Sprague Briana N, Forster Anna K
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
School of Nursing, Indiana University Indianapolis, Indianapolis, IN 46202, USA.
Healthcare (Basel). 2025 Jun 11;13(12):1397. doi: 10.3390/healthcare13121397.
What types of multilevel interventions exist to improve blood pressure among community-dwelling adults aged 18+ in the United States? What is the treatment efficacy?
Peer-reviewed articles from Cochrane Library, EMBASE, PsycINFO, and PubMed. The search strategy was pre-registered on Open Science Framework.
Inclusion criteria were community-dwelling adults in the United States aged 18 or older; interventions involving at least two levels; at least one blood pressure outcome measured; and published in a peer-reviewed journal.
Intervention activities, blood pressure outcomes, and moderation/subgroup analyses, when available, were extracted.
Qualitative synthesis and summary statistics.
Ninety-five papers covering 89 RCTs were included. Multilevel interventions involving the individual and healthcare team (without health policies = 49 studies; with health policies = 15 studies) tended to show the most consistent saltatory effects on blood pressure (systolic: 46% of studies showed statistical improvement; diastolic: 47% of studies showed statistical improvement). Interventions involving families or communities outside of healthcare settings were promising but were less frequently reported (19% of studies).
There was mixed evidence that multilevel interventions targeting cardiovascular health improved blood pressure among U.S.-based adults. Future research should continue evaluating interventions that improve the individual as well as the environments in which individuals work and play, especially those levels outside of traditional healthcare settings.
在美国，存在哪些类型的多级干预措施可改善18岁及以上社区居住成年人的血压？治疗效果如何？
来自Cochrane图书馆、EMBASE、PsycINFO和PubMed的同行评审文章。检索策略已在开放科学框架上预先注册。
纳入标准为美国18岁及以上的社区居住成年人；涉及至少两个层面的干预措施；测量了至少一项血压结果；并发表在同行评审期刊上。
提取干预活动、血压结果以及适度/亚组分析（如有的话）。
定性综合和汇总统计。
纳入了涵盖89项随机对照试验的95篇论文。涉及个人和医疗团队的多级干预措施（无卫生政策的有49项研究；有卫生政策的有15项研究）对血压往往显示出最一致的跳跃式效果（收缩压：46%的研究显示有统计学上的改善；舒张压：47%的研究显示有统计学上的改善）。涉及医疗环境之外的家庭或社区的干预措施很有前景，但报道较少（占研究的19%）。
有混合证据表明，针对心血管健康的多级干预措施可改善美国成年人的血压。未来的研究应继续评估改善个人以及个人工作和生活环境的干预措施，特别是传统医疗环境之外的那些层面。
