Impact evaluation of the Hypertension Treatment in Nigeria program using the Translational Science Benefits Model

Hypertension is a leading cause of cardiovascular disease with significant burden experienced in low-and middle-income countries. The Hypertension Treatment in Nigeria (HTN) Program implemented a large-scale hypertension treatment program in the Federal Capital Territory (FCT) of Nigeria. Identification of benefits is important to acknowledge and demonstrate the value of research beyond evaluation of pre-identified scientific outcomes. This manuscript aims to identify the benefits and impact of the HTN Program using the Translational Science Benefits Model (TSBM).

The HTN Program was a type II interrupted time series trial conducted from January 2020 to December 2023 to evaluate effectiveness and implementation of a multilevel hypertension control program in 60 primary healthcare centers in Nigeria. TSBM benefits were identified and verified by cataloging events, results, and procedures and aligning using the Translating for Impact Toolkit. The domains include policy, community, clinical, economic, and a new fifth domain, capacity building.

The HTN Program enrolled 21,922 patients. Hypertension treatment increased from 86.8% (95%CI: 86.5%, 87.2%) at baseline to 96.2% (95%CI: 96.0%, 96.4%) at the end of the study period. Hypertension control also increased from 22.3% (95%CI: 21.7%, 22.9%) at baseline to 56.4% (95%CI: 55.9%, 56.8%). Thirty-three TSBM benefits were identified across five domains. Most benefits were identified in the policy (9), capacity building (9), and community (7) domains.

The HTN Program not only improved hypertension treatment and control in primary care in the FCT of Nigeria but also demonstrated broader impacts beyond its initial effectiveness and implementation objectives supporting program sustainment and scale-up.Trial Registration: NCT04158154.