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Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial

Overview
Title:
Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial
Authors:
Jafar TH, Hatcher J, Poulter N, Islam M, Hashmi S, Qadri Z, Bux R, Khan A, Jafary FH, Hameed A, Khan A, Badruddin SH, Chaturvedi N, Hypertension Research Group
Journal:
Ann Intern Med
Publication date:
2009
Volume:
151
Issue:
9
First page:
593
Last page:
601
ISSN:
1539-3704
Link to pubmed:
http://www.ncbi.nlm.nih.gov/pubmed/19884620
Publication type:
Journal
Abstract
BACKGROUND: Despite convincing evidence that lowering blood pressure decreases cardiovascular morbidity and mortality, the hypertension burden remains high and control rates are poor in developing countries. OBJECTIVE: To assess the effectiveness of 2 community-based interventions on blood pressure in hypertensive adults. DESIGN: Cluster randomized, 2 x 2 factorial, controlled trial. (ClinicalTrials.gov registration number: NCT00327574) SETTING: 12 randomly selected communities in Karachi, Pakistan. PATIENTS: 1341 patients 40 years or older with hypertension (systolic blood pressure >or=140 mm Hg, diastolic blood pressure >or=90 mm Hg, or already receiving treatment). MEASUREMENTS: Reduction in systolic blood pressure from baseline to end of follow-up at 2 years. INTERVENTION: Family-based home health education (HHE) from lay health workers every 3 months and annual training of general practitioners (GPs) in hypertension management. RESULTS: The age, sex, and baseline blood pressure-adjusted decrease in systolic blood pressure was significantly greater in the HHE and GP group (10.8 mm Hg [95% CI, 8.9 to 12.8 mm Hg]) than in the GP-only, HHE-only, or no intervention groups (5.8 mm Hg [CI, 3.9 to 7.7 mm Hg] in each; P
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Community-based interventions to promote blood pressure control in a developing country: a cluster randomized trial Jafar TH, Hatcher J, Poulter N, Islam M, Hashmi S, Qadri Z et al. Ann Intern Med 2009; 151(9):593-601.

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