A Tulane University study published on Apr. 9 found that a team-based program in community health clinics helped low-income patients lower their blood pressure more than standard care alone. The research was conducted in 36 federally qualified health centers across Louisiana and Mississippi, focusing on adults with uncontrolled high blood pressure.
Hypertension is a leading cause of death in the United States, especially among low-income populations who often have limited access to healthcare. More than half of U.S. adults have blood pressure above the hypertension threshold, making effective treatment strategies important for public health.
The study involved a multi-faceted program where clinic teams followed an evidence-based plan for treating high blood pressure and supporting patients with medication adherence. Health coaches provided advice on lifestyle changes such as diet and exercise, both in-person and virtually, and supplied tools for home monitoring of blood pressure. In comparison, clinics providing enhanced usual care continued their regular practices but received updated education on treatment guidelines.
After 18 months, patients participating in the team-based program saw an average drop of 15.5 points in systolic blood pressure compared to a 9.1-point reduction among those receiving enhanced usual care. The program also improved patient adherence to hypertension treatments.
"Many of these patients had long-standing and treated hypertension, meaning the approach is effective in lowering blood pressure in challenging, real-world clinical settings," said Dr. M.A. "Tonette" Krousel-Wood, co-first author and principal investigator of the study at Tulane University School of Medicine.
Nearly three-quarters of participants reported family incomes below $25,000 per year; most were Black or unemployed—groups that face greater challenges managing high blood pressure, particularly in Southern states where rates are highest nationally.
Dr. Krousel-Wood said the findings show "that blood pressure lowering interventions can be successful in federally qualified health centers, serving patients who may be most at risk for hypertension-related morbidity and mortality." With about 1,400 such centers nationwide, researchers hope this model could be expanded broadly across the country.
"We found that this approach was most successful when clinics took ownership of the program," Mills said. "The approach taken in this trial can be adopted in other primary care settings to provide support and improve blood pressure control for all people living with hypertension."
