Abstract
Although the efficacy and effectiveness of lifestyle modifications and antihypertensive
pharmaceutical treatment for the prevention and control of hypertension and concomitant
cardiovascular disease have been demonstrated in randomized controlled trials, this
scientific knowledge has not been fully applied in the general population, especially
in low-income communities. This article summarizes interventions to improve hypertension
management and describes the rationale and study design for a cluster randomized trial
testing whether a comprehensive intervention program within a national public primary
care system will improve hypertension control among uninsured hypertensive men and
women and their families. We will recruit 1,890 adults from 18 clinics within a public
primary care network in Argentina. Clinic patients with uncontrolled hypertension,
their spouses and hypertensive family members will be enrolled. The comprehensive
intervention program targets the primary care system through health care provider
education, a home-based intervention among patients and their families (home delivery
of antihypertensive medication, self-monitoring of blood pressure [Bp], health education
for medication adherence and lifestyle modification) conducted by community health
workers and a mobile health intervention. The primary outcome is net change in systolic
Bp from baseline to month 18 between intervention and control groups among hypertensive
study participants. The secondary outcomes are net change in diastolic Bp, Bp control
and cost-effectiveness of the intervention. This study will generate urgently needed
data on effective, practical and sustainable intervention programs aimed at controlling
hypertension and concomitant cardiovascular disease in underserved populations in
low- and middle-income countries.
Key Indexing Terms
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Article info
Footnotes
Support to the Hypertension Control Program in Argentina is provided by the National Heart, Lung, and Blood Institute, the National Institutes of Health Grant U01HL114197 under the Global Alliance for Chronic Diseases programme.
The authors have no conflicts of interest to disclose.
Identification
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© 2014 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
