Village doctors can improve hypertension control in rural China: study

SHENYANG, May 16 (Xinhua) -- Village doctor-led multifaceted intervention has resulted in significant improvements to blood pressure control among rural residents in China, according to a peer-reviewed medical journal article.

Sun Yingxian, a researcher at the First Hospital of China Medical University, and his team tested the effectiveness of a multifaceted intervention for blood pressure control conducted by village doctors in rural China. The testing was part of the first stage of China Rural Hypertension Control Project co-organized by a host of Chinese institutes and Tulane University.

Between May 8 and Nov. 28, 2018, researchers recruited 33,995 individuals from 326 villages that had a regular village doctor. The participants were aged 40 or older and had untreated blood pressure of 140/90 millimeters of mercury (mm Hg) or higher, or had treated blood pressure of 130/80 mm Hg or higher.

The villages were designated at random to receive either village doctor-led multifaceted intervention or enhanced standard medical care.

In the intervention group, trained village doctors initiated and titrated antihypertensive medications based on a standard protocol with supervision from primary care physicians. They also conducted health coaching for home blood pressure monitoring, lifestyle changes and medication adherence.

The study concluded that village doctor-led intervention resulted in statistically significant improvements in blood pressure control in rural China, compared with the results of enhanced standard medical care. Researchers believe that the effective implementation strategy could be scaled up in other low-income and middle-income countries and used for hypertension control.

"The current findings by Sun and colleagues should convince policymakers in China and elsewhere to scale up community health worker-led programs across rural communities," read a peer comment from Tazeen H. Jafar at the Duke Global Health Institute of Duke University.

The findings have been published online in The Lancet.