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Community-based hypertension control programs hold promise for decreasing blood pressure among urban blacks

A community-based program that partnered with an academic health center to train community health workers to make home visits and do community outreach to reduce hypertension in an impoverished black community in West Baltimore was effective in reducing high blood pressure in this group. Among the nearly 800 men and women involved in the study, 37 percent suffered from hypertension.

The researchers randomly assigned 387 patients to a more intensive group of education and support and 402 patients to a less intensive group. The less intensive group received a home visit from a nurse-supervised community health worker trained in blood pressure measurement, monitoring, education, followup, and community outreach. Community health workers explained hypertension and its treatment and the importance of following treatment and achieving a target blood pressure (BP) and provided information on access to free community care for those who needed it. They gave each participant a card to record dates and levels of BP and a pamphlet that emphasized self-care behaviors, such as controlling weight, moderating salt and alcohol intake, and increasing physical activity.

The more intensive intervention added five home visits conducted over a 30-month period, as well as more extensive education, counseling, and outreach. Although both programs significantly decreased blood pressure at the 40-month followup, the differences between the groups were insignificant. Blood pressure control doubled for both groups. The percentage of individuals with normal blood pressure increased by 12 percent in the more intensive group and 14 percent in the less intensive group.

Details are in "The effectiveness of a community/academic health center partnership in decreasing the level of blood pressure in an urban African-American population." by David M. Levine, M.D., Lee R. Bone, R.N., M.P.H., Martha N. Hill, R.N., Ph.D., and others, in the Summer 2003 Ethnicity & Disease 13, pp. 354-361.

Reprints (AHRQ Publication No. 04-R003) are available from the AHRQ Publications Clearinghouse.

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