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J Clin Hypertens (Greenwich). 2011;13:563–570. ©2011 Wiley Periodicals, Inc.
Hypertension is a major risk factor for developing cardiovascular disease and is more prevalent in African Americans compared with Caucasians. African Americans are often underrepresented in clinical trials. This study was composed of a largely urban African American cohort of hypertensive patients. This was a prospective, 4-arm, randomized controlled trial designed to evaluate the comparative effectiveness of both physician and patient education (PPE), patient education only (PAE), and physician education only (PHE) vs usual care (UC). Hypertension specialists gave a series of didactic lectures to the physicians, while a nurse educator performed the patient education. The mean adjusted difference in systolic blood pressure (SBP) from baseline in the PPE group was an average reduction of 12 mm Hg (95% confidence interval [CI], −4.5 to −19.4) at 6-months, followed by average reductions of 4.6 mm Hg (6.9 to −16.12) in the PAE group, 4.1 mm Hg (3.4 to −11.7) in the PHE group, and 2.6 mm Hg (3 to −8.2) in the UC group. The PPE group achieved a significantly better reduction in SBP compared with the UC group. Additional research should be conducted to evaluate whether the use of certified hypertension educators in collaboration with physicians will result in a similar blood pressure reduction.