Trial reportBulletin of the World Health Organization2010
Cardiovascular risk management and its impact on hypertension control in primary care in low-resource settings: a cluster-randomized trial.
Trial report in Bulletin of the World Health Organization, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 15 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
81 citing papers in PubMed, 15 syntheses or guidelines pooled it, 135 citations in OpenAlex.
- Effectiveness and Safety of Using Standardized Treatment Protocols for Hypertension Compared to Usual Care: A Meta-Analysis of Randomized Clinical Trials.Journal of clinical hypertension (Greenwich, Conn.) · 2025Pooled it
- Pooled it
- Non-pharmacological interventions to achieve blood pressure control in African patients: a systematic review.BMJ open · 2022Pooled it
- Pooled it
- Assessment of Barriers and Facilitators to the Delivery of Care for Noncommunicable Diseases by Nonphysician Health Workers in Low- and Middle-Income Countries: A Systematic Review and Qualitative Analysis.JAMA network open · 2019Pooled it
- Task sharing with non-physician health-care workers for management of blood pressure in low-income and middle-income countries: a systematic review and meta-analysis.The Lancet. Global health · 2019Pooled it
- Pooled it
- A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa.BMC family practice · 2017Pooled it
- Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2017Pooled it
- Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications.PloS one · 2017Pooled it
- Interventions addressing risk factors of ischaemic heart disease in sub-Saharan Africa: a systematic review.BMJ open · 2016Pooled it
- Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review.PloS one · 2016Pooled it
- Multiple risk factor interventions for primary prevention of cardiovascular disease in low- and middle-income countries.The Cochrane database of systematic reviews · 2015Pooled it
- Pooled it
- Effectiveness of interventions for hypertension care in the community--a meta-analysis of controlled studies in China.BMC health services research · 2012Pooled it
- Trial
- Group Medical Visit and Microfinance Intervention for Patients With Diabetes or Hypertension in Kenya.Journal of the American College of Cardiology · 2021Trial
- Task shifting of cardiovascular risk assessment and communication by nurses for primary and secondary prevention of cardiovascular diseases in a tertiary health care setting of Northern India.BMC health services research · 2020Trial
- Trial
- Health insurance coverage with or without a nurse-led task shifting strategy for hypertension control: A pragmatic cluster randomized trial in Ghana.PLoS medicine · 2018Trial
21 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate a simple cardiovascular risk management package for assessing and managing cardiovascular risk using hypertension as an entry point in primary care facilities in low-resource settings.
methodsTwo geographically distant regions in two countries (China and Nigeria) were selected and 10 pairs of primary care facilities in each region were randomly selected and matched. Regions were then randomly assigned to a control group, which received usual care, or to an intervention group, which applied the cardiovascular risk management package. Each facility enrolled 60 consecutive patients with hypertension. Intervention sites educated patients about risk factors at baseline and initiated treatment with hydrochlorothiazide at 4 months in patients at medium risk of a cardiovascular event, according to a standardized treatment algorithm. Systolic blood pressure change from baseline to 12 months was the primary outcome measure.
findingsThe study included 2397 patients with baseline hypertension: 1191 in 20 intervention facilities and 1206 in 20 control facilities. Systolic and diastolic blood pressure decreased more in intervention patients than in controls. However, at 12 months more than half of patients still had uncontrolled hypertension (systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg). Behavioural risk factors had improved among intervention patients in Nigeria but not in China. Only about 2% of hypertensive patients required referral to the next level of care.
conclusionEven in low-resource settings, hypertensive patients can be effectively assessed and managed in primary care facilities.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.