Family-based interventions deliver optimal BP outcomes in adults

Lifestyle interventions centred on families appear to provide significant public health benefits in maintaining ideal blood pressure (BP) levels in at-risk individuals, suggests a study.

This open-label, cluster randomized controlled trial included first-degree family members and spouses of patients with coronary heart disease (CHD) over the age of 18. Eligible families were randomly assigned to the enhanced usual care and intervention arms.

The interventions included cardiovascular disease risk screening, systematic lifestyle modifications, facilitating access to primary healthcare services, and ensuring self-care adherence through regular follow-up. BP was measured at baseline, 12 months, and 24 months using electronic devices.

Finally, the investigators used a generalized estimating equation model to assess the between-group population average in diastolic (DBP) and systolic BP (SBP) levels.

A total of 1,671 participants (mean age 40.8 years, 1,111 women) from 750 families were included in the trial. The attrition rate was 3 percent at the 2-year follow-up.

The adjusted population average difference in SBP and DBP between groups were ‒5.23 mm Hg (95 percent confidence interval [CI], ‒7.01 to ‒3.47; p<0.001) and ‒2.56 mm Hg (95 percent CI, ‒3.63 to ‒1.49; p<0.001), respectively.

At the 2-year follow-up, the intervention arm had a 25-percent lower likelihood of BP ≥140/90 mm Hg than the usual care arm (odds ratio, 0.75, 95 percent CI, 0.60‒0.96; p=0.017).