International Journal of Epidemiology 2001;30:1485-1491
© International Epidemiological Association 2001
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Pragmatic randomized trial of home visits by a nurse to elderly people with hypertension in Mexico
a Epidemiological and Health Services Research Department, Research Coordination, Mexican Institute of Social Security, Mexico.
b Health Promotion Research Unit, London School of Hygiene and Tropical Medicine, London, UK.
c Environmental Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK.
d Medical Research Unit on Ageing, Research Coordination, Mexican Institute of Social Security, Mexico. Currently at University of Leicester.
e Research Coordination, Mexican Institute of Social Security, Mexico.
Dr Margaret Thorogood, Health Promotion Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1 7HT, UK. E-mail: M.Thorogood{at}lshtm.ac.uk
Abstract
Background In Mexico, hypertension is a major cause of disability and death in the elderly, but the most effective way to promote behaviour change in old people is unknown. Low resource interventions that are effective in normal healthcare settings are urgently needed. We report the results of a randomized trial of nurse-provided health and lifestyle advice during home visits to elderly people with hypertension in Mexico City.
Methods Subjects were 718 people with hypertension aged 
60 years, who were residents of Mexico City and were registered with the Family Medicine Clinics of the Mexican Institute of Social Security (IMSS). A randomized controlled trial was carried out in which the intervention group was offered nurse visits over 6 months with blood pressure checks and negotiated lifestyle changes. The control group continued to receive usual care.
Results After 6 months, 36.5% of the intervention versus 6.8% of the control group had a blood pressure of <160/90 mmHg. The difference in the mean change in systolic blood pressure was 3.31 mmHg (P = 0.03, 95% CI : 6.32, 0.29) and the same difference in diastolic blood pressure was 3.67 mmHg (P = 0.00, 95% CI : 5.22, 2.12). Weight and sodium excretion fell more in the intervention group, but the difference was not significant.
Conclusions Nurse home visits are effective in reducing blood pressure in hypertensive patients aged 60 years.
Keywords Hypertension, elderly, Mexico
Accepted 23 April 2001
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