Impact of a general practice nurse intervention to improve blood pressure control: The ImPress study

Abstract

Background and objectiveHypertension is a highly prevalent but often poorly controlled risk factor for cardiovascular disease (CVD). This study examined the effectiveness of a general practice nurse (GPN) intervention to reduce blood pressure in adults with hypertension who are at high risk of CVD. MethodsA cluster randomised control trial was performed across 10 general practices. Systolic (SBP) and diastolic (DBP) blood pressure were evaluated at six and 12 months. ResultsThe adjusted mean difference between intervention and control groups at six months was 8.1 mmHg (95% confidence interval [CI]: -2.92, 18.94 mmHg; P=0.146) for SBP and 0.18 mmHg (95% CI: -6.54, 4.91 mmHg; P=0.775) for DBP. The adjusted mean difference between groups at 12 months was 11.3 mmHg (95% CI: 1.18, 21.42 mmHg; P=0.030) for SBP and 7.1 mmHg (95% CI: -8.62, 22.90 mmHg; P=0.362) for DBP. DiscussionClinically significant between-group differences in mean SBP at six and 12 months provide evidence for GPNs to play a greater role in managing hypertension.