Please use this identifier to cite or link to this item: https://doi.org/10.1161/HYPERTENSIONAHA.109.134874
Title: Hypertension improvement project: Randomized trial of quality improvement for physicians and lifestyle modification for patients
Authors: Svetkey, L.P.
Pollak, K.I.
Yancy, W.S.
Dolor, R.J.
Batch, B.C.
Samsa, G.
Matchar, D.B. 
Lin, P.-H.
Keywords: Behavioral intervention
Blood pressure
DASH dietary pattern
Hypertension
Lifestyle
Quality improvement
Issue Date: Dec-2009
Citation: Svetkey, L.P., Pollak, K.I., Yancy, W.S., Dolor, R.J., Batch, B.C., Samsa, G., Matchar, D.B., Lin, P.-H. (2009-12). Hypertension improvement project: Randomized trial of quality improvement for physicians and lifestyle modification for patients. Hypertension 54 (6) : 1226-1233. ScholarBank@NUS Repository. https://doi.org/10.1161/HYPERTENSIONAHA.109.134874
Abstract: Despite widely publicized hypertension treatment guidelines for physicians and lifestyle recommendations for patients, blood pressure control rates remain low. In community-based primary care clinics, we performed a nested, 2×2 randomized, controlled trial of physician intervention versus control and/or patient intervention versus control. Physician intervention included internet-based training, self-monitoring, and quarterly feedback reports. Patient intervention included 20 weekly group sessions followed by 12 monthly telephone counseling contacts and focused on weight loss, Dietary Approaches to Stop Hypertension dietary pattern, exercise, and reduced sodium intake. The primary outcome was change in systolic blood pressure at 6 months. Eight primary care practices (32 physicians) were randomized to physician intervention or control groups. Within those practices, 574 patients were randomized to patient intervention or control groups. Patient mean age was 60 years, 61% were women, and 37% were black. Blood pressure data were available for 91% of patients at 6 months. The main effect of physician intervention on systolic blood pressure at 6 months, adjusted for baseline pressure, was 0.3 mm Hg (95% CI:-1.5 to 2.2; P=0.72). The main effect of the patient intervention was-2.6 mm Hg (95% CI:-4.4 to-0.7; P=0.01). The interaction of the 2 interventions was significant (P=0.03); the largest impact was observed with the combination of physician and patient intervention (-9.7±12.7 mm Hg). Differences between treatment groups did not persist at 18 months. Combined physician and patient interventions lowers blood pressure; future research should focus on enhancing effectiveness and sustainability of these interventions. © 2009 American Heart Association. All rights reserved.
Source Title: Hypertension
URI: http://scholarbank.nus.edu.sg/handle/10635/110560
ISSN: 0194911X
DOI: 10.1161/HYPERTENSIONAHA.109.134874
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

72
checked on Oct 16, 2019

WEB OF SCIENCETM
Citations

65
checked on Oct 8, 2019

Page view(s)

39
checked on Oct 11, 2019

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.