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Community-based intervention could significantly reduce CVD risk
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A community-based intervention that included nonphysician health workers, PCPs and patient family members significantly reduced CVD risk and increased BP control, according to data from the HOPE 4 trials presented at the European Society of Cardiology Congress.
“Adaptation of the HOPE 4 strategy ... [and] widespread implementation including community screening can help achieve the United Nations General Assembly Action Plan for a one-third reduction in premature mortality in cardiovascular disease,” Jon-David Schwalm, MD, MSc, FRCPC, associate professor in the division of cardiology at McMaster University in Hamilton, Ontario, Canada, said during the press conference.
The community-based intervention, which was conducted by nonphysician health care workers, included community screening, detection, and treatment and control of CVD risk factors. Under the supervision of PCPs, participants were given combination antihypertensive medication and statins.
A family member or friend of each patient helped to reinforce their adherence to the medication and healthy behaviors.
The trial included 1,371 patients from urban and rural communities in Malaysia and Colombia with new or poorly controlled hypertension. For 12 months, 14 communities with 644 patients used the care model to detect and manage CV risk and 16 communities with 727 patients continued with usual care.
The prevalence of patients who achieved BP control of less than 140 mm Hg was higher in the intervention group (69%) than the control group (30%).
The reduction in 10-year CVD risk on the Framingham Risk Score was –11.17% in those who received the intervention and –6.4% in those who received usual care (difference of change = –4.78; 95% CI, –7.11 to –2.44).
“This is consistent with a more than 40% greater reduction in those receiving intervention,” Schwalm said.
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Reference:
Schwalm J-D. Hot Line Session 4. Presented at: European Society of Cardiology Congress; Aug. 31-Sept. 4, 2019; Paris.
Schwalm J-D, et al. Lancet. 2019;doi:10.1016/S0140-6736(19)31949-X.
Disclosures: Schwalm reports that his institution received grants from Boehringer Ingelheim, the Canadian Institutes of Health Research, the Department of Management of Non-Communicable Disease and the Ontario Ministry of Health and Long-Term Care. Please see the study for all other authors’ relevant financial disclosures.