CRHCP
Trial question
What is the role of non-physician community healthcare provider-led intensive BP intervention in adults with hypertension?
Study design
Multi-center
Open label
RCT
Population
33995 patients.
Inclusion criteria: individuals aged ≥ 40 years with an untreated SBP ≥ 140 mmHg or a DBP ≥ 90 mmHg.
Key exclusion criteria: age < 40 years; pregnancy; life expectancy < 3 years; malignant tumors.
Interventions
N=163 non-physician community healthcare provider-led intervention (initiation and titration of antihypertensive medications to achieve a SBP goal < 130 mmHg and DBP goal < 80 mmHg with supervision from primary care physicians).
N=163 villages: usual care (villages: no intervention).
Primary outcome
Incidence of composite of MI, stroke, heart failure requiring hospitalization, and cardiovascular disease death during the 36-month follow-up
1.62% / y
2.4% / y
2.4 % / y
1.8 % / y
1.2 % / y
0.6 % / y
0.0 % / y
Non-physician community healthcare provider-led
intervention
Villages: usual
care
Significant
decrease ▼
Significant decrease in the incidence of composite of MI, stroke, HF requiring hospitalization, and CVD death during the 36-month follow-up (1.62% / y vs. 2.4% / y; HR 0.67, 95% CI 0.61 to 0.73).
Conclusion
In individuals aged ≥ 40 years with an untreated SBP ≥ 140 mmHg or a DBP ≥ 90 mmHg, non-physician community healthcare provider-led intervention was superior to villages: usual care with respect to the incidence of composite of MI, stroke, HF requiring hospitalization, and CVD death during the 36-month follow-up.
Reference
Jiang He, Nanxiang Ouyang, Xiaofan Guo et al. Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trial. Lancet. 2023 Mar 18;401(10380):928-938.
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