{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:07:26Z","timestamp":1791922046180,"version":"4.3.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2019,9,21]],"date-time":"2019-09-21T00:00:00Z","timestamp":1569024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U54NS081765"],"award-info":[{"award-number":["U54NS081765"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Uncontrolled hypertension (HTN) is a leading modifiable stroke risk factor contributing to global stroke disparities. This study is unique in testing a transitional care model aimed at controlling HTN in black and Hispanic poststroke, home health patients, an understudied group.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A 3-arm randomized controlled trial design compared (i) usual home care (UHC), with (ii) UHC plus a 30-day nurse practitioner transitional care program, or (iii) UHC plus nurse practitioner plus a 60-day health coach program. The trial enrolled 495 black and Hispanic, English- and Spanish- speaking adults with uncontrolled systolic blood pressure (SBP \u2265 140 mm Hg) who had experienced a first-time or recurrent stroke or transient ischemic attack. The primary outcome was change in SBP from baseline to 3 and 12 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Mean participant age was 67; 57.0% were female; 69.7% were black, non-Hispanic; and 30.3% were Hispanic. Three-month follow-up retention was 87%; 12-month retention was 81%. SBP declined 9\u201310 mm Hg from baseline to 12 months across all groups; the greatest decrease occurred between baseline and 3 months. The interventions demonstrated no relative advantage compared to UHC.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>The significant across-the-board SBP decreases suggest that UHC nurse\/patient\/physician interactions were the central component of SBP reduction and that additional efforts to lower recurrent stroke risk should test incremental improvements in usual care, not resource-intensive transitional care interventions. They also suggest the potential value of pragmatic home care programs as part of a broader strategy to overcome HTN treatment barriers and improve secondary stroke prevention globally.<\/jats:p><\/jats:sec><jats:sec><jats:title>CLINICAL TRIALS REGISTRATION<\/jats:title><jats:p>Trial Number NCT01918891.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajh\/hpz148","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T11:38:13Z","timestamp":1568288293000},"page":"362-370","source":"Crossref","is-referenced-by-count":30,"title":["Reducing Hypertension in a Poststroke Black and Hispanic Home Care Population: Results of a Pragmatic Randomized Controlled Trial"],"prefix":"10.1093","volume":"33","author":[{"given":"Penny H","family":"Feldman","sequence":"first","affiliation":[{"name":"Center for Home Care Policy & Research, Visiting Nurse Service of New York , New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1045-0956","authenticated-orcid":false,"given":"Margaret V","family":"McDonald","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, Visiting Nurse Service of New York , New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Trachtenberg","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, Visiting Nurse Service of New York , New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marygrace","family":"Trifilio","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, Visiting Nurse Service of New York , New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Onorato","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, Visiting Nurse Service of New York , New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridevi","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Center for Home Care Policy & Research, Visiting Nurse Service of New York , New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Silver","sequence":"additional","affiliation":[{"name":"Research Division, Hebrew Home at Riverdale, RiverSpring Health , Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Eimicke","sequence":"additional","affiliation":[{"name":"Research Division, Hebrew Home at Riverdale, RiverSpring Health , Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Teresi","sequence":"additional","affiliation":[{"name":"Research Division, Hebrew Home at Riverdale, RiverSpring Health , Bronx, New York, USA"},{"name":"Columbia University Stroud Center at New York State Psychiatric Institute , New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,21]]},"reference":[{"key":"2022100620371395500_CIT0001","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1001\/jama.2016.19043","article-title":"Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015","volume":"317","author":"Forouzanfar","year":"2017","journal-title":"JAMA"},{"key":"2022100620371395500_CIT0002","author":"WHO"},{"key":"2022100620371395500_CIT0003","doi-asserted-by":"crossref","first-page":"238","DOI":"10.2174\/1573403X11666141122220003","article-title":"Disparities in cardiovascular disease risk in the United States","volume":"11","author":"Graham","year":"2015","journal-title":"Curr Cardiol Rev"},{"key":"2022100620371395500_CIT0004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/JAHA.117.006027","article-title":"Trends in racial\/ethnic disparities in cardiovascular health among US adults from 1999\u20132012","volume":"6","author":"Pool","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"2022100620371395500_CIT0005","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1161\/CIRCULATIONAHA.115.018912","article-title":"Global disparities of hypertension prevalence and control: a systematic analysis of population-based studies from 90 Countries","volume":"134","author":"Mills","year":"2016","journal-title":"Circulation"},{"key":"2022100620371395500_CIT0006","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1053\/j.ajkd.2009.06.044","article-title":"Hypertension in the developing world: challenges and opportunities","volume":"55","author":"Mittal","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"2022100620371395500_CIT0007","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1161\/HYPERTENSIONAHA.116.06582","article-title":"Building on a legacy of hypertension research: charting our future together","volume":"69","author":"Mensah","year":"2017","journal-title":"Hypertension"},{"key":"2022100620371395500_CIT0008","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/2013.jamainternmed.857","article-title":"Racial differences in the impact of elevated systolic blood pressure on stroke risk","volume":"173","author":"Howard","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2022100620371395500_CIT0009","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1161\/HYPERTENSIONAHA.107.092650","article-title":"Blood pressure control in Hispanics in the antihypertensive and lipid-lowering treatment to prevent heart attack trial","volume":"50","author":"Margolis","year":"2007","journal-title":"Hypertension"},{"key":"2022100620371395500_CIT0010","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1161\/HYPERTENSIONAHA.116.07905","article-title":"Research needs to improve hypertension treatment and control in African Americans","volume":"68","author":"Whelton","year":"2016","journal-title":"Hypertension"},{"key":"2022100620371395500_CIT0011","doi-asserted-by":"crossref","first-page":"53","DOI":"10.7812\/TPP\/15-052","article-title":"Population care management and team-based approach to reduce racial disparities among African Americans\/blacks with hypertension","volume":"20","author":"Bartolome","year":"2016","journal-title":"Perm J"},{"key":"2022100620371395500_CIT0012","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1093\/ajh\/hpu233","article-title":"Reducing racial and ethnic disparities in hypertension prevention and control: what will it take to translate research into practice and policy?","volume":"28","author":"Mueller","year":"2015","journal-title":"Am J Hypertens"},{"key":"2022100620371395500_CIT0013","doi-asserted-by":"crossref","first-page":"c3995","DOI":"10.1136\/bmj.c3995","article-title":"Nurse led interventions to improve control of blood pressure in people with hypertension: systematic review and meta-analysis","volume":"341","author":"Clark","year":"2010","journal-title":"BMJ."},{"key":"2022100620371395500_CIT0014","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/1748-5908-8-60","article-title":"A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol","volume":"8","author":"Cooper","year":"2013","journal-title":"Implement Sci"},{"key":"2022100620371395500_CIT0015","doi-asserted-by":"crossref","first-page":"155","DOI":"10.2217\/cer.15.60","article-title":"Home-based interventions for black patients with uncontrolled hypertension: a cluster randomized controlled trial","volume":"5","author":"Feldman","year":"2016","journal-title":"J Comp Eff Res"},{"key":"2022100620371395500_CIT0016","doi-asserted-by":"crossref","first-page":"511","DOI":"10.2307\/3350391","article-title":"Organizing care for patients with chronic illness","volume":"74","author":"Wagner","year":"1996","journal-title":"Milbank Q"},{"key":"2022100620371395500_CIT0017","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1377\/hlthaff.20.6.64","article-title":"Improving chronic illness care: translating evidence into action","volume":"20","author":"Wagner","year":"2001","journal-title":"Health Aff (Millwood)"},{"key":"2022100620371395500_CIT0018","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1001\/jama.288.14.1775","article-title":"Improving primary care for patients with chronic illness","volume":"288","author":"Bodenheimer","year":"2002","journal-title":"JAMA"},{"key":"2022100620371395500_CIT0019","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/j.1532-5415.2004.52202.x","article-title":"Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial","volume":"52","author":"Naylor","year":"2004","journal-title":"J Am Geriatr Soc"},{"key":"2022100620371395500_CIT0020","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1377\/hlthaff.2011.0041","article-title":"The care span: the importance of transitional care in achieving health reform","volume":"30","author":"Naylor","year":"2011","journal-title":"Health Aff (Millwood)"},{"key":"2022100620371395500_CIT0021","doi-asserted-by":"crossref","first-page":"217","DOI":"10.31887\/DCNS.2011.13.2\/npatsopoulos","article-title":"A pragmatic view on pragmatic trials","volume":"13","author":"Patsopoulos","year":"2011","journal-title":"Dialogues Clin Neurosci"},{"key":"2022100620371395500_CIT0022","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1056\/NEJMra1510059","article-title":"Pragmatic trials","volume":"375","author":"Ford","year":"2016","journal-title":"N Engl J Med"},{"key":"2022100620371395500_CIT0023","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13063-015-0550-3","article-title":"Center for stroke disparities solutions community- based care transition interventions: study protocol of a randomized controlled trial","volume":"16","author":"Feldman","year":"2015","journal-title":"Trials"},{"key":"2022100620371395500_CIT0024","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1300\/J027v22n03_01","article-title":"The care transitions intervention: a patient-centered approach to ensuring effective transfers between sites of geriatric care","volume":"22","author":"Parry","year":"2003","journal-title":"Home Health Care Serv Q"},{"key":"2022100620371395500_CIT0025","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1177\/1740774512438980","article-title":"National Institute of Neurological Disorders and Stroke Common Data Element Project\u2014approach and methods","volume":"9","author":"Grinnon","year":"2012","journal-title":"Clin Trials"},{"key":"2022100620371395500_CIT0026","volume-title":"Analysis of Longitudinal Data","author":"Diggle","year":"1994"},{"key":"2022100620371395500_CIT0027","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1161\/01.HYP.20.5.601","article-title":"Relation between blood pressure and stroke mortality","volume":"20","author":"Palmer","year":"1992","journal-title":"Hypertension"},{"key":"2022100620371395500_CIT0028","doi-asserted-by":"crossref","first-page":"152","DOI":"10.5853\/jos.2017.00164","article-title":"Blood pressure management for stroke prevention and in acute stroke","volume":"19","author":"Hong","year":"2017","journal-title":"J Stroke"},{"key":"2022100620371395500_CIT0029","doi-asserted-by":"crossref","first-page":"E954","DOI":"10.1503\/cmaj.161142","article-title":"Long-term morbidity and mortality in patients without early complications after stroke or transient ischemic attack","volume":"189","author":"Edwards","year":"2017","journal-title":"CMAJ"},{"key":"2022100620371395500_CIT0030","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3912\/OJIN.Vol19No02Man02","article-title":"Barriers to NP practice that impact healthcare redesign","volume":"19","author":"Hain","year":"2014","journal-title":"Online J Issues Nurs"},{"key":"2022100620371395500_CIT0031","doi-asserted-by":"crossref","first-page":"123","DOI":"10.2174\/1573402111666150325234503","article-title":"Designing and evaluating health systems level hypertension control interventions for African-Americans: lessons from a pooled analysis of three cluster randomized trials","volume":"11","author":"Pavlik","year":"2015","journal-title":"Curr Hypertens Rev"},{"key":"2022100620371395500_CIT0032","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1001\/jama.2013.284427","article-title":"2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)","volume":"311","author":"James","year":"2014","journal-title":"JAMA"},{"key":"2022100620371395500_CIT0033","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1503\/cmaj.120832","article-title":"Home blood pressure monitoring with nurse-led telephone support among patients with hypertension and a history of stroke: a community-based randomized controlled trial","volume":"185","author":"Kerry","year":"2013","journal-title":"CMAJ"},{"key":"2022100620371395500_CIT0034","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1161\/HYPERTENSIONAHA.110.160911","article-title":"Role of home blood pressure monitoring in overcoming therapeutic inertia and improving hypertension control: a systematic review and meta-analysis","volume":"57","author":"Agarwal","year":"2011","journal-title":"Hypertension"},{"key":"2022100620371395500_CIT0035","doi-asserted-by":"crossref","first-page":"3560","DOI":"10.1161\/STROKEAHA.115.009533","article-title":"Stroke disparities: large global problem that must be addressed","volume":"46","author":"Morgenstern","year":"2015","journal-title":"Stroke"},{"key":"2022100620371395500_CIT0036","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/njcp.njcp_246_17","article-title":"Mid-term impact of home-based follow-up care on health-related quality of life of hypertensive patients at a teaching hospital in Ilorin, Nigeria","volume":"22","author":"Bolarinwa","year":"2019","journal-title":"Niger J Clin Pract"},{"key":"2022100620371395500_CIT0037","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/1472-6947-14-52","article-title":"Home based telemedicine intervention for patients with uncontrolled hypertension\u2013a real life non-randomized study","volume":"14","author":"Bernocchi","year":"2014","journal-title":"BMC Med Inform Decis Mak"},{"key":"2022100620371395500_CIT0038","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.cjca.2018.02.022","article-title":"Hypertension Canada's 2018 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults and children","volume":"34","author":"Nerenberg","year":"2018","journal-title":"Can J Cardiol"},{"key":"2022100620371395500_CIT0039","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.1161\/STR.0000000000000024","article-title":"Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"45","author":"Kernan","year":"2014","journal-title":"Stroke"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ajh\/advance-article-pdf\/doi\/10.1093\/ajh\/hpz148\/30246701\/hpz148.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/33\/4\/362\/46352515\/ajh_33_4_362.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/33\/4\/362\/46352515\/ajh_33_4_362.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T05:19:54Z","timestamp":1695187194000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/33\/4\/362\/5572492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,21]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,9,21]]},"published-print":{"date-parts":[[2020,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpz148","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4]]},"published":{"date-parts":[[2019,9,21]]}}}