Effectiveness of self-management for hypertension patients and behavior changes in China: a systematic review and meta-analysis

中国高血压患者自我管理及行为改变的有效性:系统评价和荟萃分析

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Abstract

INTRODUCTION: Hypertension (HTN) poses a significant health threat in China, increasing the risk of cardiovascular disease. However, the impact of self-management interventions on patients with HTN in China has yet to be thoroughly explored. METHODS: This review examines the impact of self-management strategies on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Data were collected from various sources, including PubMed, Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure, Chinese Biomedical Database, Chinese VIP Information, and WanFang Database. The study screening, quality assessment, data extraction, and meta-analysis were carried out according to Cochrane standards. RESULTS: This study included sixteen randomized controlled trials with a total of 8,652 participants. Compared to control groups, self-management interventions significantly reduced SBP (MD = -6.37, 95% CI [-9.13, -3.61]; I (2) = 96%; p < 0.001) and DBP (MD = -4.01, 95% CI [-5.64, -2.37]; I (2) = 93%; p < 0.001). In subgroup analyses based on duration, SBP and DBP improved with self-management interventions (p < 0.05), but no significant difference was found between groups (p > 0.05). Lower HTN levels were observed in the control groups within hospital and community settings (p < 0.05), but no effect was observed in rural areas (p > 0.05). CONCLUSIONS: Self-management is an effective approach to reducing both SBP and DBP in hypertensive patients.

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