High blood pressure improves with team-based care, study finds

A trial of 1,272 patients at 36 federally qualified health centers found that intensive team-based care lowered systolic blood pressure by nearly 16 mm Hg after 18 months, versus a 9 mm Hg drop with usual care.

Researchers report that intensive team-based care led to a substantial fall in systolic blood pressure in a recent clinical trial. The study enrolled 1,272 patients with high blood pressure at 36 federally qualified health centers in Louisiana and Mississippi. The team approach combined primary care doctors, nurses and community health workers with home blood pressure monitoring, coaching and medication reminders. The trial compared this model with usual care over an 18-month period. Key findings: - The trial included 1,272 patients across 36 federally qualified health centers in Louisiana and Mississippi. - The team-based model used home blood pressure measurements at least three times per week, coaching on lifestyle, medication reminders, and clinician monitoring. - After 18 months, systolic blood pressure fell by nearly 16 mm Hg in the team-based group versus a 9 mm Hg decline in the usual-care group. - About 48% of the team-based group reached systolic under 130 mm Hg and 22% reached under 120 mm Hg; corresponding rates in usual care were 36% and 15%. - Researchers reported that the observed difference could translate into an estimated 10% reduction in major heart events such as heart attack, stroke or heart failure. Summary: The trial showed larger blood pressure reductions with an intensive, team-based approach in federally qualified health centers serving low-income rural and urban populations. Researchers said they hope the strategy can be implemented more widely, including in the nation's federally qualified health centers, as a way to improve hypertension control.