HypertensionRandomised controlled trial
Home-Based Care for Hypertension in Rural South Africa
- Randomised controlled trial
- open-label
Authors' conclusion
In South Africa, home-based hypertension care led to a significantly lower mean systolic blood pressure at 6 months than standard, clinic-based care.
Study context
- Population
- Adults with hypertension in South Africa
- Participants
- 774 adults
- Comparison
- Home-based hypertension care vs standard clinic-based care
- Primary endpoint
- Systolic blood pressure
- Follow-up
- 6 months
Primary result
As reported in the abstract
Mean SBP
Each group vs standard careDifference, mm Hg (95% CI)P value
CHW
−7.9(−10.5 to −5.3)
P < 0.001Enhanced CHW
−9.1(−11.7 to −6.4)
P < 0.001Secondary outcomes
| Outcome | CHW | Enhanced CHW | Standard care | RR (95% CI) | |
|---|---|---|---|---|---|
| Hypertension control · 6 months — CHW vs Standard care | 57.4% | 61.3% | 32.5% | 1.76 (1.40–2.13) | |
| Hypertension control · 6 months — Enhanced CHW vs Standard care | 1.89 (1.51–2.27) | ||||
| 0.512Relative risk (log scale) |
SBP and hypertension control · 12 months
- Improvements with home-based care appeared to persist
Safety
Severe adverse events and deaths
- Severe adverse events (all participants)
- 2.7%
- Deaths (all participants)
- 1.0%
- Similar percentage across trial groups
Retention in care
- Retention in care in community health worker (CHW) and enhanced CHW groups
- more than 95%
Original publication
Home-Based Care for Hypertension in Rural South Africa. N Engl J Med. Published 1 September 2025. doi:10.1056/nejmoa2509958
Summarised from the published abstract; every number is checked against it