Check it, change it: a community-based intervention to improve blood pressure control.
BACKGROUND
Despite the widespread availability of effective and affordable therapies, hypertension remains this country's most significant modifiable cardiovascular risk factor. Approximately 30% to 50% of individuals with hypertension currently fail to reach guideline-recommended target blood pressure (BP) goals. Although multiple interventions have been proposed to affect better hypertension control, the integration of multiple elements in a community-based program has not been evaluated to date.


RESULTS
We created a broadly inclusive community-based initiative to control hypertension called Check It, Change It: The Durham Blood Pressure Challenge (CICI). We enrolled ≈2000 participants with hypertension in 8 ambulatory clinics across Durham County, NC. The CICI program engaged individuals by providing them with tools for self-monitoring and tied this information to their caregivers via a web-based portal (the American Heart Association's Heart360, a remote BP monitoring system). Additionally, the CICI facilitated clinical intervention of high-risk individuals using physician assistants and community health coaches. The primary outcome will be a change in BP during the 6 months postenrollment in the program, which will be compared with concurrent and historical control populations of nonparticipants.


CONCLUSIONS
We think that this integrated and tiered approach will lead to improved BP control within 6 months. If successful, the CICI program has the potential to enhance community-level BP control.
Department of Medicine, Duke University NC.
Bimal R
BR
Shah
Kevin L
KL
Thomas
Sharon
S
Elliot-Bynum
Kristin
K
Thomas
Katrina
K
Damon
Nancy
N
Allen LaPointe
Sarah A
SA
Calhoun
Laine
L
Thomas
Robin
R
Mathews
Robert M
RM
Califf
Eric D
ED
Peterson
D000572:American Heart Association; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D019058:Community Networks; D006282:Health Personnel; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology*; D017146:Models, Organizational; D058996:Quality Improvement; D012111:Residence Characteristics; D014481:United States
D000959:Antihypertensive Agents
hypertension; residence characteristics