title: Effectiveness of interventions for hypertension care in the community--a meta-analysis of controlled studies in China.
abstract: BACKGROUND
  Hypertension is a serious public health problem in China and in other developing countries. Our aim is to conduct a systematic review of studies on the effectiveness of community interventions for hypertension management in China.
  
  
  METHODS
  China National Knowledge Infrastructure, PubMed, and references of retrieved articles were searched to identify randomised or quasi-randomised controlled studies that evaluated community hypertension care in mainland China. One reviewer extracted and a second reviewer checked data from the included studies.
  
  
  RESULTS
  We included 94 studies, 93 of which were in Chinese language, that evaluated the following interventions: health education, improved monitoring, family-support, self-management, healthcare management changes and training of providers. The study quality was generally poor, with high risk of biased outcome reporting and significant heterogeneity between studies. When reported, the vast majority of the included studies reported statistically significantly improved outcomes in the intervention group. By assuming zero treatment effects for missing outcomes, the weighted reduction in the intervention group was 6.9 (95% CI: 4.9 to 8.9) mm Hg for systolic BP, and 3.8 (95% CI: 2.6 to 5.0) mm Hg for diastolic BP. Exploratory subgroup analyses found no significant differences between different interventions.
  
  
  CONCLUSIONS
  After taking account of possible reporting biases, a wide range of community interventions for hypertension care remain effective. The findings have implications for China and other low and middle income countries facing similar challenges. Because of significant heterogeneity and high risk of bias in the available studies, further well designed studies should be conducted in China to provide high quality evidence to inform policy decisions on hypertension control.
authors: Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
authors: Zuxun
authors: Z
authors: Lu
authors: Shiyi
authors: S
authors: Cao
authors: Yun
authors: Y
authors: Chai
authors: Yuan
authors: Y
authors: Liang
authors: Max
authors: M
authors: Bachmann
authors: Marc
authors: M
authors: Suhrcke
authors: Fujian
authors: F
authors: Song
mesh_terms: D002681:China; D003153:Community Health Services; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care; D016032:Randomized Controlled Trials as Topic