Key result
ImPress nurse intervention lowers SBP ~11 mmHg vs usual care in high-risk hypertensive adults.
Why the study?
Hypertension is a highly prevalent but often poorly controlled cardiovascular risk factor, and the effectiveness of a general practice nurse intervention to reduce blood pressure remained to be determined.
Does a general practice nurse intervention reduce blood pressure in adults with hypertension at high risk of CVD?
RCT (n=65)
Open-label
Cluster randomized
Yes
Does a general practice nurse intervention reduce blood pressure in adults with hypertension at high risk of CVD?
A general practice nurse-led intervention significantly reduced systolic blood pressure at 12 months in high-risk patients with hypertension, supporting a greater role for nurses in hypertension management.
Supports integrating nurse-led care models to achieve meaningful blood pressure targets in high-risk patients;.
BACKGROUND AND OBJECTIVES: Hypertension is a highly prevalent but often poorly controlled risk factor for cardiovascular disease (CVD). This study examined the effectiveness of a general practice nurse (GPN) intervention to reduce blood pressure in adults with hypertension who are at high risk of CVD. METHOD: A cluster randomised control trial was performed across 10 general practices. Systolic (SBP) and diastolic (DBP) blood pressure were evaluated at six and 12 months. RESULTS: The adjusted mean difference between intervention and control groups at six months was 8.1 mmHg (95% confidence interval [CI]: -2.92, 18.94 mmHg; P=0.146) for SBP and 0.18 mmHg (95% CI: -6.54, 4.91 mmHg; P=0.775) for DBP. The adjusted mean difference between groups at 12 months was 11.3 mmHg (95% CI: 1.18, 21.42 mmHg; P=0.030) for SBP and 7.1 mmHg (95% CI: -8.62, 22.90 mmHg; P=0.362) for DBP. DISCUSSION: Clinically significant between-group differences in mean SBP at six and 12 months provide evidence for GPNs to play a greater role in managing hypertension.
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Stephen et al. (2023) conducted an RCT in Hypertension and high risk of cardiovascular disease (n=65). General practice nurse (GPN) intervention (ImPress) vs. Usual care was evaluated on Systolic blood pressure reduction at 12 months (Adjusted mean difference 11.3 mmHg, 95% CI 1.18-21.42, p=0.030). The ImPress general practice nurse intervention reduced systolic blood pressure by an adjusted mean difference of 11.3 mmHg at 12 months compared to usual care in adults with hypertension at high cardiovascular risk.
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