title: Randomized Evaluation of the Effectiveness of a Structured Educational Program for Patients With Essential Hypertension.
abstract: Adherence to medication and lifestyle interventions are essential keys for the management of hypertension. In this respect, a structured educational program for hypertensive patients has got remarkable merits (herz.leben). In order to determine the isolated effect of participation in the educational program, neglecting the possible impact of more intense care, this prospective multicenter randomized controlled study was designed (NCT00453037).
  
  
  
  A total of 256 patients in 13 centers were enrolled and randomly assigned to 2 groups (G). G-I (n = 137) underwent the educational program immediately (T-0), G-II (n = 119) after 6 months (T-6). Follow-up visits were done after 6 (T-6) and 12 (T-12) months. Primary endpoint was a difference in office blood pressure (BP) at T-6, when only G-I had undergone the educational program.
  
  
  
  Patients' baseline characteristics were comparable. At T-6, systolic office and home BP were significantly lower in G-I compared to G-II: office BP systolic 139 (134-150) mm Hg vs. 150 (135-165) mm Hg (P < 0.01); diastolic 80 (76-85) mm Hg vs. 84 (75-90) mm Hg (ns); home BP systolic 133 (130-140) mm Hg vs. 142 (132-150) mm Hg (P < 0.01); diastolic 80 (75-85) mm Hg vs. 80 (76-89) mm Hg (ns)). At T-12, when all patients had undergone the educational program differences in BP disappeared.
  
  
  
  The results of this multicenter randomized controlled study provide significant evidence for benefit by participation in a structured educational program. Positive effects seem to be mediated by better adherence and life style changes due to higher levels of information and patient empowerment. Therefore, educational strategies should be considered as standard of care for hypertensive patients.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; sabine.perl@medunigraz.at.
authors.forename: Sabine
authors.initials: S
authors.lastname: Perl
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Ella
authors.initials: E
authors.lastname: Niederl
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Cornelia
authors.initials: C
authors.lastname: Kos
authors.affiliation: General Hospital, Voitsberg, Austria;
authors.forename: Peter
authors.initials: P
authors.lastname: Mrak
authors.affiliation: Austrian Medical Association, Graz, Austria;
authors.forename: Herbert
authors.initials: H
authors.lastname: Ederer
authors.affiliation: Joanneum Research Forschungsgesellschaft mbH, HEALTH - Institute for Biomedicine and Health Sciences, Graz, Austria;
authors.forename: Ivo
authors.initials: I
authors.lastname: Rakovac
authors.affiliation: Joanneum Research Forschungsgesellschaft mbH, HEALTH - Institute for Biomedicine and Health Sciences, Graz, Austria;
authors.forename: Peter
authors.initials: P
authors.lastname: Beck
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Kraler
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Ingrid
authors.initials: I
authors.lastname: Stoff
authors.affiliation: Public Health Fund Styria, Graz, Austria;
authors.forename: Gert
authors.initials: G
authors.lastname: Klima
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Burkert M
authors.initials: BM
authors.lastname: Pieske
authors.affiliation: Joanneum Research Forschungsgesellschaft mbH, HEALTH - Institute for Biomedicine and Health Sciences, Graz, Austria; Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Pieber
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
authors.forename: Robert
authors.initials: R
authors.lastname: Zweiker
mesh_terms: D000368:Aged; D019468:Disease Management; D000075222:Essential Hypertension / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation
keywords: arterial hypertension; cardiovascular risk; educational program; home blood pressure measurement; life style modification.