Table 2.
Effects of the Multicomponent Intervention on Primary and Secondary Outcomes in Hypertensive Patients
| Intervention | Control | Net difference (95% CI) | P Value | Adjusted net Differencea (95% CI) | P Value | |||
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| No. | Mean or No. and Proportion (95% CI) | No. | Mean or No. and Proportion (95% CI) | |||||
| Co-primary outcome: change in systolic BP from baseline, mmHg | ||||||||
| At month 6 | 722 | −11.9 (−13.3,−10.5) | 682 | −7.4 (−8.9,−5.9) | −4.5 (−6.6,−2.4) | <.001 | −3.7 (−5.7,−1.8) | <.001 |
| At month 12 | 719 | −15.6 (−16.8,−14.4) | 654 | −10.1 (−11.3,−8.8) | −5.5 (−7.3,−3.8) | <.001 | −4.8 (−6.3,−3.3) | <.001 |
| At month 18 | 709 | −19.3 (−20.8,−17.9) | 648 | −12.7 (−14.2,−11.3) | −6.6 (−8.6,−4.6) | <.001 | −5.8 (−7.5,−4.1) | <.001 |
| Overall | 722 | −15.6 (−16.8,−14.3) | 682 | −10.0 (−11.3,−8.8) | −5.5 (−7.3,−3.8) | <.001 | −4.8 (−6.3,−3.2) | <.001 |
| Co-primary outcome: change in diastolic BP from baseline, mmHg | ||||||||
| At month 6 | 722 | −6.5 (−7.4,−5.5) | 682 | −3.5 (−4.4,−2.6) | −2.9 (−4.3,−1.6) | <.001 | −2.1 (−3.4,−0.8) | .001 |
| At month 12 | 719 | −9.4 (−10.2,−8.5) | 654 | −5.2 (−6.0,−4.4) | −4.2 (−5.3,−3.0) | <.001 | −3.3 (−4.3,−2.4) | <.001 |
| At month 18 | 709 | −12.2 (−13.2,−11.2) | 648 | −6.9 (−7.8,−5.9) | −5.4 (−6.8,−4.0) | <.001 | −4.6 (−5.7,−3.4) | <.001 |
| Overall | 722 | −9.3 (−10.2,−8.5) | 682 | −5.2 (−6.0,−4.4) | −4.1 (−5.3,−3.0) | <.001 | −3.3 (−4.3,−2.3) | <.001 |
| Proportion of controlled hypertensionb, No, % | ||||||||
| At baseline | 743 | 127, 17.0 (14.4, 20.0) | 689 | 122, 17.6 (15.0, 20.7) | −0.6 (−4.6, 3.4) | .77 | 1.9 (−1.1, 5.0) | .22 |
| At month 6 | 722 | 333, 46.1 (42.5, 50.0) | 682 | 277, 40.4 (36.8, 44.4) | 5.7 (0.4, 11.0) | .04 | 8.0 (2.9, 13.1) | .002 |
| At month 12 | 719 | 439, 61.0 (57.3, 64.8) | 654 | 288, 43.9 (40.2, 47.9) | 17.1 (11.7, 22.5) | <.001 | 18.4 (13.2, 23.6) | <.001 |
| At month 18 | 709 | 517, 72.9 (69.6, 76.3) | 648 | 340, 52.2 (48.4, 56.4) | 20.6 (15.4, 25.9) | <.001 | 22.1 (17.1, 27.2) | <.001 |
| Proportion of high adherence in patients taking antihypertensive medications,c,d No, % | ||||||||
| At baseline | 620 | 197, 31.3 (27.6, 35.6) | 570 | 223, 38.0 (34.0, 42.5) | −6.7 (−12.6,−0.9) | .03 | −6.3 (−12.1,−0.5) | .03 |
| At month 6 | 627 | 309, 48.3 (44.2, 52.8) | 575 | 237, 41.2 (37.0, 45.7) | 7.1 (1.0, 13.2) | .02 | 8.2 (2.4, 14.0) | .005 |
| At month 12 | 633 | 353, 54.5 (50.4, 58.9) | 550 | 280, 49.6 (45.3, 54.4) | 4.9 (−1.4, 11.1) | .13 | 6.0 (−0.1, 12.1) | .05 |
| At month 18 | 629 | 422, 66.1 (62.2, 70.4) | 542 | 292, 53.0 (48.7, 57.7) | 13.1 (7.0, 19.2) | <.001 | 14.9 (8.8, 20.9) | <.001 |
| Proportion of intensification of antihypertensive treatment from baseline,e No, % | ||||||||
| At month 6 | 722 | 248, 34.5 (31.1, 38.2) | 683 | 177, 26.0 (22.9, 29.5) | 8.5 (3.7, 13.4) | <.001 | 7.8 (3.0, 12.7) | .001 |
| At month 12 | 719 | 339, 47.2 (43.8, 51.0) | 655 | 244, 37.3 (33.7, 41.3) | 9.9 (4.7, 15.2) | <.001 | 8.9 (3.7, 14.2) | <.001 |
| At month 18 | 709 | 407, 57.6 (54.1, 61.3) | 648 | 276, 42.8 (39.0, 47.0) | 14.8 (9.4, 20.2) | <.001 | 13.7 (8.3, 19.1) | <.001 |
Adjusted for age, sex, history of major cardiovascular disease, history of hypercholesterolemia, alcohol drinking, physical activity, baseline body-mass index, and systolic (or diastolic) blood pressure.
Controlled hypertension was defined as systolic BP <140 mmHg and diastolic DBP <90 mmHg among patients with hypertension.
High adherence was defined as eight-item Morisky Medication Adherence Scale score equal to eight. Patients who were not taking antihypertensive medication did not collect information on medical adherence.
Adjusted for age, sex, history of major cardiovascular disease, history of hypercholesterolemia, alcohol drinking, physical activity, and baseline body-mass index, systolic blood pressure, and eight-item Morisky Medication Adherence Scale score.
Titration or addition of new antihypertensive medications since baseline.