A 5-week cognitive-behavioural self-management programme significantly reduced systolic blood pressure by a mean difference of 10.15 mmHg compared to an information-only control at 4 months.
RCT (n=140)
Single-blind
Computer-generated allocation sequence (STATA)
No
Does a 5-week cognitive-behavioural self-management programme reduce blood pressure in adults with mild-to-moderate primary hypertension?
A community-based, 5-week cognitive-behavioural self-management program significantly reduced systolic and diastolic blood pressure in patients with mild-to-moderate hypertension.
Mean Difference: 10.15 (95% CI 7.25–13.05)
Absolute Event Rate: 130.57% vs 140.72%
p-value: p=<0.001
BACKGROUND: In Shanghai there are 1.2 million people with hypertension, many of whom have difficulty in affording medical treatment. Community based, anti-hypertensive clubs have been created to provide health education but education alone is often ineffective. Lifestyle change programmes have shown some potential for reducing blood pressure but in previous trials have required specialist staff and extensive contact. We have previously demonstrated that self-management programmes delivered by health professionals, such as a nurse who has had short training in self-management techniques can change health behaviour and reduce symptoms. This study was designed to evaluate the benefits of a simple, cognitive-behavioural, self-management programme for hypertension based around a hypertension manual and delivered in the setting of a community anti-hypertensive club in Shanghai. METHOD: The method was a pragmatic randomised controlled trial with an intention-to-treat analysis. Adult patients with mild-to-moderate primary hypertension, waiting to join a neighbourhood anti-hypertension club, were randomised to the self-management programme or to an information only control procedure. They attended the group treatment sessions on 4 occasions over 5 weeks for education combined with goal setting for lifestyle change and an introduction to exercise. The main outcome measures were: changes in blood pressure; blood total cholesterol; diet; activity level and health related quality of life 1 month and 4 months after the end of treatment. RESULTS: A total of 140 adults with mild-to-moderate primary hypertension took part. All of the main outcomes showed beneficial changes. Four months after the end of treatment the mean blood pressure differences between groups were systolic 10.15 mm Hg (P < 0.001, 95% CI 7.25-13.05), and diastolic 8.29 mmHg (P < 0.001, 95% CI 6.71-9.88). Patients in the intervention group also had significantly reduced weight, lowered blood total cholesterol, increased physical activity and improved quality of life. CONCLUSION: Patients with mild-to-moderate primary hypertension attending a 5 week, group and manual based, cognitive-behavioural self-management programme, delivered through a voluntary club in Shanghai experienced a significant reduction in blood pressure. TRIAL REGISTRATION: Current Controlled Trials ISRCTN73114566.
Xue et al. (Tue,) conducted a rct in Mild-to-moderate primary hypertension (n=140). Cognitive-behavioural self-management programme vs. Information only control was evaluated on Systolic blood pressure at 4 months post-treatment (MD 10.15, 95% CI 7.25-13.05, p=<0.001). A 5-week cognitive-behavioural self-management programme significantly reduced systolic blood pressure by a mean difference of 10.15 mmHg compared to an information-only control at 4 months.