Effectiveness and Safety of Using Standardized Treatment Protocols for Hypertension Compared to Usual Care: A Meta-Analysis of Randomized Clinical Trials

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Conn.), 2024-12
• Main Authors: Satheesh, Gautam, Dhurjati, Rupasvi, Jha, Vivekanand, Schutte, Aletta E, Banigbe, Bolanle, Prabhakaran, Dorairaj, Moran, Andrew E, Salam, Abdul
• Format: Article
• Language: English
• ISSN: 1751-7176; 1751-7176
• DOI: 10.1111/jch.14950

Large gaps persist in the diagnosis, awareness, treatment, and control of hypertension globally. Standardized treatment protocols (STPs) have been widely proposed to guide hypertension treatment, particularly in primary healthcare settings. However, there has been no review that quantifies the effects of hypertension STPs on blood pressure (BP) reduction and control. We conducted a systematic review of randomized clinical trials (RCTs) among adults with hypertension, comparing hypertension STPs (intervention) with usual care (comparator) for effects on BP. Relevant RCTs were identified by searching multiple electronic databases. Random-effects meta-analyses were conducted to evaluate between-group differences in systolic BP reduction (primary outcome), diastolic BP reduction, BP control, and adverse events (AEs). Sixteen RCTs involving 59,945 participants (baseline mean BP: 149/91 mmHg) were included. Reductions in systolic and diastolic BP with STPs compared to usual care were 6.7 (95% CI 3.7-9.8) mmHg and 2.6 (1.2-4.1) mmHg, respectively (p