The effect of follow-up on the blood pressure control: a longitudinal study in rural areas of China

BACKGROUND: High health risk and low management compliance pose significant challenges in controlling hypertensive patients' blood pressure. Therefore, this study aims to investigate the impact of follow-up services on blood pressure control at the primary level. METHODS: A total of 871 hypertensive patients consecutively enrolled from 2016 to 2021 were randomly selected from Qianjiang County, Hubei Province and Changsha County, Hunan Province of China. Blood pressure measurements (systolic blood pressure, SBP, and diastolic blood pressure, DBP) were defined as outcome variables, whereas the interval and regularity of follow-up visits served as key explanatory variables. A fixed-effects model was used to examine the influence of follow-up behaviors on blood pressure control among hypertensive patients. RESULTS: An increased frequency of follow-up visits, particularly those closer to or above the minimum threshold outlined in the 2020 Guidelines for Prevention and Control of Hypertension in China, was found to be beneficial for blood pressure control. The effectiveness of blood pressure control further improved with shorter follow-up intervals. However, when the number of follow-up visits deviated significantly from the minimum threshold, optimizing blood pressure control was achievable by extending follow-up intervals. CONCLUSIONS: A moderate increase in follow-up visits may be more effective in reducing hypertension patients' blood pressure than limiting follow-up intervals. It is suggested that primary hypertension management should focus on the regularity and intervals of follow-up visits and flexibly complete follow-up tasks. Moreover, the formal review of follow-up frequency and intervals, along with the efficiency of interventions implemented, should not be overlooked in hypertension control.