Cardiovascular Disease
Conditions
Keywords
High blood pressure, Primary care, Cardiovascular disease prevention, Salt reduction
Brief summary
Cardiovascular disease is the leading cause of death in China. At the village level, strategies for the control of cardiovascular disease are mostly absent. National clinical guidelines for the management of hypertension and cardiovascular disease are rarely disseminated to, or implemented by, the village primary care providers. Salt reduction has greater potential in rural China than almost anywhere else in the world. Very high levels of salt consumption, very little use of processed food and most dietary salt deriving from home cooking makes the removal of salt from the diet easier, cheaper and more worthwhile than in almost any other setting. The two large-scale cluster-randomized controlled trials proposed here will precisely and reliably define the effect of two highly plausible intervention strategies on important clinical outcomes. The evidence provided by the project will form the basis for policy setting that has the potential to greatly reduce the occurrence of vascular disease in rural China and take an important step towards balancing the rural urban divide in health and healthcare.
Interventions
A primary-care based high cardiovascular risk management package delivered by village doctors
A community-based salt reduction program delivered mainly by community health educators
Sponsors
Study design
Eligibility
Inclusion criteria
* Physician-diagnosed history of coronary heart disease, ischemic stroke, or hemorrhagic stroke, or * Older age (50 years or older for men; 60 years or older for women) and having physician-diagnosed Type I or Type II diabetes * Older age (50 years or older for men; 60 years or older for women) and systolic blood pressure 160 mmHg (note that for simplicity, diastolic blood pressure is not included in the criteria)
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 24 hour urinary sodium | October -December 2012 |
| Mean systematic blood pressure level | October 2010 - December 2012 |
Secondary
| Measure | Time frame |
|---|---|
| Receiving therapeutic lifestyle recommendations from village doctors | Oct 2010 - Dec 2012 |
| 24 hour urinary potassium | October-December 2012 |
| Urinary sodium:potassium ratio | October-December 2012 |
| Receiving regular primary care | October 2010 -December 2012 |
| Taking anti-hypertensive medications | October 2010 -December 2012 |
| Taking aspirin | October 2010 -December 2012 |
Other
| Measure | Time frame |
|---|---|
| Knowledge, attitude and behaviour relating to salt consumption | October-December 2012 |
| Awareness, treatment, and control of hypertension | October 2010 - December 2012 |
Countries
China