Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Mar;35(3):627-636.
doi: 10.1097/HJH.0000000000001177.

Effects of risk assessment and management programme for hypertension on clinical outcomes and cardiovascular disease risks after 12 months: a population-based matched cohort study

Esther Y T Yu  1 , Eric Y F Wan, Carlos K H Wong, Anca K C Chan, Karina H Y Chan, Sin-Yi Ho, Ruby L P Kwok, Cindy L K Lam
Affiliations
Comparative Study

Effects of risk assessment and management programme for hypertension on clinical outcomes and cardiovascular disease risks after 12 months: a population-based matched cohort study

Esther Y T Yu et al. J Hypertens. 2017 Mar.

Abstract

Objectives: This study evaluated the effectiveness of a structured multidisciplinary risk assessment and management programme for patients with hypertension (RAMP-HT) who were managed in public primary care clinics but had suboptimal blood pressure (BP) control in improving BP, LDL-cholesterol (LDL-C) and predicted 10-year cardiovascular disease (CVD) risk after 12 months of intervention.

Methods: A total of 10 262 hypertension patients with suboptimal BP despite treatment, aged less than 80 years and without existing CVD were enrolled in RAMP-HT between October 2011 and March 2012 from public general out-patient clinics in Hong Kong. Their clinical outcomes and predicted 10-year CVD risk were compared with a matched cohort of hypertension patients who were receiving usual care in general out-patient clinics without any RAMP-HT intervention by propensity score matching. Multivariable linear and logistic regressions were used to determine the independent effectiveness of RAMP-HT after adjusting for potential confounding variables.

Results: Compared with the usual care group after 12 months, significantly greater proportions of RAMP-HT participants achieved target BP (i.e. BP < 140/90 mmHg) (OR = 1.18, P < 0.01) and LDL-C levels (i.e. <3.4 mmol/l for patients with CVD risk ≤20% or <2.6 mmol/l for CVD risk >20%) (OR = 1.13, P < 0.01). RAMP-HT participants also had significantly greater reduction in predicted 10-year CVD risk by 0.44% (coefficient = -0.44, P < 0.01).

Conclusion: The structured multidisciplinary RAMP-HT was more effective than usual care in achieving target BP, LDL-C and reducing predicted 10-year CVD risk in public primary care patients with suboptimal hypertension control after 12 months of intervention. A long-term follow-up should be conducted to confirm whether the improvement in clinical outcomes can be translated into actual reductions in CVD complications and mortalities and whether such approach is cost-effective.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Risk assessment and management programme for hypertension workflow.
FIGURE 2
FIGURE 2
Flow chart of patients matching.
FIGURE 3
FIGURE 3
Changes between baseline and 12 months on clinical outcomes in risk assessment and management programme for hypertension and non-risk assessment and management programme for hypertension groups. All differences between baseline and 12 months for risk assessment and management programme for hypertension/non–risk assessment and management programme for hypertension are significant with P values <0.0001.
See this image and copyright information in PMC

Comment in

References

    1. World Health Organization. A global brief on hypertension: silent killer, global public health crisis. World Health Day 2013. 2013.
    1. World Health Organization. Causes of death 2008 summary tables. Geneva, Switzerland: World Health Organization; 2011.
    1. Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database Syst Rev 2010; 3:CD005182. - PubMed
    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289:2560–2571. - PubMed
    1. Wood D, Wray R, Poulter N, Williams B, Kirby M, Patel V, et al. JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005; 91:1–52. - PMC - PubMed

Publication types