HealthDay News — For patients with hypertension, multilevel, multicomponent strategies, followed by patient-level strategies, are the most effective for blood pressure (BP) control, according to a review published in the Annals of Internal Medicine.
Katherine T. Mills, PhD, from the Tulane University School of Public Health and Tropical Medicine in New Orleans, and colleagues examined the comparative effectiveness of 8 implementation strategies for BP control vs usual care for adults with hypertension. They included 121 comparisons from 100 articles regarding 55,920 patients with hypertension.
The researchers found that for systolic BP reduction, multilevel, multicomponent strategies were the most effective; these included team-based care with medication titration by a nonphysician, team-based care with medication titration by a physician, and multilevel strategies without team-based care (−7.1 mm Hg, −6.2mm Hg, and −5 mm Hg, respectively). Systolic BP changes of −3.9 mm Hg and −2.7 mm Hg resulted from the patient-level strategies of health coaching and home BP monitoring. The trends for diastolic BP reduction were similar.
“Multilevel, multicomponent strategies, followed by patient-level strategies, are most effective for BP control in patients with hypertension and should be used to improve hypertension control,” the authors wrote.
Mills KT, Obst Km, Shen W, et al. Comparative effectiveness of implementation strategies for blood pressure control in hypertensive patients: a systemic review and meta-analysis [published online December 26, 2017]. Ann Intern Med. doi:10.7326/M17-1805