+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Comprehensive approach for hypertension control in low-income populations: rationale and study design for the hypertension control program in Argentina



Comprehensive approach for hypertension control in low-income populations: rationale and study design for the hypertension control program in Argentina



American Journal of the Medical Sciences 348(2): 139-145



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.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052269976

Download citation: RISBibTeXText

PMID: 24978148

DOI: 10.1097/maj.0000000000000298


Related references

Cost-Effectiveness of a Comprehensive Approach for Hypertension Control in Low-Income Settings in Argentina: Trial-Based Analysis of the Hypertension Control Program in Argentina. Value in Health 21(12): 1357-1364, 2018

Rationale for a community approach to hypertension control among inner city minority populations. Heart Disease and Stroke 3(2): 61-62, 1994

Rationale and design of a randomized clinical trial on prevention of stroke in isolated systolic hypertension. The Systolic Hypertension in the Elderly Program (SHEP) Cooperative Research Group. Journal of Clinical Epidemiology 41(12): 1197-1208, 1988

Effect of comprehensive intervention on hypertension control program in workplaces in China. Zhonghua Liu Xing Bing Xue Za Zhi 40(2): 212-217, 2019

The ABCD (Appropriate Blood Pressure Control in Diabetes) trial. Rationale and design of a trial of hypertension control (moderate or intensive) in type II diabetes. Online Journal of Current Clinical Trials Doc no 104: 6250 Words; 128 Paragraphs, 1993

One-size-fits-all management of hypertension: a key to poor control of hypertension in low income settings in sub-Saharan Africa?. Annals of Translational Medicine 4(21): 437, 2016

Patient participation in a hypertension control program. Hypertension Detection and Follow-up Program Cooperative Group. JAMA 239(15): 1507-1514, 1978

On the transition from a nurse-led hypertension clinic to hypertension control in primary care: identifying barriers to and factors acting against continuous hypertension control. Blood Pressure 25(4): 263-267, 2016

Shake Rattle & Roll - Design and rationale for a pragmatic trial to improve blood pressure control among blacks with persistent hypertension. Contemporary Clinical Trials 76: 85-92, 2019

EXCEED: Exforge-intensive control of hypertension to evaluate efficacy in diastolic dysfunction: study rationale, design, and participant characteristics. Therapeutic Advances in Cardiovascular Disease 3(6): 429-439, 2009

Design and rationale for Home Blood Pressure Telemonitoring and Case Management to Control Hypertension (HyperLink): a cluster randomized trial. Contemporary Clinical Trials 33(4): 794-803, 2012

The effect of the Missouri WISEWOMAN program on control of hypertension, hypercholesterolemia, and elevated blood glucose among low-income women. Preventing Chronic Disease 11: E74, 2014

The Ashkelon Hypertension Detection and Control Program (AHDC Program): a community approach to reducing cardiovascular mortality. Preventive Medicine 37(6 Pt 1): 571-576, 2003

Opera Design and rationale for a novel placebo control trial testing the benefits of blood pressure reduction in patients with Stage I isolated systolic hypertension. American Journal of Hypertension 13(4 Part 2): 70A-71A, 2000

The Mayo Three-Community Hypertension Control Program. I. Design and initial screening results. Mayo Clinic Proceedings 54(5): 289-298, 1979