Peer Coaches, Staff Support Beneficial in Uncontrolled HTN

No significant drop in coronary heart disease risk, but reduced SBP for African-Americans with HTN

FRIDAY, June 1 (HealthDay News) -- For African-American patients with uncontrolled hypertension, an intervention consisting of peer- and practice-based support is associated with reduced systolic blood pressure (SBP) and a nonsignificant trend toward reduced coronary heart disease (CHD) risk at four years, according to a study published online May 9 in the Journal of General Internal Medicine.

To evaluate whether peer coaching and office staff support reduces participants' four-year CHD risk and SBP, Barbara J. Turner, M.D., of the University of Texas Health Science Center in San Antonio, and colleagues conducted a six-month trial involving 280 African-American participants, aged 40 to 75 years, with sustained, uncontrolled hypertension. Participants were randomized to receive three monthly calls from trained peer patients with well-controlled hypertension as well as two office staff visits every other month (intervention; 136 participants) or usual care (144 participants).

The researchers found that, based on CHD end point data from 69 percent of intervention participants and 82 percent of control patients, there was a trend toward reduced risk for CHD favoring the intervention, but the reduction was not statistically significant. Significantly more intervention versus control patients achieved a >5 mm Hg reduction in SBP (61 versus 45 percent). The absolute SBP reduction was also significantly higher for the intervention group (difference, −6.47 mm Hg).

"A complementary peer- and practice-based intervention resulted in a nonsignificant reduction of four-year CHD risk, but a clinically significant drop in systolic blood pressure in African-Americans with poorly controlled hypertension," the authors write.

The study was partially funded by an unrestricted grant from Pfizer.

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