clinical scenario, often misinterpreted as adequate control. However, this level remains associated with cardiovascular risk and progression of target organ damage. Yet, evidence is lacking regarding effective community-based interventions in this population. This study aimed to evaluate the effects of a 12-month, community physician-led standardized health management intervention on blood pressure control rates, lifestyle improvements, and influencing factors in hypertensive patients with high-normal blood pressure, and to explore effective management strategies for this key population. Methods A series of information surveys and health interventions were conducted among 721 patients (aged 18–80 years) with high-normal blood pressure from communities in Shenyang. Descriptive analysis and multivariable logistic regression analysis were used as primary analytical methods. Results After 1 year of community intervention, both systolic and diastolic blood pressure significantly decreased in 721 individuals with high-normal blood pressure ( P 0.05). Knowledge about hypertension, awareness of prevention, medication adherence, and behavioral adherence also improved compared to pre-intervention levels ( P 0.05). A repeated-measures analysis of variance revealed a statistically significant main effect of time on both systolic and diastolic blood pressure SBP: F (1.90 , 1, 369.92) = 135.833, partial η 2 = 0.159; DBP: F (1.995 , 1, 436.10) = 50.181, partial η 2 = 0.065, both P 0.05. Analysis of factors influencing blood pressure control at the end of the intervention demonstrated that poor medication adherence due to adverse drug reactions was associated with inadequate blood pressure control OR (95% CI): 3.222 (1.169–8.878), P 0.05. Additionally, after the intervention, not reducing smoking was identified as a factor inversely associated with uncontrolled diastolic blood pressure OR (95% CI): 0.192 (0.068–0.562), P 0.05, while higher body weight remained associated with uncontrolled diastolic blood pressure OR (95% CI): 1.018 (1.003–1.035), P 0.05. Furthermore, using non-drink-reducers as the reference group, alcohol reduction was identified as an influencing factor for uncontrolled systolic blood pressure OR (95% CI): 2.550 (1.419–4.583), P 0.05. Conclusion Community-based interventions by primary care physicians targeting individuals with high-normal blood pressure can effectively modify unhealthy lifestyle habits and improve blood pressure control.
Gao et al. (Wed,) conducted a other in Hypertensive patients aged 18-80 years with high-normal blood pressure (SBP 120-139 mmHg and/or DBP 80-89 mmHg) receiving community-based intervention in Shenyang, China (n=721). Community physician-led standardized health management intervention including health education, lifestyle modification counseling, medication adherence support vs. Pre-intervention baseline (same participants) was evaluated on Blood pressure control rate defined as average follow-up blood pressure <130/80 mmHg at 12 months post intervention (OR 3.222 for poor medication adherence due to adverse reactions as risk for uncontrolled BP, 95% CI 1.169–8.878, p=<0.05). Community physician-led intervention increased blood pressure control rate from 19.7% to 36.3% and significantly reduced median SBP from 132 to 130 mmHg and DBP from 78 to 76 mmHg after 12 months in hypertensive patients with high-normal BP.