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September 5, 2026Journal of the American College of Cardiology

A coordinated community and family intervention lowers SBP by ~11 mm Hg vs usual care.

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Why the study?

Hypertension prevention strategies predominantly focus on treating individuals with established hypertension, but whether a coordinated community- and family-based intervention can shift the population distribution of systolic blood pressure remains uncertain.

Does a coordinated community- and family-based intervention reduce systolic blood pressure in adults aged 40 to 80 years in rural China?

Population

8,001 adults aged 40 to 80 years across 80 village clusters in rural China

Comparison

Multifaceted community- and family-based intervention vs usual care

Design

Cluster-randomized trial

Follow-up

12 months

Key result

A coordinated community- and family-based intervention significantly reduced systolic blood pressure compared to usual care at 6 months (adjusted difference -10.7 mm Hg; 95% CI -11.8 to -9.6).

Authors

XDXin DuCJChao JiangYTYangyang Tang

Discussion

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Member takes

Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

DXDr. Xin Du

“Most blood pressure programs focus on treatment for people with high blood pressure, whereas our study included the whole family regardless of their blood pressure levels. This approach could transform how we prevent heart disease in communities worldwide. By involving entire families and communities rather than treating individuals, we can likely reduce everyone's risk of heart attack and stroke, especially in areas where health care resources are limited.”

Beijing Anzhen Hospital, Capital Medical UniversityAmerican Heart Association Newsroom

Overview

A multifaceted community- and family-based intervention significantly reduced systolic blood pressure at 6 months in a rural Chinese population, though the effect attenuated by 12 months.

Key Points

  • To evaluate the effectiveness of a coordinated community- and family-based healthcare intervention led by village doctors on blood pressure control in rural populations.
  • Conducted an open-label, cluster-randomized trial across rural villages assigned to either a comprehensive intervention or usual care.
  • The multi-faceted intervention included village doctor-led blood pressure management, standard medication protocols, health coaching, home blood pressure monitoring, and family support.
  • Tracked blood pressure reduction and the proportion of individuals achieving blood pressure control targets over follow-up.
  • The community- and family-based intervention achieved significantly higher rates of blood pressure control compared with usual care.
  • Participants in the intervention group experienced substantial reductions in mean systolic and diastolic blood pressure relative to standard care.

Study Design

Type

RCT (n=8,001)

Blinding

Blinded outcome assessment

Randomization

Cluster-randomized (1:1)

Multicenter

Yes

Structured PICO

Does a coordinated community- and family-based intervention reduce systolic blood pressure in adults aged 40 to 80 years in rural China?

P
Population
8,001 adults aged 40 to 80 years in 80 village clusters in rural China, irrespective of baseline blood pressure, followed for 12 months.
I
Intervention
Multifaceted coordinated community- and family-based intervention including community instructor support, potassium-enriched low-sodium salt substitute, home BP and weight monitoring, physical activity promotion, and facilitation of antihypertensive treatment during an initial 6-month active intervention phase, followed by continued digital BP monitoring support through 12 months.
C
Comparator
Usual care.
O
Outcome
Between-group difference in change in systolic blood pressure (SBP) from baseline to 6 months.surrogate

Main Result

Mean Difference: -10.7 (95% CI -11.8–-9.6)

Absolute Event Rate: -6% vs 5.1%

A multifaceted community- and family-based intervention significantly reduced systolic blood pressure at 6 months in a rural Chinese population, though the effect attenuated by 12 months.

Limitations

  • Attenuation of the treatment effect over time

Cite This Study

Du et al. (2026) conducted an RCT in Blood pressure control (n=8,001). Coordinated community- and family-based intervention vs. Usual care was evaluated on Between-group difference in change in systolic blood pressure from baseline to 6 months (MD -10.7 mm Hg, 95% CI -11.8 to -9.6). A coordinated community- and family-based intervention significantly reduced systolic blood pressure compared to usual care at 6 months (adjusted difference -10.7 mm Hg; 95% CI -11.8 to -9.6).

synapsesocial.com/papers/6a9c32df6697e5c854ee6bcdhttps://doi.org/10.1016/j.jacc.2026.07.045
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1#347 Long-term effectiveness of a village doctor-led multifaceted strategy on blood pressure control: a cluster randomized trial2024
  2. 2The effectiveness of hypertension management in China: a community-based intervention study2019 · 37 citations
  3. 3Population-wide impact of a pragmatic program to identify and manage individuals at high-risk of cardiovascular disease: a cluster randomized trial in 120 villages from Northern China2024 · 1 citations
  4. 4Implementation Research and Results of Hypertension Control Strategy and Model in Rural Areas2023
  5. 5Family-based interventions for optimal blood pressure outcomes in adults: a cluster randomised controlled trial in India.2025 · 3 citations