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Multilevel Interventions Demonstrate Mixed Effectiveness for Improving Blood Pressure Outcomes: A Rapid Review
Briana N Sprague1, Anna K Forster2
1Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Healthcare (Basel, Switzerland)
|June 26, 2025
Summary
Multilevel interventions improved blood pressure in U.S. adults, particularly those engaging the individual and healthcare team. Further research is needed on interventions outside traditional healthcare settings.
Area of Science:
- Public Health
- Cardiovascular Health
- Health Intervention Research
Background:
- High blood pressure (hypertension) is a significant public health concern in the United States.
- Community-dwelling adults are a key demographic for blood pressure management interventions.
- Multilevel interventions, targeting various environmental and social factors, show potential for improving health outcomes.
Purpose of the Study:
- To identify and evaluate multilevel interventions aimed at improving blood pressure in U.S. community-dwelling adults.
- To assess the treatment efficacy and identify effective components of these interventions.
- To understand the landscape of existing multilevel interventions for hypertension management.
Main Methods:
- Systematic review of peer-reviewed articles from major databases (Cochrane Library, EMBASE, PsycINFO, PubMed).
- Inclusion criteria focused on U.S. adults (18+), interventions at two or more levels, and blood pressure outcomes.
- Data extraction included intervention activities, blood pressure results, and subgroup analyses; synthesis used qualitative and statistical methods.
Main Results:
- Ninety-five papers representing 89 randomized controlled trials were analyzed.
- Interventions involving the individual and healthcare team demonstrated the most consistent positive effects on systolic (46%) and diastolic (47%) blood pressure.
- Interventions engaging families or communities outside healthcare settings showed promise but were less frequently studied (19%).
Conclusions:
- Evidence for the effectiveness of multilevel interventions on blood pressure in U.S. adults is mixed.
- Interventions that address individual factors alongside broader environmental influences (work, social settings) warrant further investigation.
- Future research should prioritize interventions extending beyond traditional healthcare to improve cardiovascular health outcomes.
Keywords:
adultsblood pressurecardiovascular healthhealth promotionmultilevel interventionrandomized controlled trialMore Related Videos
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