Older persons grant payment sites as an innovative strategy for managing hypertension in older populations
1
Faculty of Health Sciences, Universitat Oberta de Catalunya (Open University of Catalonia, UOC), Barcelona, Spain
2
School of Public Health, University of the Witswatersrand, Johannesburg, South Africa
3
goGOGOgo, Johannesburg, South Africa
4
South African Medical Research Council, Cape Town, South Africa
5
Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witswatersrand, Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A122
ABSTRACT
INTRODUCTION:
South Africa has amongst the highest prevalence of hypertension in persons ≥ 60 years worldwide. Interventions to reduce blood pressure (BP) are needed. Locations where older persons collect older oersons grants present a unique opportunity to deliver such an intervention.
METHODS:
Monthly BP measurements were conducted at six grant collection locations in Bushbuckridge, Mpumalanga Province, South Africa. During the three-month baseline we measured BP, reported BP to participants and referred to care if hypertensive. In the 12-month intervention, we measured BP, promoted hypertension knowledge, introduced a BP risk assessment card and referred to care if hypertensive. Hypertension was defined as systolic BP (SBP) ≥140 mmHg or diastolic BP (DBP)≥90 mmHg or on hypertension medication. Linear quantile regression models were used to estimate the median intervention effect for SBP and DBP with robust variance estimates. Contrast between pooled baseline and pooled intervention months is reported as the overall intervention effect. Binomial regression models were used to estimate the intervention effect on measured hypertensive status and knowledge of hypertension status using the difference between baseline and first three months of intervention.
RESULTS:
We performed 7066 measurements, 73% in women, average age 71.4 years, 39% of contacts being hypertensive. SBP dropped by 3.6 mmHg [95%CI -4.5; -2.7] throughout the overall intervention (4.9 mmHg [95%CI -7.5; -2.3] in men, 3.5 mm/Hg [95%CI -4.4; -2.6] in women). DBP dropped by 0.83 mmHg [95%CI -1.53; -0.13] overall (3.3 mmHg [95% CI -6.9; -1.0] (p=0.630) in men, 1.0 mmHg [95% CI -1.8; -0.2]) in women. Overall, there was a 17.9% reduction in measured hypertension over the intervention [95% CI -24.7;-11.0] (p<0.001), adjusted for time, age and sex.
CONCLUSIONS:
Measuring BP in grant payment sites together with hypertension knowledge and awareness is effective in reducing BP in older populations.
South Africa has amongst the highest prevalence of hypertension in persons ≥ 60 years worldwide. Interventions to reduce blood pressure (BP) are needed. Locations where older persons collect older oersons grants present a unique opportunity to deliver such an intervention.
METHODS:
Monthly BP measurements were conducted at six grant collection locations in Bushbuckridge, Mpumalanga Province, South Africa. During the three-month baseline we measured BP, reported BP to participants and referred to care if hypertensive. In the 12-month intervention, we measured BP, promoted hypertension knowledge, introduced a BP risk assessment card and referred to care if hypertensive. Hypertension was defined as systolic BP (SBP) ≥140 mmHg or diastolic BP (DBP)≥90 mmHg or on hypertension medication. Linear quantile regression models were used to estimate the median intervention effect for SBP and DBP with robust variance estimates. Contrast between pooled baseline and pooled intervention months is reported as the overall intervention effect. Binomial regression models were used to estimate the intervention effect on measured hypertensive status and knowledge of hypertension status using the difference between baseline and first three months of intervention.
RESULTS:
We performed 7066 measurements, 73% in women, average age 71.4 years, 39% of contacts being hypertensive. SBP dropped by 3.6 mmHg [95%CI -4.5; -2.7] throughout the overall intervention (4.9 mmHg [95%CI -7.5; -2.3] in men, 3.5 mm/Hg [95%CI -4.4; -2.6] in women). DBP dropped by 0.83 mmHg [95%CI -1.53; -0.13] overall (3.3 mmHg [95% CI -6.9; -1.0] (p=0.630) in men, 1.0 mmHg [95% CI -1.8; -0.2]) in women. Overall, there was a 17.9% reduction in measured hypertension over the intervention [95% CI -24.7;-11.0] (p<0.001), adjusted for time, age and sex.
CONCLUSIONS:
Measuring BP in grant payment sites together with hypertension knowledge and awareness is effective in reducing BP in older populations.
| eISSN: | 2654-1459 |
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