- Question
- Can a comprehensive community-based model of care led by non-physician health workers reduce cardiovascular risk in people with newly diagnosed or poorly controlled hypertension, compared with usual care?
- Design
- Open-label, community-based, cluster-randomised trial in 30 communities (townships) in Colombia and Malaysia: 16 assigned to control and 14 to intervention. It included 1371 participants with 12 months of follow-up.
- Population
- Adults with newly diagnosed or poorly controlled hypertension identified through community screening.
- Intervention
- Cardiovascular risk factor management by non-physician health workers using tablet-based simplified algorithms and counselling programmes; free antihypertensive and statin medications recommended by them and supervised by physicians; and support from a family member or friend to improve adherence and healthy behaviours.
- Control
- Usual care in control communities.
- Primary outcome
- Change at 12 months in the Framingham Risk Score 10-year cardiovascular disease risk estimate, comparing intervention and control participants.
- Results
- The Framingham 10-year cardiovascular risk fell by −6.40% (95% CI 8.00 to −4.80) in the control group and −11.17% (−12.88 to −9.47) in the intervention group, a difference of change of −4.78% (95% CI −7.11 to −2.44; p<0.0001). Systolic blood pressure fell by 11.45 mm Hg more (95% CI −14.94 to −7.97) with the intervention, and blood pressure control (<140 mm Hg) was 69% versus 30% in controls.
- Safety
- No safety concerns were identified with the intervention.
- Conclusion
- A comprehensive model led by non-physician health workers, involving primary care physicians and family, substantially improved blood pressure control and reduced cardiovascular risk.
- Why it matters
- It showed that a pragmatic strategy of task-shifting and family support, adapted to local context, can be effective compared with traditional physician-based approaches, with potential in resource-limited settings.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 15, 2026