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Is a targeted intensive intervention effective for improvements in hypertension control? A randomized controlled trial

Is a targeted intensive intervention effective for improvements in hypertension control? A... BackgroundHigh blood pressure (BP) is one of the most important risk factors for stroke, and antihypertensive therapy significantly reduces the risk of cardiovascular morbidity and mortality. However, achieving a regulated BP in hypertensive patients is still a challenge.ObjectiveTo evaluate the impact of an intervention targeting GPs' management of hypertension.MethodsA cluster randomized trial comprising 124 practices and 2646 patients with hypertension. In the Capital Region of Denmark, the participating GPs were randomized to an intensive or to a moderately intensive intervention group or to a control group and in Region Zealand and Region of Southern Denmark, practices were randomized into a moderately intensive intervention and to a control group. The main outcome measures were change in proportion of patients with high BP and change in systolic BP (SBP) and diastolic BP (DBP) from the first to the second registration.ResultsThe proportion of patients with high BP in 2007 was reduced in 2009 by 9% points. The mean SBP was reduced significantly from 2007 to 2009 by 3.61 mmHg [95% confidence interval (CI): 4.26 to 2.96], and the DBP was reduced significantly by 1.99 mmHg (95% CI: 2.37 to 1.61). There was no additional impact in either of the intervention groups.ConclusionThere was no impact of the moderate intervention and no additional impact of the intensive intervention on BP. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Family Practice Oxford University Press

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References (24)

Publisher
Oxford University Press
Copyright
The Author 2012. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Subject
Original Article
ISSN
0263-2136
eISSN
1460-2229
DOI
10.1093/fampra/cms031
pmid
22565110
Publisher site
See Article on Publisher Site

Abstract

BackgroundHigh blood pressure (BP) is one of the most important risk factors for stroke, and antihypertensive therapy significantly reduces the risk of cardiovascular morbidity and mortality. However, achieving a regulated BP in hypertensive patients is still a challenge.ObjectiveTo evaluate the impact of an intervention targeting GPs' management of hypertension.MethodsA cluster randomized trial comprising 124 practices and 2646 patients with hypertension. In the Capital Region of Denmark, the participating GPs were randomized to an intensive or to a moderately intensive intervention group or to a control group and in Region Zealand and Region of Southern Denmark, practices were randomized into a moderately intensive intervention and to a control group. The main outcome measures were change in proportion of patients with high BP and change in systolic BP (SBP) and diastolic BP (DBP) from the first to the second registration.ResultsThe proportion of patients with high BP in 2007 was reduced in 2009 by 9% points. The mean SBP was reduced significantly from 2007 to 2009 by 3.61 mmHg [95% confidence interval (CI): 4.26 to 2.96], and the DBP was reduced significantly by 1.99 mmHg (95% CI: 2.37 to 1.61). There was no additional impact in either of the intervention groups.ConclusionThere was no impact of the moderate intervention and no additional impact of the intensive intervention on BP.

Journal

Family PracticeOxford University Press

Published: Dec 7, 2012

Keywords: APO method blood pressure intervention primary care quality improvements

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