{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:20:34Z","timestamp":1788927634790,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Large gaps persist in the diagnosis, awareness, treatment, and control of hypertension globally. Standardized treatment protocols (STPs) have been widely proposed to guide hypertension treatment, particularly in primary healthcare settings. However, there has been no review that quantifies the effects of hypertension STPs on blood pressure (BP) reduction and control. We conducted a systematic review of randomized clinical trials (RCTs) among adults with hypertension, comparing hypertension STPs (intervention) with usual care (comparator) for effects on BP. Relevant RCTs were identified by searching multiple electronic databases. Random\u2010effects meta\u2010analyses were conducted to evaluate between\u2010group differences in systolic BP reduction (primary outcome), diastolic BP reduction, BP control, and adverse events (AEs). Sixteen RCTs involving 59,945 participants (baseline mean BP: 149\/91\u00a0mmHg) were included. Reductions in systolic and diastolic BP with STPs compared to usual care were 6.7 (95% CI 3.7\u20139.8)\u00a0mmHg and 2.6 (1.2\u20134.1) mmHg, respectively (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001 for both). BP control achieved was 57% in the STP group compared to 24% in the usual care group (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The overall incidence of any AEs was 14.5%\u00a0versus 13.5% (RR 1.27 [0.88\u20131.82]) with STPs and usual care, respectively. In summary, interventions involving hypertension STPs significantly reduce systolic and diastolic BP and improve BP control compared to usual care. STPs can, therefore, be an efficient strategy to implement evidence\u2010based treatments and upscale treatment coverage, given the large untreated and uncontrolled hypertension burdens globally.<\/jats:p>","DOI":"10.1111\/jch.14950","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T08:50:04Z","timestamp":1733820604000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Effectiveness and Safety of Using Standardized Treatment Protocols for Hypertension Compared to Usual Care: A Meta\u2010Analysis of Randomized Clinical Trials"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2211-145X","authenticated-orcid":false,"given":"Gautam","family":"Satheesh","sequence":"first","affiliation":[{"name":"The George Institute for Global Health  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupasvi","family":"Dhurjati","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivekanand","family":"Jha","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health University of New South Wales  Sydney New South Wales Australia"},{"name":"School of Public Health Imperial College  London UK"},{"name":"Prasanna School of Public Health Manipal Academy of Higher Education  Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9217-4937","authenticated-orcid":false,"given":"Aletta E.","family":"Schutte","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health University of New South Wales  Sydney New South Wales Australia"},{"name":"SAMRC\/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"Hypertension in Africa Research Team (HART), MRC Unit for Hypertension and Cardiovascular Disease North\u2010West University  Potchefstroom South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolanle","family":"Banigbe","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health  Boston Massachusetts USA"},{"name":"Resolve to Save Lives  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorairaj","family":"Prabhakaran","sequence":"additional","affiliation":[{"name":"Centre for Chronic Disease Control  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E.","family":"Moran","sequence":"additional","affiliation":[{"name":"Resolve to Save Lives  New York New York USA"},{"name":"Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Salam","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health  Hyderabad Telangana India"},{"name":"The George Institute for Global Health University of New South Wales  Sydney New South Wales Australia"},{"name":"Prasanna School of Public Health Manipal Academy of Higher Education  Manipal India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)33216-1"},{"issue":"10190","key":"e_1_2_11_3_1","article-title":"Global, Regional, and National age\u2010sex\u2010Specific Mortality for 282 Causes of Death in 195 Countries and Territories, 1980\u20102017: A Systematic Analysis for the Global Burden of Disease Study 2017","volume":"393","author":"GBD 2017 Causes of Death Collaborators","year":"2019","journal-title":"Lancet"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018912"},{"key":"e_1_2_11_5_1","volume-title":"Hypertension Factsheet","author":"World Health Organization","year":"2023"},{"key":"e_1_2_11_6_1","volume-title":"HEARTS Technical Package for Cardiovascular Disease Management in Primary Health Care: Systems for Monitoring","year":"2018"},{"key":"e_1_2_11_7_1","unstructured":"Resolve to Save Lives. Improve Heart Health: Hypertension [Internet]. New York: Resolve to Save Lives. [Cited 2023 May 4] https:\/\/resolvetosavelives.org\/cardiovascular\u2010health\/hypertension."},{"key":"e_1_2_11_8_1","unstructured":"G.Satheesh R.Dhurjati andA.Salam.INPLASY Protocol 202380021: Efficacy and Safety of Standard Treatment Protocols for Blood Pressure Reduction Compared With Usual Care: A Systematic Review and Meta\u2010Analysis of Randomised Trials.2023 https:\/\/inplasy.com\/inplasy\u20102023\u20108\u20100021\/."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M17\u20101805"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005182"},{"issue":"3","key":"e_1_2_11_11_1","article-title":"Interventions Used to Improve Control of Blood Pressure in Patients With Hypertension","author":"Glynn L. G.","year":"2010","journal-title":"Cochrane Database of Systematic Reviews (Online)"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000220260.30768.32"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp10X544113"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3995"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00325-7"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(77)90077-7"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(79)92397-3"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-7435(79)90024-0"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.82.5.1616"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(96)00305-6"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1086-5802(16)30371-0"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/1356182031000122852"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(03)01034-3"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.23.2.209.32096"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2004.06.006"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050030"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.134874"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.108.123455"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.062364"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3283619d6a"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jch.12861"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.26633\/RPSP.2022.153"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.5334\/gh.1082"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.26633\/RPSP.2022.125"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-022-00742-5"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2024-324253"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003636"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-022-00766-x"}],"container-title":["The Journal of Clinical Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jch.14950","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T07:36:19Z","timestamp":1744270579000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jch.14950"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,10]]},"references-count":39,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/jch.14950"],"URL":"https:\/\/doi.org\/10.1111\/jch.14950","archive":["Portico"],"relation":{},"ISSN":["1524-6175","1751-7176"],"issn-type":[{"value":"1524-6175","type":"print"},{"value":"1751-7176","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,10]]},"assertion":[{"value":"2024-09-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14950"}}