ORIGINAL RESEARCH article
Front. Med.
Sec. Family Medicine and Primary Care
Study on the effect of community intervention on patients with hypertension in high-normal blood pressure
Qingxia Gao 1
Zhiguang Gao 2
Qianfeng Yang 1
Lijun Wang 2
Lishuang Xu 3
1. Chengde Medical University, Chengde, China
2. Chaoyang Central Hospital, Chaoyang, China
3. Shengjing Hospital of China Medical University, Shenyang, China
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Abstract
Introduction Among patients with hypertension, maintaining blood pressure within the high-normal range is a common clinical scenario, often misinterpreted as adequate control. However, this level remains associated with cardiovascular risk and progression of target organ damage. Yet, evidence is lacking regarding effective community-based interventions for this population. This study aimed to evaluate the effects of a 12-month, community physician-led standardized health management intervention on blood pressure control rates, lifestyle improvements, and influencing factors in hypertensive patients with high-normal blood pressure, in order to explore effective management strategies for this key population. Methods A series of information surveys and health interventions were conducted among 721 patients (aged 18–80 years) with high-normal blood pressure from communities in Shenyang. Descriptive analysis and multivariable logistic regression analysis were used as the primary analytical methods. Results After one year of community intervention, both systolic and diastolic blood pressure significantly decreased in 721 individuals with high-normal blood pressure (P<0.05). Knowledge about hypertension, awareness of prevention, medication adherence, and behavioral adherence also improved compared to pre-intervention levels (P<0.05).A repeated-measures analysis of variance revealed a statistically significant main effect of time on both systolic and diastolic blood pressure (SBP: F(1.90, 1369.92) = 135.833, partial η² = 0.159; DBP: F(1.995, 1436.10) = 50.181, partial η² = 0.065 ,both P<0.05). Analysis of factors influencing blood pressure control at the end of the intervention demonstrated that poor medication adherence due to adverse drug reactions was associated with inadequate blood pressure control [OR (95%CI):3.222(1.169-8.878), P<0.05]. Additionally, after the intervention, not reducing smoking was identified as a factor inversely associated with uncontrolled diastolic blood pressure [OR (95% CI):0.192(0.068-0.562), P<0.05], while higher body weight remained associated with uncontrolled diastolic blood pressure [OR (95% CI):1.018(1.003-1.035), P<0.05]. Furthermore, using non-drink-reducers as the reference group, alcohol reduction was identified as an influencing factor for uncontrolled systolic blood pressure [OR (95% CI): 2.550 (1.419-4.583), P < 0.05]. Conclusions Community-based interventions by primary care physicians targeting individuals with high-normal blood pressure can effectively modify unhealthy lifestyle habits and improve blood pressure control.
Summary
Keywords
community intervention, Health managament, High-normal blood pressure, Hypertension, lifestyle
Received
05 December 2025
Accepted
13 February 2026
Copyright
© 2026 Gao, Gao, Yang, Wang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Zhiguang Gao
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