Table.

Interventions aimed at primary prevention of cardiovascular diseases in low and middle income countries

First author	Year of publication	Country/ region	Study type	Follow-up duration	Participants	Interventions	Outcome
Randomized control trials involving community health workers
Jafar et al22	2009	Pakistan	Community based 2 × 2 factorial cluster randomized trial	24 m	12 communities (1341 individuals) from rural Pakistan	Home-based health education and a providerlevel intervention in 2 × 2 factorial design	10.8 mm Hg BP reduction in combined homebased health education and provider-level intervention
Joshi et al24	2012	India	Community- based double cluster randomized trial	Between 12 and 24 m	44 villages (3712 individuals) from rural India	Health promotion and algorithmbased care by nonphysician health workers	No difference in gain in knowledge or identification of high-risk individuals using an algorithm
Community based primary care programs involving community health workers
Balcazar et al25	2009	US-Mexico Border	Program with intervention arm alone	3 m	High-risk Hispanic subgroups (256 participants, outcomes analyzed in 85)	Health education campaign through promotoras	Before and after comparison showed reduction in DBP, LDL cholesterol, and HbA1c levels
Mohammadifard et al27	2009	Iran	Isfahan healthy heart program survey-resurvey technique	6 y	12514 individuals in baseline and 5000 in follow-up survey	Health education campaigns though community-based and legislative actions	Reduction in fat consumption index and meat consumption index and improvement in global dietary index
Facility-based programs/interventions involving care coordinators or health educators
Prabhakaran et al28	2009	India	Industrial sites who agreed for worksite interventions vs those who did not	4 y	6 intervention and 1 control site (5828 participants)	Multimodal health educational interventions delivered by worksite health officers	Reduction in weight, waist circumference, blood sugar, and lipid levels in intervention worksites
Shah et al29	2010	India	School based program preand postanalysis	6 m	40000 children, 25000 parents, and 1500 teachers	Nutritional education through lectures, discussions, and small group activities	Improved knowledge and behavior among children aged 8-11 y
Mendis et al31	2011	Nigeria and China	Primary health care facility based cluster randomized trial	12 m	40 primary health facilities, 2397 patients	Facility-level patient education and standardized treatment for hypertension	SBP reduction 13.28 vs 9.41 (China)11.01 vs 6.62 (Nigeria)
Ongoing studies
Lijing Y   (NCT01259700)	Ongoing	China	Community- based cluster randomized trial	2 y	10000 individuals	CVD risk reduction and salt reduction educational interventions	Primary outcome is BP reduction
Prabhakaran D   (NCT01212328)	Ongoing	India	Individual patient randomized control trial	42 m	1120 patients with diabetes mellitus	Clinical care coordinator and decision support system	Multiple CVD risk control targets
Anchala et al32   (CTRI/2012/03/002476)	Ongoing	India	Facility-based cluster- randomized trial	12 m	16 primary health center clusters (8 in each arm)	Physicians using a decision support system vs no such system	4 mm Hg reduction in SBP

NCT refers to National Institutes of Health clinical trials registry number (clinicaltrials.gov); CTRI refers to clinical trial registry of India number (www.ctri.nic.in). Abbreviation: DBP, Diastolic BP.