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Randomized trial of an intervention to improve blood pressure control in stroke survivors

Circulation: Cardiovascular Quality and Outcomes Dec 18, 2019

Owolabi MO, et al. - In this first-of-its-kind randomized stroke trial, researchers examined the impact of implementing a THRIVES (Tailored Hospital-based Risk reduction to Impede Vascular Events after Stroke) intervention on blood pressure (BP) control among patients with stroke in Africa. A patient global risk factor control report card, personalized phone text-messaging, and educational video were included in the intervention. From 4 distinct medical facilities in Nigeria, 400 patients (aged ≥ 18 years) with stroke-onset within 1-year were randomized to THRIVES intervention and control group. Patients in the control group also received text messages; modest financial incentives were provided to both the groups. Participants randomized to the intervention vs controls exhibited no better change in mean systolic BP at 12 months. In a subset analysis of individuals with baseline BP > 140/90 mm Hg (n = 168), THRIVES presented a significant mean systolic BP (diastolic BP) decrease of 11.7 (7.0) mm Hg and control group presented a significant mean systolic BP (diastolic BP) decrease of 11.2 (7.9) mm Hg at 12 months. As both treatment arms had text-messaging and a modest financial incentive in common, they suggest performing further research to ascertain if these measures alone can improve BP control among stroke survivors.
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