Department of Population Health, Division of Global Health, The University of Texas at Austin Dell Medical School, 1601 Trinity St., Bldg. B, Austin, TX, 78712, USA.
Department of Internal Medicine, Division of Cardiology, The University of Texas at Austin Dell Medical School, Austin, TX, USA.
Curr Hypertens Rep. 2020 May 13;22(5):39. doi: 10.1007/s11906-020-01045-1.
This review summarizes the most recent and innovative implementation strategies for hypertension control in low- and middle-income countries (LMICs).
Implementation strategies from Latin America, Africa, and Asia were organized across three levels: community, health system, and policy/population. Multicomponent interventions involving task-shifting strategies, with or without mobile health tools, had the most supporting evidence, with policy or population-level interventions having the least, focused only on salt reduction with mixed results. More research is needed to better understand how context affects intervention implementation. There is an emerging evidence base for implementation strategies for hypertension control and CVD risk reduction in LMICs at the community and health system levels, but further research is needed to determine the most effective policy and population-level strategies. How to best account for local context in adapting and implementing these evidence-based interventions in LMICs still remains largely unknown. Accelerating the translation of this implementation research into policy and practice is imperative to improve health and save lives globally.
综述目的：本文总结了在中低收入国家（LMICs）中控制高血压的最新和创新实施策略。
最近发现：本文从拉丁美洲、非洲和亚洲组织了三个层面的实施策略：社区、卫生系统和政策/人群。涉及任务转移策略的多组分干预措施，无论是否使用移动健康工具，都具有最多的支持证据，而政策或人群层面的干预措施则最少，仅关注盐的减少，结果喜忧参半。需要进一步的研究来更好地了解环境如何影响干预措施的实施。在社区和卫生系统层面上，针对 LMICs 中高血压控制和 CVD 风险降低的实施策略，已经有了越来越多的证据，但需要进一步的研究来确定最有效的政策和人群层面的策略。如何在 LMICs 中适应和实施这些基于证据的干预措施时，如何最好地考虑当地情况，这在很大程度上仍然未知。加速将这一实施研究转化为政策和实践，对于改善全球健康和拯救生命至关重要。
