Abstract Body: Background: Uncontrolled hypertension is a major global public health challenge, especially in low- and middle-income countries. In the Caribbean and South America Team-based Strategy to Control Hypertension (CATCH) trial, we are testing the effectiveness and implementation of a team-based care strategy for blood pressure control among patients with uncontrolled hypertension in Colombia and Jamaica.
Objectives: To describe the baseline characteristics of participants in the CATCH trial.
Methods: The CATCH is a cluster randomized-effectiveness implementation trial conducted in 40 primary care clinics in Colombia and Jamaica. We randomly assigned 20 clinics to the team-based care intervention and 20 to provider training intervention stratified by county and urbanization. A care team consisting of physicians-nurses-community health workers collaborated to deliver the intervention. The intervention and data collection will last for 18 months.
Results: We screened 2,339 individuals and successfully recruited 1,710 hypertensive patients (1,050 in Colombia and 660 in Jamaica) who met the eligibility criteria. A total of 692 individuals were excluded from the trial: 563 (81.4%) due to BP <130/80mmHg with standardized measurement, 63 (9.1%) due to kidney disease or heart failure, and 58 (8.4%) due to other reasons. Approximately 1% refused to consent for the trial. Participants were, on average, 62 years old, 70% were women, and 51% has less than high school education. Overall, 50% of participants identified as Mixed race and 36% identified as Black. Almost all (98%) of participants were taking antihypertensive medications at recruitment. In addition, 29% participants had diabetes, 46% had hypercholesterolemia, and 7% had grade 3 or 4 chronic kidney disease.
Compared to Jamaicans, participants from Colombia were older (63 vs. 60 years) and more likely to be male (37% vs. 18%), and to identify as Mixed race (76% vs. 10%). Education status was similar between the two countries. Participants in Jamaica had a higher cardiovascular disease risk burden - diabetes (35% vs. 24%), hypercholesterolemia (51% vs. 43%), and chronic kidney disease (11% vs. 5%).
Conclusion: We successfully recruited primary care patients with hypertension into the CATCH trial representative of primary care patients in Jamaica and Colombia. In future work we will assess reach by comparing our participants’ demographic characteristics to those of the overall hypertensive populations in both countries.