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The intervention effects of a community-based hypertension control programme in two rural South African towns: the
K Steyn1, J E Rossouw, P L Jooste
1Centre for Epidemiological Research in Southern Africa, Research Institute for Nutritional Diseases, Parowvallei, CP.
Insights
Community-based hypertension interventions significantly reduced blood pressure in women and men. High-intensity follow-up showed greater reductions, demonstrating the effectiveness of this public health approach.
Area of Science:
- Public Health
- Cardiovascular Disease Prevention
- Hypertension Management
Background:
- Hypertension is a major risk factor for cardiovascular disease.
- Community-based interventions are crucial for managing population-level health issues.
- The Coronary Risk Factor Study (CORIS) aimed to assess hypertension control strategies.
Purpose of the Study:
- To evaluate the effectiveness of a 4-year community-based hypertension intervention program.
- To compare the impact of high-intensity versus low-intensity intervention strategies.
- To assess blood pressure changes in hypertensive individuals and the general population.
Main Methods:
- Screening for hypertension at a community blood pressure station.
- Providing non-drug management and referral for drug therapy.
- Implementing two intervention levels: high-intensity (active follow-up) and low-intensity (no active follow-up).
- Utilizing a control town for comparison.
Main Results:
- Statistically significant reductions in systolic and diastolic blood pressure were observed in both intervention groups.
- High-intensity intervention led to greater blood pressure reductions compared to low-intensity intervention.
- Reductions in the hypertensive cohort were mirrored in the total population changes.
Conclusions:
- Community-based hypertension programs can effectively lower blood pressure.
- Active follow-up within intervention programs enhances effectiveness.
- Public health strategies targeting hypertension are vital for cardiovascular health.
Abstract:
The objective of the hypertension programme of the Coronary Risk Factor Study (CORIS) was to evaluate the effectiveness of the first 4 years of community-based intervention. The hypertension intervention model comprised a blood pressure station where the whole population was screened for hypertension, non-drug management was provided and hypertensives were monitored after referral to general practitioners for drug therapy. Two levels of intervention were maintained: in the high-intensity intervention town (N = 2,278) hypertensives were actively followed up, and in the low-intensity intervention town (N = 2,620) no active follow-up procedure existed. A third town acted as control (N = 2,290). In the cohort which was hypertensive at baseline, the net decreases in systolic blood pressure (mean +/- SE) after correction for changes in the control town were 0.5 +/- 2.2 mmHg (men) and 4.5 +/- 2.2 mmHg (women) in the low-intensity intervention town, and 5.6 +/- 2.3 mmHg (men) and 7.5 +/- 2.2 mmHg (women) in the high-intensity intervention town. The net decrease in diastolic blood pressure was 3.4 +/- 1.2 mmHg (men) and 4.4 +/- 1.1 mmHg (women) in the low-intensity intervention town, and 6.1 +/- 1.2 mmHg (men) and 5.9 +/- 1.1 mmHg (women) in the high-intensity intervention town. These reductions were statistically significant with one exception. The changes in the total population in the 3 communities after 4 years of intervention were similar to those found in the hypertensive cohort.(ABSTRACT TRUNCATED AT 250 WORDS)