A Cluster-Randomized, Controlled Trial of a Simplified Multifaceted Management Program for Individuals at High Cardiovascular Risk (SimCard Trial) in Rural Tibet, China, and Haryana, India

Tian, Maoyi; Ajay, Vamadevan S.; Danzeng, Dunzhu; Hameed, Safraj Shahul; Li, Xian; Zhong, Linda L. D.; Li, Cong; Chen, Hao; Cho, Ka Wing; Li, Ruilai; Zhao, Xingshan; Jindal, Devraj; Rawal, Ishita; Ali, Mohammed K.; Peterson, Eric D.; Ji, Jiachao; Amarchand, Ritvik; Krishnan, Anand; Tandon, Nikhil; Xu, Liqun; Wu, Yangfeng; Prabhakaran, Dorairaj; Yan, Lijing L.

doi:10.1161/circulationaha.115.015373

Cited by 133 publications

(155 citation statements)

References 34 publications

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“…An example is technology-driven CVD risk ascertainment by community health workers in India and China. 16 …”

Section: Discussionmentioning

confidence: 99%

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Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI—UnitedHealth Global Health Centers of Excellence Program

Engelgau¹,

Sampson²,

Rabadan‐Diehl³

et al. 2016

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“…An example is technology-driven CVD risk ascertainment by community health workers in India and China. 16 …”

Section: Discussionmentioning

confidence: 99%

“…15, 16 . Others took advantage of the well characterized cohorts to ask fundamental basic science questions such as a comparative analysis of the pulmonary microbiome within biomass fuel exposed and unexposed populations.…”

Section: High Level Collaboration: Development Of a Program Wide Harmmentioning

confidence: 99%

Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI—UnitedHealth Global Health Centers of Excellence Program

Engelgau¹,

Sampson²,

Rabadan‐Diehl³

et al. 2016

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“…7,8 Control can also be improved with use of fixed-dose combination pills, more frequent contact with providers (including cost-effective providers such as nurses, community health workers, or pharmacists), or decision support tools. [9][10][11] These approaches and their combinations have rarely been directly compared, so for now, hypertension control programs should be planned on the basis of local strengths and obstacles. Even when mass screening and program costs are added, hypertension control programs likely remain cost-effective in LMICs.…”

Section: Treatment and Controlmentioning

confidence: 99%

Still on the Road to Worldwide Hypertension Control

Moran

2016

Circulation

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Editorial article, see p 441 r aised blood pressure (BP) is the leading preventable risk factor responsible for disease burden in high-, middle-, and low-income countries and was responsible for ≈9 to 12 million deaths worldwide in 2013.1 However, raised BP is chronic and almost always asymptomatic, thereby making it low priority for health systems, providers, and patients. Estimates of global and regional mean BP benchmark temporal trends in raised BP-related risks and demonstrate the potential public health benefit of shifting populations to healthier BP distributions.2 However, these estimates are not immediately relevant to current clinical practice, which is focused on eliminating above-threshold raised BP, that is, hypertension. Antihypertensive medication treatment lowers stroke risk by 35% to 40% and coronary heart disease and heart failure by 20% to 25% among hypertensive patients, so the case for identifying, treating, and controlling hypertension is founded on strong evidence and should be a top public health priority. 3,4 In this issue of Circulation, Mills et al 5 use data from 135 population-based studies representing 90 countries to estimate the global, regional, and country-level epidemiology of hypertension and hypertension awareness, treatment, and control.Measuring BP to detect hypertension, and then treating it, seems simple to us and in fact has been the bread and butter of routine medical practice for generations of healthcare providers. It is therefore sobering to learn that in low-and middle-income countries (LMICs), the epidemic of hypertension appears to be growing (7.7% increase in age-standardized adult prevalence to 31.5%, [2000][2001][2002][2003][2004][2005][2006][2007][2008][2009][2010]. Among LMIC adults with hypertension, only about a third of were aware of their diagnosis, one quarter were treated, and <10% were controlled to <140/90 mm Hg. There were minimal improvements in these benchmarks in LMICs from 2000 to 2010. In contrast, the authors found a slight hypertension prevalence decrease in high-income regions (to 28.5% in 2010, a −2.6% change from 2000) and incremental improvements in high-income country awareness (to more than two-thirds of hypertensive patients), treatment (to more than one-half), and control (to more than one-quarter). Mills et al included studies that used standard BP measurement methods and defined hypertension as self-reported use of antihypertensive medications or mean BP ≥140 mm Hg systolic or 90 mm Hg diastolic. Readers should interpret their country-level hypertension epidemiology estimates with a grain of salt. For many countries, no data were available, and estimates were derived by imputation based on age, sex, geographic proximity, and country income. Imputation of the component of prevalence based on the diagnostic criterion of self-reported treatment may be particularly problematic because awareness and subsequent treatment depend on health system access and quality, which vary even among countries at the same national income level.Still on t...

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“…8 The study was designed to develop and evaluate a sim plified yet guideline-based, multifaceted management program for 2,086 patients at high card iovascular risk living in resource-constrained environments. 8 Participants in the treatment arm received monthly trained community health workers’ (CHWs) support through an Android smartphone-based app regarding use of medications (aspirin and antihypertensive agents) and lifestyle modifications (smoking cessation and salt reduction). 8 In rural China, CHWs were village non-physician clinicians with basic health professional training and ability to prescribe medications.…”

mentioning

confidence: 99%

“…8 Participants in the treatment arm received monthly trained community health workers’ (CHWs) support through an Android smartphone-based app regarding use of medications (aspirin and antihypertensive agents) and lifestyle modifications (smoking cessation and salt reduction). 8 In rural China, CHWs were village non-physician clinicians with basic health professional training and ability to prescribe medications. 8 In India, the CHWs were non-physician volunteer members of the community, supported by a partnership with licensed physicians in healthcare centers who provided clinical expertise and prescribed medications.…”

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confidence: 99%

Confluence of Cultural Context and Technological Innovation to Reduce Cardiovascular Disparities in India

Sinha

Prabhakaran

Chopra

2017

Circ: Cardiovascular Quality and Outcomes

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A Cluster-Randomized, Controlled Trial of a Simplified Multifaceted Management Program for Individuals at High Cardiovascular Risk (SimCard Trial) in Rural Tibet, China, and Haryana, India

Cited by 133 publications

References 34 publications

Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI—UnitedHealth Global Health Centers of Excellence Program

Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI—UnitedHealth Global Health Centers of Excellence Program

Still on the Road to Worldwide Hypertension Control

Confluence of Cultural Context and Technological Innovation to Reduce Cardiovascular Disparities in India

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