We initiated a 2-year population-based intervention trial in Shanghai, China to explore the long term effectiveness of a community-based comprehensive intervention strategy of blood pressure (BP) control.Methods:
A non-randomized controlled intervention program was conducted from 2008 to 2010 in the intervention and the control communities. Comprehensive interventions including health education, lifestyle interventions, and antihypertensive treatment were offered to participants in the intervention community. We assessed the effect of the intervention through comparing the outcomes of the two communities using propensity score analysis to adjust the imbalance of baseline characteristics between them.Results:
Totally 16,389 subjects participating in both baseline and outcome surveys were included in the analysis. The propensity score analysis showed that the adjusted mean systolic blood pressure (SBP) reduction among all participants and participants without hypertension at baseline of the intervention community was 0.66 mm Hg and 0.24 mm Hg larger when compared to those in the control community, respectively (P < 0.05). We also observed significant SBP reduction only among non-smokers with hypertension at baseline (0.58 mm Hg, P = 0.02) in the intervention community. Besides, we found diastolic blood pressure reduced significantly after the intervention (Adjusted P-values < 0.001).Conclusion:
Net adjusted reductions in BP were observed after the intervention, and the intervention on SBP was more effective among non-smoking hypertensive patients. The findings demonstrated the importance of developing better BP control intervention strategy based on different risk factors at baseline.