Period: February 2017 – February 2018

Financier: Inter-American Development Bank – IDB

Participating institutions: IECS

Researchers: Vilma Irazola, Analía Nejamis, Andrea Beratarrechea, Daniela Moyano, Laura Gutierrez

Summary:

Cardiovascular diseases (CVD) are increasing and are the leading cause of death. In Argentina, CVD represents 34,2% of deaths and 12,6% of years of life potentially lost. High blood pressure is one of the greatest risk factors for CVD and early death in the world. A population-based prospective cohort study carried out in the Southern Cone of

Latin America estimated a prevalence of 42.5% (95% CI 41.3, 43.7). It also revealed that only 21% of all hypertensive patients and 43,3% of treated hypertensive patients had their blood pressure controlled. The present study will explore strategies based on behavioral economics. They are emerging around the world as a key element to act in modifying habits related to factors that lead to an increase in cardiovascular diseases. The proposed study will evaluate whether two strategies based on Behavioral Economics manage to improve hypertension control, compared to usual care, in people with poorly controlled hypertension, who only have public health coverage. To do this, an individual controlled randomized clinical trial with three arms will be carried out. Approximately 429 patients will be recruited (143 per branch) distributed in 6 Primary Care Health Centers (CAPS) belonging to the province of Buenos Aires. The population of interest is made up of adults with hypertension belonging to the selected CAPS. The proposed interventions include the delivery of a device for self-monitoring of blood pressure conditional on the signing of a “commitment contract”, and mentoring with hypertensive peers who have managed to control their blood pressure, compared to usual care. that these patients receive and will have a follow-up of 3 months.

As the main expected outcome, the difference in systolic and diastolic blood pressure values ​​between the intervention and control groups will be measured from the baseline stage to the end of the intervention at 3 months. Then, as secondary outcomes, the proportion of patients with hypertension control (blood pressure <140/90 mm Hg), the net change in body weight throughout the follow-up, whether there was intensification of pharmacological treatment, the self-report will be evaluated. report of medication adherence by the patient and the number of visits to the CAPS over the course of the intervention period.