Efficacy of empowerment strategies for patients with hypertension: A systematic review and meta-analysis

Patient Educ Couns. 2020 May;103(5):898-907. doi: 10.1016/j.pec.2019.11.025. Epub 2019 Nov 28.

Abstract

Background: Cardiovascular disease has caused heavy health care burdens in many countries, and hypertension (HTN) is a well-known independent cardiovascular risk factor.

Objective: To assess the efficacy of empowerment strategies that affect systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), quality of life, and self-management behaviours for patients with hypertension.

Methods: A literature search of the Cochrane Library, PubMed, MEDLINE, Embase, Web of Science, and several Chinese medical databases was performed. Study screening, quality assessment, data extraction, and meta-analysis were conducted according to Cochrane standards.

Results: Eleven randomised controlled trials with 988 subjects were identified. Relative to control groups, the empowerment strategies showed significant decreases in SBP (the mean difference [MD] = 9.46, 95 % confidence interval [CI] = 6.36-12.55, p < 0.00001) and DBP (MD = 6.68, 95 % CI = 3.07-10.29, p = 0.0003). However, no significant difference was found in BMI (p = 0.05). Subgroup analysis showed significant differences in the improvement of both SBP and DBP among the various groups, regardless of the duration and type of interventions.

Discussion: Empowerment strategies can decrease both SBP and DBP in hypertension patients. However, its influence on patients' BMI, quality of life, and self-management behaviour remains unclear.

Practical value: Empowerment strategies are useful for controlling the blood pressure of hypertension patients.

Keywords: Empowerment strategy; Hypertension; Meta-analysis; Randomised controlled trial; Systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Body Mass Index
  • Cardiovascular Diseases / prevention & control*
  • Empowerment*
  • Humans
  • Hypertension / psychology
  • Hypertension / therapy*
  • Quality of Life*
  • Self-Management