Jing Xiao1,2, Wen-Long Ren1, Yuan-Yuan Liang1, Huan Shen1, Yue-Xia Gao1,2, Min-Jie Chu1,2, Zhou Li1, Xiao-Jian Wang3, Zuo-Feng Zhang2, Xun Zhuang4,5, Yong-Fu Yu2,6. 1. Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, People's Republic of China. 2. Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA. 3. Department of Chronic Disease and Prevention, Center for Disease Control and Prevention of Haian, Nantong, People's Republic of China. 4. Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, People's Republic of China. ntzhuang@163.com. 5. Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA. ntzhuang@163.com. 6. Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
Abstract
BACKGROUND: Strict medication guidance and lifestyle interventions to manage blood pressure (BP) in hypertensive patients are typically difficult to follow. OBJECTIVE: To evaluate the 1-year effectiveness of lifestyle and drug intervention in the management of rural hypertensive patients. DESIGN: Randomized community intervention trial. PARTICIPANTS: The control group comprised 967 patients who received standard antihypertensive drug intervention therapy from two communities, whereas the intervention group comprised 1945 patients who received antihypertensive drug and lifestyle intervention therapies from four communities in rural China. MAIN MEASURES: Data on lifestyle behaviors and BP measurements at baseline and 1-year follow-up were collected. A difference-in-difference logistic regression model was used to assess the effect of the intervention. KEY RESULTS: BP control after the 1-year intervention was better than that at baseline in both groups. The within-group change in BP control of 59.3% in the intervention group was much higher than the 25.2% change in the control group (P < 0.001). Along with the duration of the follow-up period, systolic and diastolic BP decreased rapidly in the early stages and then gradually after 6 months in the intervention group (P < 0.001). In the intervention group, drug therapy adherence was increased by 39.5% (from 48.1% at 1 month to 87.6% at 1 year) (P < 0.001), more in women (45.6%) than in men (31.2%; P < 0.001). The net effect of the lifestyle intervention improved the rate of BP control by 56.1% (70.8% for men and 44.7% for women). For all physiological and biochemical factors, such as body mass index, waist circumference, lipid metabolism, and glucose control, improvements were more significant in the behavioral intervention group than those in the control group (all P < 0.001). CONCLUSION: The addition of lifestyle intervention by physicians or nurses helps control BP effectively and lowers BP better than usual care with antihypertensive drug therapy alone.
BACKGROUND: Strict medication guidance and lifestyle interventions to manage blood pressure (BP) in hypertensive patients are typically difficult to follow. OBJECTIVE: To evaluate the 1-year effectiveness of lifestyle and drug intervention in the management of rural hypertensive patients. DESIGN: Randomized community intervention trial. PARTICIPANTS: The control group comprised 967 patients who received standard antihypertensive drug intervention therapy from two communities, whereas the intervention group comprised 1945 patients who received antihypertensive drug and lifestyle intervention therapies from four communities in rural China. MAIN MEASURES: Data on lifestyle behaviors and BP measurements at baseline and 1-year follow-up were collected. A difference-in-difference logistic regression model was used to assess the effect of the intervention. KEY RESULTS: BP control after the 1-year intervention was better than that at baseline in both groups. The within-group change in BP control of 59.3% in the intervention group was much higher than the 25.2% change in the control group (P < 0.001). Along with the duration of the follow-up period, systolic and diastolic BP decreased rapidly in the early stages and then gradually after 6 months in the intervention group (P < 0.001). In the intervention group, drug therapy adherence was increased by 39.5% (from 48.1% at 1 month to 87.6% at 1 year) (P < 0.001), more in women (45.6%) than in men (31.2%; P < 0.001). The net effect of the lifestyle intervention improved the rate of BP control by 56.1% (70.8% for men and 44.7% for women). For all physiological and biochemical factors, such as body mass index, waist circumference, lipid metabolism, and glucose control, improvements were more significant in the behavioral intervention group than those in the control group (all P < 0.001). CONCLUSION: The addition of lifestyle intervention by physicians or nurses helps control BP effectively and lowers BP better than usual care with antihypertensive drug therapy alone.
Entities:
Keywords:
blood pressure control rate; effectiveness; hypertension; lifestyle intervention
Authors: Pedro Pallangyo; Makrina Komba; Zabella S Mkojera; Peter R Kisenge; Smita Bhalia; Henry Mayala; Engerasiya Kifai; Mwinyipembe K Richard; Khuzeima Khanbhai; Salma Wibonela; Jalack Millinga; Robert Yeyeye; Nelson F Njau; Thadei K Odemary; Mohamed Janabi Journal: Integr Blood Press Control Date: 2022-08-10