Stepped Care for hypertension resulted in substantially lower five-year all-cause death rates (by 15% to 28%) compared to Referred Care for most race-sex and age subgroups.
RCT
Yes
Does Stepped Care improve blood pressure control and reduce five-year all-cause mortality compared to Referred Care in hypertensive patients across different race, sex, and age subgroups?
A Stepped Care approach to hypertension management significantly improves blood pressure control and reduces five-year all-cause mortality across most demographic subgroups compared to standard Referred Care.
Effect estimate: 15% to 28% reduction
Data are reported for four race-sex and three age subgroups of the Hypertension Detection and Follow-up Program (HDFP). Throughout the HDFP trial, for black men, black women, white men, and white women and for persons aged 30 to 49, 50 to 59, and 60 to 69 years at entry, control of blood pressure was consistently better for Stepped Care (SC) than Referred Care (RC) participants. This difference in degree of control was least for white women; it was less for whites than for blacks of the same sex. For white men, black men, and black women and for age subgroups 50 to 59 and 60 to 69 years, five-year all-cause death rates were substantially lower—by 15% to 28%—for the SC subgroups compared to the RC subgroups. (JAMA242:2572-2577, 1979)
A 1979 study conducted an RCT in Hypertension. Stepped Care (SC) vs. Referred Care (RC) was evaluated on five-year all-cause death rates (15% to 28% reduction). Stepped Care for hypertension resulted in substantially lower five-year all-cause death rates (by 15% to 28%) compared to Referred Care for most race-sex and age subgroups.