HypertensionRandomised controlled trial
Long-Term Effectiveness of Intensive Blood Pressure Management Led by Nonphysician Community Healthcare Providers on Cardiovascular Events: 7-Year Follow-Up of a Cluster Randomized Trial
- Cluster randomised controlled trial (7-year follow-up of the CRHCP trial)
- posttrial follow-up
- prespecified subgroup analyses
Authors' conclusion
Multicomponent BP management strategy with a BP target <130/80 mm Hg led by NPCHPs achieved sustained BP control and reduced CVD risk during both the 7-year overall and 3-year posttrial periods.
Study context
- Population
- Adults ≥40 years with hypertension in rural China (326 villages)31,334 entered posttrial follow-up
- Participants
- 33,995 adults
- Comparison
- Nonphysician community healthcare provider (NPCHP)-led intensive blood pressure (BP) control vs usual care
- Primary endpoint
- Composite of:
- MI
- Stroke
- Hospitalization for HF
- CVD death
- Follow-up
- 7-year overall period
Primary result
Composite CVD events
Hazard ratio
0.76
95% CI 0.72–0.81
P < 0.0001
By group
Intervention vs Usual care
HR 0.76 (95% CI 0.72–0.81); P < 0.0001
As reported in the abstract
Further findings
per person-year
| Outcome | Intervention | Usual care | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Composite CVD events, 3-year posttrial period · years 4 to 7 | 3.4% | 4.2% | 0.79 (0.73–0.85) | P < 0.0001 | |
| 0.512Hazard ratio (log scale) |
BP <130/80 mm Hg · end of 7-year period
P < 0.0001
| Outcome | Intervention | Usual care | between-group difference (mm Hg) | P value |
|---|---|---|---|---|
| BP (systolic/diastolic) · end of 7-year period · for both systolic and diastolic BPs | 138.8/80.7 mm Hg | 152.3/86.1 mm Hg | −13.5/−5.4 | P < 0.0001 |
Composite cardiovascular disease (CVD) events, 3-year posttrial period · years 4 to 7
- Posttrial effects generally consistent across subgroups by age, sex, education and antihypertensive use
Safety
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Hypotension · 7-year overall period | 1.58 (1.39–1.79) | P < 0.001 | |
| Mild hypokalemia · 7-year overall period | 1.38 (1.23–1.56) | P < 0.001 | |
| 0.512Relative risk (log scale) |
Original publication
Long-Term Effectiveness of Intensive Blood Pressure Management Led by Nonphysician Community Healthcare Providers on Cardiovascular Events: 7-Year Follow-Up of a Cluster Randomized Trial. Circulation. Published 28 August 2026. doi:10.1161/circulationaha.126.082511
Summarised from the published abstract; every number is checked against it