Lay health workers prevents deaths from high blood pressure, a leading cause of global deaths
[RESEARCH ARTICLE]: Article Link
Embargo Date: 23.30 hrs UK time on Monday 11 December
Lay health workers prevents deaths from high blood pressure, a leading cause of global deaths: According to a latest study published in the Lancet Global Health, Female Community Health Volunteers-led life style intervention is effective for the reduction of high blood pressure in the general population of Nepal. Every year 10 million people die due to hypertension related events worldwide. Over 85% of these cardiovascular related deaths occur in low and middle-income countries (LMICs). In Nepal, one in four adults have high blood pressure, and approximately half of them do not know they have it.
Community health workers (CHWs) such as female community health volunteers (FCHVs) of Nepal are the key pillars of health system in many LMICs. Although the effectiveness of CHWs for preventing maternal and child health is univocal, there has been little evidence on whether existing CHWs within formal government health care delivery system could be mobilized for reducing high blood pressure. The new study assessed the effectiveness of lifestyle interventions led by FCHVs in a real life setting in Nepal. The FCHV visited the selected households every three months for providing health promotion messages and screening the blood pressure. This has led to a significant reduction in blood pressure not only those hypertensive but also those who had blood pressure within normal range. “Our study has given a crucial evidence that CHWs can be instrumental in the blood pressure reduction through lifestyle modification”, says Dr Neupane, a Post-doctoral fellow at the Duke Kunshan University, China who led the study. Previous studies have established that even a small drop in blood pressure at the population level is beneficial for reducing cardiovascular disease events and mortality. For example previous studies have estimated that even, a 5 mm Hg reduction in systolic blood pressure could reduce stroke mortality by 14%, of coronary heart disease mortality by 9% and of all-cause mortality by 7%.
The results of this study provide proof of concept. There is now the potential to scale up and replicate this intervention program in other developing countries. Many low and middle income countries have strong community health worker programs that can be utilized for primary care interventions to prevent and reduce the burden of cardiovascular disease. In Nepal alone, there are over 50,000 FCHV’s.
“ In summary while these outcomes are exciting, there is always more work to be done, for improving the length of follow-up of the individuals, as well as the assessing the sustainability of the intervention”, says Dr Neupane. A longer follow-up duration with a large sample size is needed to see how sustainable the blood pressure reduction is, in the long term. Also, it is imperative to convince health authorities to promote and fund such programs.
Associate Prof Per Kallestrup
Center for Global Health, Department of Public Health
Aarhus University, Denmark
The article will be available in the online-first (External Link) in The Lancet Global Health.
Effectiveness of a lifestyle intervention led by female community health volunteers versus usual care in blood pressure reduction (COBIN): an open-label, cluster-randomised trial
List of authors: Dinesh Neupane, Craig S McLachlan, Shiva Raj Mishra, Michael Hecht Olsen, Henry B Perry, Arjun Karki, Per Kallestrup Affiliations: Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark (D Neupane PhD, P Kallestrup PhD); Rural Clinical School, University of New South Wales, Kensington, NSW, Australia (C S McLachlan PhD); Nepal Development Society, Chitwan, Nepal (S R Mishra MPH); Department of Internal Medicine, Holbaek Hospital, University of Southern Denmark, Odense, Denmark (Prof M H Olsen PhD); Department of International Health, Health Systems Program, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA (H B Perry PhD); and Department of Internal Medicine, Grande International Hospital, Kathmandu, Nepal (Prof A Karki MD).
About the journal, visit official Website. (External Link)
Blog post Contributor: Kamal Ranabhat