title: Is a targeted intensive intervention effective for improvements in hypertension control? A randomized controlled trial.
abstract: BACKGROUND
  High blood pressure (BP) is one of the most important risk factors for stroke, and antihypertensive therapy significantly reduces the risk of cardiovascular morbidity and mortality. However, achieving a regulated BP in hypertensive patients is still a challenge.
  
  
  OBJECTIVE
  To evaluate the impact of an intervention targeting GPs' management of hypertension.
  
  
  METHODS
  A cluster randomized trial comprising 124 practices and 2646 patients with hypertension. In the Capital Region of Denmark, the participating GPs were randomized to an intensive or to a moderately intensive intervention group or to a control group and in Region Zealand and Region of Southern Denmark, practices were randomized into a moderately intensive intervention and to a control group. The main outcome measures were change in proportion of patients with high BP and change in systolic BP (SBP) and diastolic BP (DBP) from the first to the second registration.
  
  
  RESULTS
  The proportion of patients with high BP in 2007 was reduced in 2009 by ~9% points. The mean SBP was reduced significantly from 2007 to 2009 by 3.61 mmHg [95% confidence interval (CI): -4.26 to -2.96], and the DBP was reduced significantly by 1.99 mmHg (95% CI: -2.37 to -1.61). There was no additional impact in either of the intervention groups.
  
  
  CONCLUSIONS
  There was no impact of the moderate intervention and no additional impact of the intensive intervention on BP.
authors.affiliation: Department of Clinical Pharmacology, Bispebjerg Hospital, København NV, Denmark. lreu0001@bbh.regionh.dk
authors.forename: Lene Ørskov
authors.initials: LØ
authors.lastname: Reuther
authors.forename: Maja Skov
authors.initials: MS
authors.lastname: Paulsen
authors.forename: Morten
authors.initials: M
authors.lastname: Andersen
authors.forename: Peter
authors.initials: P
authors.lastname: Schultz-Larsen
authors.forename: Hanne Rolighed
authors.initials: HR
authors.lastname: Christensen
authors.forename: Anders
authors.initials: A
authors.lastname: Munck
authors.forename: Pia Veldt
authors.initials: PV
authors.lastname: Larsen
authors.forename: Jens
authors.initials: J
authors.lastname: Damsgaard
authors.forename: Lars
authors.initials: L
authors.lastname: Poulsen
authors.forename: Dorte Gilså
authors.initials: DG
authors.lastname: Hansen
authors.forename: Bo
authors.initials: B
authors.lastname: Christensen
authors.forename: Jens
authors.initials: J
authors.lastname: Søndergaard
mesh_terms: D000368:Aged; D003191:Comprehensive Health Care / Q000379:methods*; D016001:Confidence Intervals; D003718:Denmark; D005260:Female; D058005:General Practitioners / Q000193:education; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians'; D058996:Quality Improvement; D011795:Surveys and Questionnaires