Matão Controlling Hypertension (MatCH Study): Rationale and Design

Summary

Background Hypertension is the main risk factor for most cardiovascular diseases. Blood pressure (BP) control has been shown to reduce the incidence of stroke, myocardial infarction, renal diseases and heart failure. Although BP lowering is effective, few population programs can achieve BP control. A coordinated and organized system from the Brazilian Ministry of Healthy involving Family Health Strategy (FHS), a program for the prevention of chronic disease, and the Popular Pharmacy Program (PPP), which subsidizes medications for the population, could allow an earlier identification and better BP control. Matão Controlling Hypertension (MatCH) is a community-based population project that aims to apply an organized, integrated and coordinated program in the city of Matão, Brazil, involving FSH and PPP in order to actively search, treat and follow-up hypertensive subjects. Method This is a population community-based, prospective, interventional, follow-up study where all subjects aged ≥ 40 years assisted by the FHS program in Matão will have BP assessed monthly by trained Community Health Agents (CHA) during a domiciliary visit. Identified hypertensive subjects will be referred to FHS physicians for nonpharmacological and pharmacological treatment. Most of the hypertensive drugs used will be available thought the PPP. Prevalence of hypertension, awareness, demographics and risk factors will be correlated with BP control. The population study is expected to involve approximately 15,000 subjects. The study period will be four years. Discussion Considering that hypertension is asymptomatic in most cases, to reduce the population burden of BP-related deaths and diseases it is essential to detect and treat early all hypertensive patients. If BP control be achieved on a large scale, this program can be applied to other populations from developing countries.

Timeline

Start

2018-02-01

Primary completion

2020-06-30

Completion

2021-06-30

Publications

• Results Ribeiro AL, Duncan BB, Brant LC, Lotufo PA, Mill JG, Barreto SM. Cardiovascular Health in Brazil: Trends and Perspectives. Circulation. 2016 Jan 26;133(4):422-33. doi: 10.1161/CIRCULATIONAHA.114.008727.
• Results Macinko J, Harris MJ. Brazil's family health strategy--delivering community-based primary care in a universal health system. N Engl J Med. 2015 Jun 4;372(23):2177-81. doi: 10.1056/NEJMp1501140. No abstract available.
• Results Emmerick IC, do Nascimento JM Jr, Pereira MA, Luiza VL, Ross-Degnan D; ISAUM-Br Collaborative Group. Farmacia Popular Program: changes in geographic accessibility of medicines during ten years of a medicine subsidy policy in Brazil. J Pharm Policy Pract. 2015 Mar 9;8(1):10. doi: 10.1186/s40545-015-0030-x. eCollection 2015.
• Results Malachias MVB, Gomes MAM, Nobre F, Alessi A, Feitosa AD, Coelho EB. 7th Brazilian Guideline of Arterial Hypertension: Chapter 2 - Diagnosis and Classification. Arq Bras Cardiol. 2016 Sep;107(3 Suppl 3):7-13. doi: 10.5935/abc.20160152. No abstract available.
• Results Malachias MVB, Paulo Cesar Veiga Jardim PCV Junior, Almeida FA, Lima E Junior, Feitosa GS. 7th Brazilian Guideline of Arterial Hypertension: Chapter 7 - Pharmacological Treatment. Arq Bras Cardiol. 2016 Sep;107(3 Suppl 3):35-43. doi: 10.5935/abc.20160157. No abstract available.
• Results Arima H, Barzi F, Chalmers J. Mortality patterns in hypertension. J Hypertens. 2011 Dec;29 Suppl 1:S3-7. doi: 10.1097/01.hjh.0000410246.59221.b1.
• Results Minelli C, Borin LA, Trovo Mde C, Dos Reis GC. Hypertension Prevalence, Awareness and Blood Pressure Control in Matao, Brazil: A Pilot Study in Partnership With the Brazilian Family Health Strategy Program. J Clin Med Res. 2016 Jul;8(7):524-30. doi: 10.14740/jocmr2582w. Epub 2016 May 29.

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Indications