Efficacy of the HOPE 4 strategy compared with conventional strategy for the control of arterial hypertension in Nicaragua. ARJÉ Trial

Abstract

Introduction: control of patients with hypertension is insufficient globally. There are different strategies to achieve this goal, but they have very rarely been compared in Latin America. Objective: to compare the effectiveness of the HOPE 4 strategy adapted to the context of Jinotega (HOPE-4J) with conventional strategy in the control of hypertension. Methods: adult patients with hypertension enrolled in the Clinica de Falla Cardiaca in the Hospital Victoria Motta were included during the period of study. The patients were divided into 2 arms: the HOPE 4 group and control group with the traditional Family and Community Health Model of Nicaragua (MOSAFC). An initial evaluation was conducted, and another one done in 6 months in a double-blind manner to compare hypertension control parameters in both groups. Results: Relative Risk (RR) was determined and NNT - number necessary to treat to make a comparison with the control group. A RR of 0.1510 and an NNT of 3.35 showed positive results for the HOPE-4J strategy. Conclusions: The HOPE 4 strategy modified to fit the population in Jinotega shows overall improvement over the MOSAFC. A comprehensive model was conducted by medical and non-medical staff and family members that helped the overall reduction of poorly controlled hypertension.