Strategy for Blood Pressure Control in Pakistan Examined

Physician office and home health visits found to work better then either intervention alone
By Jeff Muise
HealthDay Reporter

WEDNESDAY, Nov. 4 (HealthDay News) -- A combination of family physician office visits and family-based home health education (HHE) may be effective in reducing blood pressure (BP), according to a study completed in Pakistan and reported in the Nov. 3 issue of the Annals of Internal Medicine.

Tazeen H. Jafar, M.D., of Aga Khan University in Karachi, Pakistan, and colleagues randomized 1,341 hypertension patients (systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or already in treatment) living in 12 Pakistani communities to either receive general practitioner education on BP control, HHE visits by lay workers trained in BP control, both interventions, or neither intervention. The researchers tracked reduction in systolic BP in the groups from baseline through a two-year follow-up.

The researchers found that patients receiving both interventions exhibited the greatest decrease in systolic BP (10.8 mm Hg) after two years, while decreases were similar among the general practitioner education-only, HHE visit-only, and neither intervention groups (5.8 mm Hg). However, 22 percent of the patients were lost for follow-up and the method of BP lowering was not provided.

"Family-based HHE delivered by trained lay health workers, coupled with educating general practitioners on hypertension, can lead to significant blood pressure reductions among patients with hypertension in Pakistan," the authors conclude. "Both strategies in combination may be feasible for upscaling within the existing health care systems of Indo-Asian countries."

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