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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Effectiveness of interventions for hypertension care in the community – a meta-analysis of controlled studies in China

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Zuxun Lu, Shiyi Cao, Yun Chai, Yuan Liang, Max Bachmann, Marc Suhrcke, Fujian Song
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-216) contains supplementary material, which is available to authorized users.

Competing interests

We declare that we have no conflict of interest. No specific funding received for this systematic review.

Abstract

Background

Hypertension is a serious public health problem in China and in other developing countries. Our aim is to conduct a systematic review of studies on the effectiveness of community interventions for hypertension management in China.

Methods

China National Knowledge Infrastructure, PubMed, and references of retrieved articles were searched to identify randomised or quasi-randomised controlled studies that evaluated community hypertension care in mainland China. One reviewer extracted and a second reviewer checked data from the included studies.

Results

We included 94 studies, 93 of which were in Chinese language, that evaluated the following interventions: health education, improved monitoring, family-support, self-management, healthcare management changes and training of providers. The study quality was generally poor, with high risk of biased outcome reporting and significant heterogeneity between studies. When reported, the vast majority of the included studies reported statistically significantly improved outcomes in the intervention group. By assuming zero treatment effects for missing outcomes, the weighted reduction in the intervention group was 6∙9 (95% CI: 4∙9 to 8∙9) mm Hg for systolic BP, and 3∙8 (95% CI: 2∙6 to 5∙0) mm Hg for diastolic BP. Exploratory subgroup analyses found no significant differences between different interventions.

Conclusions

After taking account of possible reporting biases, a wide range of community interventions for hypertension care remain effective. The findings have implications for China and other low and middle income countries facing similar challenges. Because of significant heterogeneity and high risk of bias in the available studies, further well designed studies should be conducted in China to provide high quality evidence to inform policy decisions on hypertension control.
Zusatzmaterial
Additional file 1: Literature search strategy. (PDF 9 KB)
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Additional file 2: Sheet used to extract data from controlled studies on hypertension care in China. (PDF 45 KB)
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Additional file 3: Method used to assess the quality of included studies. (PDF 23 KB)
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Additional file 4: References of included studies – hypertension care in the community in China. (PDF 157 KB)
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Additional file 5: Main characteristics of included studies –hypertension care in the community in China. (PDF 104 KB)
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Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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Authors’ original file for figure 4
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Authors’ original file for figure 5
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Authors’ original file for figure 6
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Authors’ original file for figure 7
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