When it comes to initiatives aimed at reducing community hypertension, a recent study found that pharmacists and community health workers have had the most success in effectively lowering blood pressure. These results highlight the importance of engaging healthcare professionals who can dedicate time and have established relationships in the community.
A study conducted by Tulane University reveals that pharmacists and community health workers are most successful in helping patients with high blood pressure manage their hypertension.
The study, which was published in Circulation: Cardiovascular Quality and Outcomes, examined data from 100 hypertension trials worldwide and compared the effectiveness of blood pressure reduction based on the type of healthcare professionals leading the interventions.
While interventions led by nurses, physicians, and a combination of healthcare professionals were effective in reducing patients’ blood pressure, pharmacists exhibited the most significant improvements, closely followed by community health workers.
Interventions conducted in both clinical and community settings have proven to be successful in treating hypertension, a leading preventable cause of premature death worldwide, especially in communities where financial and geographical constraints contribute to its prevalence. The study suggests that healthcare professionals with more available time are best equipped to address the disease.
“Managing blood pressure often requires more time than what is typically available during primary care visits,” noted Katherine Mills, the lead author of the study and an associate professor at Tulane University School of Public Health and Tropical Medicine. “Having individuals leading such efforts who are not constrained by time limitations might be the most effective approach.”
On average, interventions led by pharmacists led to a reduction in systolic blood pressure of 7.3 mmHg, while community health workers saw a decrease of 7.1 mmHg. Nurse-led and pharmacist-led interventions resulted in a 2-3 mmHg reduction in systolic blood pressure. Pharmacists and community health workers also demonstrated the most substantial decreases in diastolic blood pressure. Hypertension is typically diagnosed when blood pressure reaches 130/80 mm Hg or higher in adults, according to current guidelines.
Mills expressed no surprise at the findings, stating that “the encouraging aspect is that all healthcare professionals were successful in delivering interventions.” However, pharmacists may be especially suited to addressing the diverse medical needs of hypertensive patients.
“One major challenge is determining the appropriate combinations and doses of antihypertensive medications, which can be complex for certain patients requiring multiple visits,” Mills remarked. “Pharmacists are ideally positioned for this task.”
“This study emphasizes the significance of adopting a team-based care model to effectively manage blood pressure,” noted Lawrence J. Fine, M.D., a senior advisor in the Division of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (NIH). “In addition to traditional healthcare providers like physicians, the involvement of other team members such as pharmacists and community healthcare workers can aid individuals in achieving their treatment objectives, particularly amidst the recent nationwide decline in blood pressure control,” Fine added.
Community health workers are also likely to be highly effective in interventions due to their cultural ties to the community, which can foster trust and enhance engagement. Moreover, the utilization of community health workers is often more cost-effective compared to interventions led by other healthcare professionals.
“Hypertension is frequently asymptomatic, making it a secondary concern for patients during brief primary care visits, especially when they have multiple health issues. The key is determining who should take the lead in these interventions and what approach is best suited to address this critical health issue,” Mills concluded.
This study received support from grants issued by the NIH, including the NHLBI (UH3HL151309, UH3HL152373, R01HL133790), the National Institute of General Medical Sciences (P20GM109036), the National Institute on Aging (R33AG068481), and the National Institute on Minority Health and Health Disparities (R01MD018193).
