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The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

A Community-Based Intervention for Managing Hypertension in Rural South Asia

Open access
Jafar, Tazeen H., Gandhi, Mihir, de Silva, H. Asita, Jehan, Imtiaz, Naheed, Aliya, Finkelstein, Eric A., Turner, Elizabeth L., Morisky, Donald, Kasturiratne, Anuradhani, Khan, Aamir H., Clemens, John D., Ebrahim, Shah, Assam, Pryseley N., Feng, Liang·2020·New England Journal of Medicine

Abstract

BACKGROUND: The burden of hypertension is escalating, and control rates are poor in low- and middle-income countries. Cardiovascular mortality is high in rural areas. METHODS: We conducted a cluster-randomized, controlled trial in rural districts in Bangladesh, Pakistan, and Sri Lanka. A total of 30 communities were randomly assigned to either a multicomponent intervention (intervention group) or usual care (control group). The intervention involved home visits by trained government community health workers for blood-pressure monitoring and counseling, training of physicians, and care coordination in the public sector. A total of 2645 adults with hypertension were enrolled. The primary outcome was reduction in systolic blood pressure at 24 months. Follow-up at 24 months was completed for more than 90% of the participants. RESULTS: At baseline, the mean systolic blood pressure was 146.7 mm Hg in the intervention group and 144.7 mm Hg in the control group. At 24 months, the mean systolic blood pressure fell by 9.0 mm Hg in the intervention group and by 3.9 mm Hg in the control group; the mean reduction was 5.2 mm Hg greater with the intervention (95% confidence interval [CI], 3.2 to 7.1; P<0.001). The mean reduction in diastolic blood pressure was 2.8 mm Hg greater in the intervention group than in the control group (95% CI, 1.7 to 3.9). Blood-pressure control (<140/90 mm Hg) was achieved in 53.2% of the participants in the intervention group, as compared with 43.7% of those in the control group (relative risk, 1.22; 95% CI, 1.10 to 1.35). All-cause mortality was 2.9% in the intervention group and 4.3% in the control group. CONCLUSIONS: In rural communities in Bangladesh, Pakistan, and Sri Lanka, a multicomponent intervention that was centered on proactive home visits by trained government community health workers who were linked with existing public health care infrastructure led to a greater reduction in blood pressure than usual care among adults with hypertension. (Funded by the Joint Global Health Trials scheme; COBRA-BPS ClinicalTrials.gov number, NCT02657746.).

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Metadata

Authors
Jafar, T. H., Gandhi, M., de Silva, H. A., Jehan, I., Naheed, A., Finkelstein, E. A., Turner, E. L., Morisky, D., Kasturiratne, A., Khan, A. H., Clemens, J. D., Ebrahim, S., Assam, P. N., & Feng, L.
Venue
New England Journal of Medicine
Published
2020-02-20
Volume
382
Issue
8
Pages
717-726
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W3006880319
Cited by
303
References
38
FWCI
18.99
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: A Community-Based Intervention for Managing Hypertension in Rural South Asia. https://app.cochat.ai/papers/10.1056/nejmoa1911965
The paper
Jafar, T. H., Gandhi, M., de Silva, H. A., Jehan, I., Naheed, A., Finkelstein, E. A., Turner, E. L., Morisky, D., Kasturiratne, A., Khan, A. H., Clemens, J. D., Ebrahim, S., Assam, P. N., & Feng, L. (2020). A Community-Based Intervention for Managing Hypertension in Rural South Asia. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1911965

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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