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Home visits from community health workers spur blood pressure reduction

As little as one home visit by a community health worker, as part of a community/academic health center program, may be enough to encourage someone with high blood pressure to take measures to lower it, a Johns Hopkins study demonstrates.

For their study, Johns Hopkins physicians, nurses and public health workers joined forces with the community health advisory board of Sandtown-Winchester, a 72-square block neighborhood of more than 10,000, mostly African-American residents in West Baltimore, with the goal of helping residents lower their blood pressure. High blood pressure-related heart disease death rates in this community are among the highest in the United States. In 1991, 35 percent of residents were hypertensive, and only 15 percent had controlled blood pressure.

Community-based health workers trained by the Johns Hopkins team identified people with hypertension, then visited those patients at home up to five times over a 40-month period to educate them about blood pressure control. Three years after the initial visit, the residents' average blood pressure reading had dropped by 4.5 mmHg systolic (the upper number) and 4 mmHg diastolic (the lower number). In addition, the percentage of individuals who were controlling their blood pressure doubled. Study results are published in the summer issue of the journal Ethnicity & Disease.

"We've had excellent treatment for blood pressure for over 30 years," says David M. Levine, M.D., Sc.D., M.P.H., lead author of the paper and a professor of medicine, public health and nursing at Johns Hopkins. "If patients are able to come in and remain in medical care, adhering to treatment recommendations, they do well. But most urban residents are not in that group, especially if they live in high-risk communities. Academic health centers can reach out to these communities, but it's best to do so in a partnership approach."

In setting up the program, the Johns Hopkins team trained commu
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Contact: Karen Blum
kblum@jhmi.edu
410-955-1534
Johns Hopkins Medical Institutions
7-Aug-2003


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