A clinical trial funded by the National Institutes of Health (NIH) demonstrated that a low-cost, team-based care approach effectively lowered systolic blood pressure among low-income patients with hypertension. The study took place at 36 federally qualified health centers (FQHCs) in Louisiana and Mississippi and involved over 1,270 participants aged 40 or older with elevated blood pressure.
The intervention combined intensive blood pressure management, regular tracking and feedback to providers, health coaching focused on lifestyle changes and medication adherence, as well as home blood pressure monitoring. This team-based strategy achieved a reduction in systolic blood pressure exceeding 15 mm Hg, compared to about 9 mm Hg in the enhanced usual care group, which involved physician education on hypertension guidelines.
At 18 months, 21.8% of patients in the intervention group reached a systolic blood pressure below 120 mm Hg, compared with 15.1% in the control group. Additionally, 47.7% of the intervention group achieved readings under 130 mm Hg, versus 36.4% in the control group. These improvements are associated with an estimated 10% reduction in cardiovascular events, based on prior research.
The average cost of the team-based intervention was approximately $760 per patient, which is substantially lower than the cost of treating advanced heart conditions. The model also reduced provider burden by shifting some management tasks to health coaches and enabling patient self-management through home monitoring.
Why it matters
Hypertension is a major preventable risk factor for cardiovascular disease and mortality, with only one in four U.S. adults having controlled blood pressure. Nearly 37 million adults live with uncontrolled hypertension, disproportionately affecting low-income populations. This trial offers evidence that affordable, scalable strategies implemented in primary care settings can improve blood pressure control and reduce health disparities.
Background
Uncontrolled high blood pressure, defined as readings of 140/90 mm Hg or higher, significantly increases the risk of heart disease and stroke. Federally qualified health centers serve medically underserved communities and are critical venues for managing chronic diseases like hypertension. Prior to this study, evidence-based approaches tailored to low-income populations were lacking despite their high burden of uncontrolled hypertension.
This NIH-supported trial was led by researchers at the University of Texas Southwestern Medical Center and Tulane University. It received funding from multiple NIH institutes, including the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities.
Sources
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