A pilot study on the implementation of community guidelines and education was shown to effectively improve blood pressure control rate and decrease morbidity and mortality in Chinese hypertensive patients.

Hypertension is one the major modifiable risk factors of coronary heart disease and stroke in low- and middle-income countries, including China. Hypertension control rates (6%), as well as the rates of awareness (30%) and treatment (25%) of hypertension, are lower in China than in West. Physicians’ knowledge of hypertension prevention and control are crucial factors in successful disease management and, thus, there is a great need to constantly enhance the skills and training of primary care doctors on hypertension, and for the government to continue catalyzing the development of community health services.

Dr Zengwu Wang and colleagues at The National Center for Cardiovascular Disease, China, developed a patient educational program which aimed to treat 1 million hypertensive patients nationwide using recommended treatment guidelines.  In the pilot trial, hypertension control improved (ie, decreased SBP level to 131 mmHg from baseline) in the patient population. In the process, guideline-based hypertension control, consistent with national and international standards were promoted.

The program was designed to provide training to 20,000 grassroots doctors on the use of guideline-based treatment of 1 million hypertensives from a total of 200 counties across China for a minimum of 1 year. Records of cardiovascular events were used to evaluate the effect of guideline-based treatment and hypertension control, targeting to increase control rates by 50%. The study gathered and evaluated data from the patients managed using the protocol. Patients with hypertension, defined as having a blood pressure ≥140/90 mmHg, and aged 18 to 70 years, were included in the study.

Training materials and teaching slides were used to instruct the study doctors. The management protocol consisted of patient screening, global risk stratification, lifestyle and drug treatment, follow-up, patient-referral if necessary, and health education. Case report forms were used to collect information and develop the patient database. BP level and control rate, lifestyle modification, improved clinical profile, smoking cessation and cost-efficiency were among the success indicators evaluated.

Session: Hypertension in developing countries (Symposium)
Venue: Indus – Level 4 (402 A & B)
Time: 10:30 – 12:00