Trial reportThe New England journal of medicine2025
Home-Based Care for Hypertension in Rural South Africa.
Trial report in The New England journal of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05492955 (Implementation of a Combination Intervention for Sustainable Blood Pressure Control in KwaZulu-Natal, South Africa), which is not on this map. Cited by 9 papers, 1 of them a synthesis 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.
Implementation of a Combination Intervention for Sustainable Blood Pressure Control in KwaZulu-Natal, South Africa (IMPACT-BP)
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the scope and impact of rural primary healthcare innovations using digital health technology.BMJ open · 2026Pooled it
- Nurse-led interventions for hypertension management in Sub-Saharan Africa: A scoping review.International journal of nursing studies advances · 2026Review
- Co-designing a Blueprint for Home Delivery of Long-Acting Injectable Pre-exposure Prophylaxis for Sexual Minority Men in Chicago.AIDS and behavior · 2026Article
- The longitudinal care cascade for hypertension in people with and without HIV in South Africa: A clinic-based observational study.PLoS medicine · 2026Observational
- Task-Shifting to Nurses for Hypertension Control in Rural Sub-Saharan Africa: A Narrative Review of Effectiveness and Implementation Challenges.Tropical medicine & international health : TM & IH · 2026Review
- Community-based interventions for non-communicable diseases in Africa: a scoping review of scope, effectiveness, and implementation factors.BMC public health · 2026Article
- Ischemic heart disease burden and healthcare system readiness across sub-Saharan Africa.Nature cardiovascular research · 2026Review
- The longitudinal care cascade for hypertension: a clinic-based study of people with and without HIV in South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Effect of a community-based intervention for cardiovascular risk factor control on stroke mortality in rural Gadchiroli, India: a cluster-randomised controlled trial.Wellcome open research · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
13 authors.
Funding
Abstract
backgroundPoorly controlled hypertension is a common problem worldwide, particularly in low-resource settings.
methodsWe conducted an open-label, randomized, controlled trial of a home-based model of hypertension care in South Africa. Adults with hypertension were assigned to receive home-based care, which consisted of patient monitoring of blood pressure, home visits from a community health worker (CHW) for data collection and medication delivery, and remote nurse-led decision making supported by a mobile application (CHW group); enhanced home-based care, which consisted of the same intervention but with blood-pressure machines transmitting readings automatically (enhanced CHW group); or standard care with clinic-based management (standard-care group). The primary outcome was the systolic blood pressure at 6 months. Secondary outcomes were the systolic blood pressure at 12 months and hypertension control at 6 and 12 months. Safety outcomes included adverse events, deaths, and retention in care.
resultsA total of 774 adults underwent randomization. The mean age was 62 years; 76.0% of the participants were women, 13.6% had diabetes mellitus, and 46.5% had human immunodeficiency virus infection. The mean systolic blood pressure at 6 months was lower in the CHW group than in the standard-care group (difference, -7.9 mm Hg; 95% confidence interval [CI], -10.5 to -5.3; P<0.001) and was also lower in the enhanced CHW group than in the standard-care group (difference, -9.1 mm Hg; 95% CI, -11.7 to -6.4; P<0.001). The percentage of participants with hypertension control at 6 months was 32.5% in the standard-care group, as compared with 57.4% in the CHW group (relative risk, 1.76; 95% CI, 1.40 to 2.13) and 61.3% in the enhanced CHW group (relative risk, 1.89; 95% CI, 1.51 to 2.27). The improvements in systolic blood pressure and hypertension control with home-based care appeared to persist at 12 months. Severe adverse events and deaths occurred in 2.7% and 1.0% of the participants, respectively, and occurred in a similar percentage of participants across trial groups. Retention in care was observed in more than 95% of the participants in the CHW and enhanced CHW groups.
conclusionsIn South Africa, home-based hypertension care led to a significantly lower mean systolic blood pressure at 6 months than standard, clinic-based care. (Supported by the National Institutes of Health and others; IMPACT-BP ClinicalTrials.gov number, NCT05492955; South African National Clinical Trials Register number, DOH-27-112022-4895.).
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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.