Government-Expert Joint Intervention with Treatment Algorithm and Improved Hypertension Management and Reduced Stroke Mortality in a Primary-Care Setting

• Published in: International journal of hypertension Vol. 2021; pp. 9661576 - 9
• Main Authors: Heizhati, Mulalibieke, Li, Nanfang, Zhang, Delian, Abulikemu, Suofeiya, Chang, Guijuan, Hong, Jing, Maimaiti, Nuerguli, Hu, Junli, Wang, Lei, Duiyimuhan, Gulinuer
• Format: Journal Article
• Language: English
• Published: United States Hindawi 14.10.2021; Hindawi Limited; Wiley
• Subjects: Algorithms; Antihypertensives; Blood pressure; Cardiovascular disease; Community health care; Developing countries; Education; Evaluation; Evidence-based medicine; Family physicians; Health aspects; Health care; Health services; Heart failure; Hospitals; Hydrochlorothiazide; Hypertension; Intervention; Low income groups; Medical screening; Mortality; Physicians; Population; Public schools; Risk factors; Stroke; China
• ISSN: 2090-0384; 2090-0392; 2090-0392
• DOI: 10.1155/2021/9661576

Hypertension management is suboptimal in the primary-care setting of developing countries, where the burden of both hypertension and cardiovascular disease is huge. Therefore, we conducted a government-expert joint intervention in a resource-constrained primary setting of Emin, China, between 2014 and 2016, to improve hypertension management and reduce hypertension-related hospitalization and mortality. Primary-care providers were trained on treatment algorithm and physicians for specialized management. Public education was delivered by various ways including door-to-door screening. Program effectiveness was evaluated using screening data by comparing hypertension awareness, treatment, and control rates and by comparing hypertension-related hospitalization and total cardiovascular disease (CVD) and stroke mortality at each phase. As results, 313 primary-health providers were trained to use the algorithm and 3 physicians attended specialist training. 1/3 of locals (49490 of 133376) were screened. Compared to the early phase, hypertension awareness improved by 9.3% (58% vs. 64%), treatment by 11.4% (39% vs. 44%), and control rates by 33% (10% vs. 15%). The proportion of case/all-cause hospitalization was reduced by 35% (4.02% vs. 2.60%) for CVD and by 17% (3.72% vs. 3.10%) for stroke. The proportion of stroke/all-cause death was reduced by 46% (21.9% in 2011–2013 vs. 15.0% in 2014–2016). At the control area, the proportion of case/all-cause mortality showed no reduction. In conclusion, government-expert joint intervention with introducing treatment algorithm may improve hypertension control and decrease related hospitalization and stroke mortality in underresourced settings.