Key result
GP-led community management boosts hypertension control by ~36 percentage points over 5 years.
Why the study?
Hypertension is a leading cause of CVD, and the effectiveness of community healthcare in controlling BP and mitigating related risk factors over 5 y of follow-up needed evaluation.
Does a 5-year general practitioner-led community hypertension management programme improve blood pressure control rates and reduce systolic and diastolic blood pressure in adults with hypertension in southwest China?
Cohort (n=4,235)
Yes
Does a 5-year general practitioner-led community hypertension management programme improve blood pressure control rates and reduce systolic and diastolic blood pressure in adults with hypertension in southwest China?
Long-term general practitioner-led community hypertension management in southwest China more than doubled blood pressure control rates (from 28.33% to 64.05%) and significantly reduced blood pressure over 5 years.
Answers are grounded in this paper and cite their sources.
GP-led community hypertension management was associated with improved control; leaves open whether RCTs confirm benefits beyond this southwest China cohort.
BACKGROUND: Hypertension is a leading cause of cardiovascular disease (CVD). The purpose of this study was to examine the effectiveness of community healthcare in controlling blood pressure (BP) and mitigating related risk factors after 5 y of follow-up. METHODS: Hierarchical clustering sampling was employed to choose a representative sample of 10 rural and 10 urban community populations (N=4235). The 5y prospective cohort study was completed by the medical group in the community clinical centre. RESULTS: The study included 4235 patients, median age 69 y (range 61-76), with hypertension in 2009; 2533 (59.81%) were female. The rate of BP control increased from 28.33% in 2009 to 64.05% in 2014. The BP control rate was higher in patients with CVD and kidney disease and lower in those with obesity than in those without. Comparing 2009 and 2014 values, the intervention resulted in median systolic BP and diastolic BP reductions of 7.0 mmHg and 6.5 mmHg, respectively. Age, medication treatment, antihypertensive agents, BP at baseline and follow-up, complications of diabetes, CVD, obesity and kidney disease, the aspartate aminotransferase:aminotransferase ratio and smoking were identified as risk factors for BP control. CONCLUSIONS: Community management of hypertension by general practitioners achieved significant BP control over 5 y of intervention.
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Liang et al. (2020) conducted a cohort in Hypertension (n=4,235). Community hypertension management programme by general practitioners vs. Baseline pre-intervention status (2009) was evaluated on Blood pressure control rate and median systolic blood pressure reduction at 5 years (2014 vs 2009) (MD 7.00 mmHg, 95% CI 5.16-6.51, p=<0.01). Community hypertension management by general practitioners increased blood pressure control from 28.33% to 64.05% and reduced median systolic BP by 7.00 mmHg over 5 years.
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