Trial reportAmerican heart journal2019
Cardiovascular risk factor reduction by community health workers in rural India: A cluster randomized trial.
Trial report in American heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 6 of them syntheses that pooled it.
What it found
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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
21 citing papers in PubMed, 6 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Gut Microbiota and Liver Health: Meta-Analysis ofInternational journal of molecular sciences · 2025Pooled it
- Peer-led lifestyle interventions for the primary prevention of cardiovascular disease in community: a systematic review of randomised controlled trials.BMC public health · 2024Pooled it
- Lay advisor interventions for hypertension outcomes: A Systematic Review, Meta-analysis and a RE-AIM evaluation.Frontiers in medicine · 2024Pooled it
- Interventions to promote medication adherence for chronic diseases in India: a systematic review.Frontiers in public health · 2023Pooled it
- Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review.PLoS medicine · 2022Pooled it
- Pooled it
- Community health worker-facilitated telehealth for moderate-severe hypertension care in Kenya and Uganda: A randomized controlled trial.PLoS medicine · 2025Trial
- Budget impact and cost-effectiveness analyses of the COBRA-BPS multicomponent hypertension management programme in rural communities in Bangladesh, Pakistan, and Sri Lanka.The Lancet. Global health · 2021Trial
- Evaluation of a synchronous training program on common primary care medications for community health workers in Karnataka, India.BMC health services research · 2026Article
- Medication adherence interventions for South Asian populations with cardiovascular disease: A systematic review and narrative synthesis.PLOS global public health · 2026Article
- Effects of community health worker-led interventions on cardiometabolic outcomes in vulnerable populations: A systematic review and meta-analysis.PLOS global public health · 2026Article
- Task-sharing for non-communicable disease prevention and control in low- and middle-income countries in the context of health worker shortages: A systematic review.PLOS global public health · 2025Article
- Impact of a community health worker led intervention for improved blood pressure control in urban Nepal: an open-label cluster randomised controlled trial.The Lancet regional health. Southeast Asia · 2024Article
- Behavioural interventions for tobacco cessation in India: A systematic review and meta-analysis.Journal of family medicine and primary care · 2023Review
- Determining the frequency and level of task-sharing for hypertension management in LMICs: A systematic review and meta-analysis.EClinicalMedicine · 2022Article
- Evidence-Based Recommendations for Medical Management of Peripheral Artery Disease.Journal of atherosclerosis and thrombosis · 2021Review
- Community-Based Interventions for Cardiovascular Disease Prevention in Low-and Middle-Income Countries: A Systematic Review.Public health reviews · 2021Article
- Article
- Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic Review.Patient preference and adherence · 2021Review
- Strategies to Improve Adherence to Anti-Hypertensive Medications: a Narrative Review.Current hypertension reports · 2020Review
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundThere is a need to identify and test low-cost approaches for cardiovascular disease (CVD) risk reduction that can enable health systems to achieve such a strategy.
objectiveCommunity health workers (CHWs) are an integral part of health-care delivery system in lower income countries. Our aim was to assess impact of CHW based interventions in reducing CVD risk factors in rural households in India.
methodsWe performed an open-label cluster-randomized trial in 28 villages in 3 states of India with the household as a unit of randomization. Households with individuals at intermediate to high CVD risk were randomized to intervention and control groups. In the intervention group, trained CHWs delivered risk-reduction advice and monitored risk factors during 6 household visits over 12 months. Households in the non-intervention group received usual care. Primary outcomes were a reduction in systolic BP (SBP) and adherence to prescribed BP lowering drugs.
resultsWe randomized 2312 households (3261 participants at intermediate or high risk) to intervention (1172 households) and control (1140 households). At baseline prevalence of tobacco use (48.5%) and hypertension (34.7%) were high. At 12 months, there was significant decline in SBP (mmHg) from baseline in both groups- controls 130.3 ± 21 to 128.3 ± 15; intervention 130.3 ± 21 to 127.6 ± 15 (P < .01 for before and after comparison) but there was no difference between the 2 groups at 12 months (P = .18). Adherence to antihypertensive drugs was greater in intervention vs control households (74.9% vs 61.4%, P = .001).
conclusionA 12-month CHW-led intervention at household level improved adherence to prescribed drugs, but did not impact SBP. To be more impactful, a more comprehensive solution that addresses escalation and access to useful therapies is needed.
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Registered trials
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.