Community program helps lower blood pressure among minorities

Researchers assessed the use of the American Heart Association's Check. Change. Control. program in 18 urban, predominately African-American communities with a high rate of high blood pressure.

The 4,069 participants used the program over four months in 2013 in churches, workplace wellness facilities, healthcare centers and housing centers.

Researchers found that those who checked their blood pressure more frequently had the largest drop in blood pressure. The programs that included blood pressure monitoring kits, blood pressure checks during activities like walking clubs and cooking classes and volunteers who led activities had the best results.

"This program capitalizes on local resources that can bring about change in behavior and improve blood pressure rates," said Monique Anderson, M.D., lead researcher of the study and a medical instructor in cardiology at the Duke Clinical Research Institute and the Duke School of Medicine in Durham, N.C. "As participants became more knowledgeable, they probably started exercising more, taking their medication more, and those who were really engaged showed dramatic responses in blood pressure change."

They also found:

• Among all participants, systolic pressure dropped 7.5 mmHg and diastolic dropped 3.3 mmHg during the study period.
• When participants entered at least eight of their readings, the reduction was even greater: 13.9 mmHg in systolic and 5.0 mmHg in diastolic.
• The largest average reduction at one site was 29.8 mmHg (systolic) and 9.9 mmHg (diastolic).

While each community could design some elements of their program, they had certain factors in common that are easy to replicate and implement:

• All participants were encouraged to upload their blood pressure readings to www.heart360.org for tracking.
• American Heart Association staff led the programs and partnered with businesses and others such as senior residential institutions.
• Programs with the highest engagement were more likely to hold hypertension education classes and follow up with participants via telephone or face-to-face contact.

About 78 million people in the United States have high blood pressure. It's called the silent killer because it typically has no symptoms. Some populations, including African-Americans, have higher risks of developing high blood pressure.

"Check. Change. Control. is remarkable because of its size and scope and its impact on public health," said Eric Peterson, M.D., M.P.H., principal investigator. "But rather than just being satisfied with success, we're trying to understand which parts of the program were most effective so we can improve it as it is expanded to the rest of the nation."