Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial

Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. This study was a...

Full description

Saved in:
Bibliographic Details
Published in:Frontiers in cardiovascular medicine 2024-05, Vol.11, p.1355037-1355037
Main Authors: Unda Villafuerte, Fabián, Llobera Cànaves, Joan, Estela Mantolan, Andreu, Bassante Flores, Patricia, Rigo Carratalà, Fernando, Requena Hernández, Ana, Oliver Oliver, Bartolomé, Pou Bordoy, Joan, Moreno Sancho, María Lucía, Leiva, Alfonso, Lorente Montalvo, Patricia
Format: Article
Language:English
Subjects:
blood pressure
Cardiovascular Medicine
hypertension
primary care
randomized trial
self-monitoring
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites cdi_FETCH-LOGICAL-c348t-dcbde114998cf1d295b9f17b4da01bf82620df7551fc71bf1a626f4938040cab3
container_end_page 1355037
container_issue
container_start_page 1355037
container_title Frontiers in cardiovascular medicine
container_volume 11
creator Unda Villafuerte, Fabián
Llobera Cànaves, Joan
Estela Mantolan, Andreu
Bassante Flores, Patricia
Rigo Carratalà, Fernando
Requena Hernández, Ana
Oliver Oliver, Bartolomé
Pou Bordoy, Joan
Moreno Sancho, María Lucía
Leiva, Alfonso
Lorente Montalvo, Patricia
description Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9],  
doi_str_mv 10.3389/fcvm.2024.1355037
format article
fullrecord <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_12410902a72048a68b067525044ef5a8</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_12410902a72048a68b067525044ef5a8</doaj_id><sourcerecordid>3064924170</sourcerecordid><originalsourceid>FETCH-LOGICAL-c348t-dcbde114998cf1d295b9f17b4da01bf82620df7551fc71bf1a626f4938040cab3</originalsourceid><addsrcrecordid>eNpVks9uEzEQxlcIRKvSB-CCfOTABv9de7kgFNI2UhGXIsHJ8nrtxJXXDrYTKbwP74nThKqVLNkef_ObGetrmrcIzggR_Uerd9MMQ0xniDAGCX_RnGPc8xYy9vPlk_NZc5nzPYQQMSpYJ143Z0QI0sFOnDd_F9YaXdzOBJMziBZMZnRaFRcDyMbbdlJBrcxkQvlwCsTgSkwurIAKI1DAO2ty2XsDXCgmVdRDdl3r_cakYkI-3F0AmxiT3wMdQ0nRezOCTa1U9fkTuFsb8G3xdTm_-QVSBcfJ_amCkpzyb5pXVvlsLk_7RfPjanE3v2lvv18v519uW02oKO2oh9EgRPteaItG3LOht4gPdFQQDVbgDsPRcsaQ1bwGkOpwZ2lPBKRQq4FcNMsjd4zqXm6Sm1Tay6icfAjEtJIqFae9kQhTBHuIFceQCtWJAXacYQYpNZYpUVmfj6zNdqh_quuUSfln0Ocvwa3lKu4kqhMIznklvD8RUvy9rV8sJ5e18V4FE7dZEtjRvrbBYZWio1SnmHMy9rEOgvJgF3mwizzYRZ7sUnPePW3wMeO_Ocg_akLAMQ</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3064924170</pqid></control><display><type>article</type><title>Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial</title><source>PubMed Central</source><creator>Unda Villafuerte, Fabián ; Llobera Cànaves, Joan ; Estela Mantolan, Andreu ; Bassante Flores, Patricia ; Rigo Carratalà, Fernando ; Requena Hernández, Ana ; Oliver Oliver, Bartolomé ; Pou Bordoy, Joan ; Moreno Sancho, María Lucía ; Leiva, Alfonso ; Lorente Montalvo, Patricia</creator><creatorcontrib>Unda Villafuerte, Fabián ; Llobera Cànaves, Joan ; Estela Mantolan, Andreu ; Bassante Flores, Patricia ; Rigo Carratalà, Fernando ; Requena Hernández, Ana ; Oliver Oliver, Bartolomé ; Pou Bordoy, Joan ; Moreno Sancho, María Lucía ; Leiva, Alfonso ; Lorente Montalvo, Patricia ; MEDICHY Group ; The MEDICHY Group</creatorcontrib><description>Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9],  &lt; 0.001) and a significantly lower diastolic blood pressure (83.5 mmHg [±8.8] 87.00 mmHg [±9.0], adjusted mean difference: 5.4 [95% CI: 2.9, 7.8],  &lt; 0.0001). The intervention group also had significantly more patients who achieved successful blood pressure control (&lt;140/90 mmHg; 54.4% 32.9%,  = 0.011). Self-monitoring of blood pressure in combination with self-management of hypertensive medications, diet, and physical activity in a primary care setting leads to significantly lower blood pressure in patients with poorly controlled hypertension. ClinicalTrials.gov, identifier ISRCTN14433778.</description><identifier>ISSN: 2297-055X</identifier><identifier>EISSN: 2297-055X</identifier><identifier>DOI: 10.3389/fcvm.2024.1355037</identifier><identifier>PMID: 38836068</identifier><language>eng</language><publisher>Switzerland: Frontiers Media S.A</publisher><subject>blood pressure ; Cardiovascular Medicine ; hypertension ; primary care ; randomized trial ; self-monitoring</subject><ispartof>Frontiers in cardiovascular medicine, 2024-05, Vol.11, p.1355037-1355037</ispartof><rights>2024 Unda Villafuerte, Llobera Cànaves, Estela Mantolan, Bassante Flores, Rigo Carratalà, Requena Hernández, Oliver Oliver, Pou Bordoy, Moreno Sancho, Leiva, Lorente Montalvo and The MEDICHY Group.</rights><rights>2024 Unda Villafuerte, Llobera Cànaves, Estela Mantolan, Bassante Flores, Rigo Carratalà, Requena Hernández, Oliver Oliver, Pou Bordoy, Moreno Sancho, Leiva, Lorente Montalvo and The MEDICHY Group. 2024 Unda Villafuerte, Llobera Cànaves, Estela Mantolan, Bassante Flores, Rigo Carratalà, Requena Hernández, Oliver Oliver, Pou Bordoy, Moreno Sancho, Leiva, Lorente Montalvo and The MEDICHY Group</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c348t-dcbde114998cf1d295b9f17b4da01bf82620df7551fc71bf1a626f4938040cab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11148777/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11148777/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38836068$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Unda Villafuerte, Fabián</creatorcontrib><creatorcontrib>Llobera Cànaves, Joan</creatorcontrib><creatorcontrib>Estela Mantolan, Andreu</creatorcontrib><creatorcontrib>Bassante Flores, Patricia</creatorcontrib><creatorcontrib>Rigo Carratalà, Fernando</creatorcontrib><creatorcontrib>Requena Hernández, Ana</creatorcontrib><creatorcontrib>Oliver Oliver, Bartolomé</creatorcontrib><creatorcontrib>Pou Bordoy, Joan</creatorcontrib><creatorcontrib>Moreno Sancho, María Lucía</creatorcontrib><creatorcontrib>Leiva, Alfonso</creatorcontrib><creatorcontrib>Lorente Montalvo, Patricia</creatorcontrib><creatorcontrib>MEDICHY Group</creatorcontrib><creatorcontrib>The MEDICHY Group</creatorcontrib><title>Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial</title><title>Frontiers in cardiovascular medicine</title><addtitle>Front Cardiovasc Med</addtitle><description>Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9],  &lt; 0.001) and a significantly lower diastolic blood pressure (83.5 mmHg [±8.8] 87.00 mmHg [±9.0], adjusted mean difference: 5.4 [95% CI: 2.9, 7.8],  &lt; 0.0001). The intervention group also had significantly more patients who achieved successful blood pressure control (&lt;140/90 mmHg; 54.4% 32.9%,  = 0.011). Self-monitoring of blood pressure in combination with self-management of hypertensive medications, diet, and physical activity in a primary care setting leads to significantly lower blood pressure in patients with poorly controlled hypertension. ClinicalTrials.gov, identifier ISRCTN14433778.</description><subject>blood pressure</subject><subject>Cardiovascular Medicine</subject><subject>hypertension</subject><subject>primary care</subject><subject>randomized trial</subject><subject>self-monitoring</subject><issn>2297-055X</issn><issn>2297-055X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVks9uEzEQxlcIRKvSB-CCfOTABv9de7kgFNI2UhGXIsHJ8nrtxJXXDrYTKbwP74nThKqVLNkef_ObGetrmrcIzggR_Uerd9MMQ0xniDAGCX_RnGPc8xYy9vPlk_NZc5nzPYQQMSpYJ143Z0QI0sFOnDd_F9YaXdzOBJMziBZMZnRaFRcDyMbbdlJBrcxkQvlwCsTgSkwurIAKI1DAO2ty2XsDXCgmVdRDdl3r_cakYkI-3F0AmxiT3wMdQ0nRezOCTa1U9fkTuFsb8G3xdTm_-QVSBcfJ_amCkpzyb5pXVvlsLk_7RfPjanE3v2lvv18v519uW02oKO2oh9EgRPteaItG3LOht4gPdFQQDVbgDsPRcsaQ1bwGkOpwZ2lPBKRQq4FcNMsjd4zqXm6Sm1Tay6icfAjEtJIqFae9kQhTBHuIFceQCtWJAXacYQYpNZYpUVmfj6zNdqh_quuUSfln0Ocvwa3lKu4kqhMIznklvD8RUvy9rV8sJ5e18V4FE7dZEtjRvrbBYZWio1SnmHMy9rEOgvJgF3mwizzYRZ7sUnPePW3wMeO_Ocg_akLAMQ</recordid><startdate>20240521</startdate><enddate>20240521</enddate><creator>Unda Villafuerte, Fabián</creator><creator>Llobera Cànaves, Joan</creator><creator>Estela Mantolan, Andreu</creator><creator>Bassante Flores, Patricia</creator><creator>Rigo Carratalà, Fernando</creator><creator>Requena Hernández, Ana</creator><creator>Oliver Oliver, Bartolomé</creator><creator>Pou Bordoy, Joan</creator><creator>Moreno Sancho, María Lucía</creator><creator>Leiva, Alfonso</creator><creator>Lorente Montalvo, Patricia</creator><general>Frontiers Media S.A</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20240521</creationdate><title>Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial</title><author>Unda Villafuerte, Fabián ; Llobera Cànaves, Joan ; Estela Mantolan, Andreu ; Bassante Flores, Patricia ; Rigo Carratalà, Fernando ; Requena Hernández, Ana ; Oliver Oliver, Bartolomé ; Pou Bordoy, Joan ; Moreno Sancho, María Lucía ; Leiva, Alfonso ; Lorente Montalvo, Patricia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-dcbde114998cf1d295b9f17b4da01bf82620df7551fc71bf1a626f4938040cab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>blood pressure</topic><topic>Cardiovascular Medicine</topic><topic>hypertension</topic><topic>primary care</topic><topic>randomized trial</topic><topic>self-monitoring</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Unda Villafuerte, Fabián</creatorcontrib><creatorcontrib>Llobera Cànaves, Joan</creatorcontrib><creatorcontrib>Estela Mantolan, Andreu</creatorcontrib><creatorcontrib>Bassante Flores, Patricia</creatorcontrib><creatorcontrib>Rigo Carratalà, Fernando</creatorcontrib><creatorcontrib>Requena Hernández, Ana</creatorcontrib><creatorcontrib>Oliver Oliver, Bartolomé</creatorcontrib><creatorcontrib>Pou Bordoy, Joan</creatorcontrib><creatorcontrib>Moreno Sancho, María Lucía</creatorcontrib><creatorcontrib>Leiva, Alfonso</creatorcontrib><creatorcontrib>Lorente Montalvo, Patricia</creatorcontrib><creatorcontrib>MEDICHY Group</creatorcontrib><creatorcontrib>The MEDICHY Group</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in cardiovascular medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Unda Villafuerte, Fabián</au><au>Llobera Cànaves, Joan</au><au>Estela Mantolan, Andreu</au><au>Bassante Flores, Patricia</au><au>Rigo Carratalà, Fernando</au><au>Requena Hernández, Ana</au><au>Oliver Oliver, Bartolomé</au><au>Pou Bordoy, Joan</au><au>Moreno Sancho, María Lucía</au><au>Leiva, Alfonso</au><au>Lorente Montalvo, Patricia</au><aucorp>MEDICHY Group</aucorp><aucorp>The MEDICHY Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial</atitle><jtitle>Frontiers in cardiovascular medicine</jtitle><addtitle>Front Cardiovasc Med</addtitle><date>2024-05-21</date><risdate>2024</risdate><volume>11</volume><spage>1355037</spage><epage>1355037</epage><pages>1355037-1355037</pages><issn>2297-055X</issn><eissn>2297-055X</eissn><abstract>Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9],  &lt; 0.001) and a significantly lower diastolic blood pressure (83.5 mmHg [±8.8] 87.00 mmHg [±9.0], adjusted mean difference: 5.4 [95% CI: 2.9, 7.8],  &lt; 0.0001). The intervention group also had significantly more patients who achieved successful blood pressure control (&lt;140/90 mmHg; 54.4% 32.9%,  = 0.011). Self-monitoring of blood pressure in combination with self-management of hypertensive medications, diet, and physical activity in a primary care setting leads to significantly lower blood pressure in patients with poorly controlled hypertension. ClinicalTrials.gov, identifier ISRCTN14433778.</abstract><cop>Switzerland</cop><pub>Frontiers Media S.A</pub><pmid>38836068</pmid><doi>10.3389/fcvm.2024.1355037</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 2297-055X
ispartof Frontiers in cardiovascular medicine, 2024-05, Vol.11, p.1355037-1355037
issn 2297-055X
2297-055X
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_12410902a72048a68b067525044ef5a8
source PubMed Central
subjects blood pressure
Cardiovascular Medicine
hypertension
primary care
randomized trial
self-monitoring
title Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T11%3A42%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Effectiveness%20of%20medication%20self-management,%20self-monitoring%20and%20a%20lifestyle%20intervention%20on%20hypertension%20in%20poorly%20controlled%20patients:%20The%20MEDICHY%20randomized%20trial&rft.jtitle=Frontiers%20in%20cardiovascular%20medicine&rft.au=Unda%20Villafuerte,%20Fabi%C3%A1n&rft.aucorp=MEDICHY%20Group&rft.date=2024-05-21&rft.volume=11&rft.spage=1355037&rft.epage=1355037&rft.pages=1355037-1355037&rft.issn=2297-055X&rft.eissn=2297-055X&rft_id=info:doi/10.3389/fcvm.2024.1355037&rft_dat=%3Cproquest_doaj_%3E3064924170%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c348t-dcbde114998cf1d295b9f17b4da01bf82620df7551fc71bf1a626f4938040cab3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3064924170&rft_id=info:pmid/38836068&rfr_iscdi=true