In:
PLOS Medicine, Public Library of Science (PLoS), Vol. 19, No. 12 ( 2022-12-27), p. e1004151-
Abstract:
Hypertension represents one of the major risk factors for cardiovascular morbidity and mortality globally. Early detection and treatment of this condition is vital to prevent complications. However, hypertension often goes undetected, and even if detected, not every patient receives adequate treatment. Identifying simple and effective interventions is therefore crucial to fight this problem and allow more patients to receive the treatment they need. Therefore, we aim at investigating the impact of a population-based blood pressure (BP) screening and the subsequent “low-threshold” information treatment on long-term cardiovascular disease (CVD) morbidity and mortality. Methods and findings We examined the impact of a BP screening embedded in a population-based cohort study in Germany and subsequent personalized “light touch” information treatment, including a hypertension diagnosis and a recommendation to seek medical attention. We pooled four waves of the KORA study, carried out between 1984 and 1996 ( N = 14,592). Using a sharp multivariate regression discontinuity (RD) design, we estimated the impact of the information treatment on CVD mortality and morbidity over 16.9 years. Additionally, we investigated potential intermediate outcomes, such as hypertension awareness, BP, and behavior after 7 years. No evidence of effect of BP screening was observed on CVD mortality (hazard ratio (HR) = 1.172 [95% confidence interval (CI): 0.725, 1.896]) or on any (fatal or nonfatal) long-term CVD event (HR = 1.022 [0.636, 1.641] ) for individuals just above (versus below) the threshold for hypertension. Stratification for previous self-reported diagnosis of hypertension at baseline did not reveal any differential effect. The intermediate outcomes, including awareness of hypertension, were also unaffected by the information treatment. However, these results should be interpreted with caution since the analysis might not be sufficiently powered to detect a potential intervention effect. Conclusions The study does not provide evidence of an effect of the assessed BP screening and subsequent information treatment on BP, health behavior, or long-term CVD mortality and morbidity. Future studies should consider larger datasets to detect possible effects and a shorter follow-up for the intermediate outcomes (i.e., BP and behavior) to detect short-, medium-, and long-term effects of the intervention along the causal pathway.
Type of Medium:
Online Resource
ISSN:
1549-1676
DOI:
10.1371/journal.pmed.1004151
DOI:
10.1371/journal.pmed.1004151.g001
DOI:
10.1371/journal.pmed.1004151.g002
DOI:
10.1371/journal.pmed.1004151.g003
DOI:
10.1371/journal.pmed.1004151.t001
DOI:
10.1371/journal.pmed.1004151.t002
DOI:
10.1371/journal.pmed.1004151.s001
DOI:
10.1371/journal.pmed.1004151.s002
DOI:
10.1371/journal.pmed.1004151.s003
DOI:
10.1371/journal.pmed.1004151.s004
DOI:
10.1371/journal.pmed.1004151.s005
DOI:
10.1371/journal.pmed.1004151.s006
DOI:
10.1371/journal.pmed.1004151.s007
DOI:
10.1371/journal.pmed.1004151.s008
DOI:
10.1371/journal.pmed.1004151.s009
DOI:
10.1371/journal.pmed.1004151.s010
DOI:
10.1371/journal.pmed.1004151.s011
DOI:
10.1371/journal.pmed.1004151.s012
DOI:
10.1371/journal.pmed.1004151.s013
DOI:
10.1371/journal.pmed.1004151.s014
DOI:
10.1371/journal.pmed.1004151.s015
DOI:
10.1371/journal.pmed.1004151.s016
DOI:
10.1371/journal.pmed.1004151.r001
DOI:
10.1371/journal.pmed.1004151.r002
DOI:
10.1371/journal.pmed.1004151.r003
DOI:
10.1371/journal.pmed.1004151.r004
DOI:
10.1371/journal.pmed.1004151.r005
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2164823-2
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