Note: Single-source report; awaiting corroboration.
Uncontrolled hypertension is a leading cause of heart disease and stroke in the U.S., occurring more frequently among low-income populations. It develops when blood pressure is too high against artery walls, increasing cardiovascular risk. Integrated health systems have used multifaceted interventions to help lower blood pressure, but their effectiveness in resource-limited, low-income settings is less understood.
An NIH-funded team led by Dr. Katherine Mills at Tulane University tested an intensive approach to blood pressure control among low-income adults aged 40 and older. The goal was to determine if the approach could be used successfully in real-world primary care clinics.
The study enrolled over 1,200 patients with uncontrolled hypertension at 36 Federally Qualified Health Centers in Louisiana and Mississippi. Clinics were randomly assigned to either continue standard care or deliver a multifaceted, team-based strategy. About half of the participants received the intervention, which included intensive blood pressure tracking and feedback, health coaching on lifestyle changes and medication adherence, and home blood pressure monitoring. The control group received enhanced usual care, including clinician education on hypertension guidelines.
Participants were followed for 18 months, aiming to lower systolic blood pressure—the upper number reflecting blood force during heartbeats—and to increase adherence to the treatment program. Normal blood pressure is less than 120 mm Hg systolic and less than 80 mm Hg diastolic. The results, published in the New England Journal of Medicine, may help guide future efforts to improve blood pressure control in underserved populations through team-based care strategies.