NCT05405920<\/a>) was a multicounty, unblinded, pragmatic, cluster-randomized clinical trial involving 40 primary care clinics in Colombia and Jamaica.. The 40 clinics were randomized 1:1 to the intervention or standard care before enrollment of 1,706 adults with uncontrolled hypertension. The intervention lasted 18 months, followed by an additional six months to assess sustainability. In intervention clinics, patients received single-pill combinations consisting primarily of valsartan and amlodipine, with hydrochlorothiazide added when necessary. The treatment strategy incorporated physician and nurse training, medication titration, health coaching, home blood pressure monitoring, and regular audit and feedback. Community health workers provided counseling on medication adherence and lifestyle modification. Patients in standard care clinics received guideline-recommended antihypertensive medications through existing health insurance or government programs.<\/p>\n\n\n\nThe primary endpoint was the between-group difference in change in systolic blood pressure from baseline to 18 months. Secondary endpoints included blood pressure control below 130\/80 mm Hg, changes in diastolic blood pressure, medication adherence, patient satisfaction, and quality of life. Sustainability was assessed at 24 months.<\/p>\n\n\n\n
The mean age of participants was 61.4 years, 69.9% were women, and 98.2% were already receiving antihypertensive medications at enrollment. Baseline mean systolic blood pressure was approximately 145 mm Hg in both groups. Of the 1,706 enrolled participants, 1,574 were included in the primary analysis.<\/p>\n\n\n\n
At 18 months, mean systolic blood pressure declined from 145.9 to 126.8 mm Hg in the intervention group, representing a reduction of 19.1 mm Hg, compared with a decline from 145.0 to 136.1 mm Hg in the standard care group, representing a reduction of 9.0 mm Hg. The between-group difference was \u221210.1 mm Hg (95% CI, \u221213.3 to \u22126.9; P<\/em><0.001). The treatment effect remained significant after adjustment for prespecified covariates (\u22129.7 mm Hg; 95% CI, \u221212.4 to \u22127.0), with most of the additional blood pressure reduction achieved within six months.<\/p>\n\n\n\nBlood pressure control below 130\/80 mm Hg was achieved in 69.5% of intervention participants compared with 29.2% receiving standard care, an absolute difference of 40.4%(95% CI, 26.8\u201353.9). Diastolic blood pressure also declined significantly more with the intervention, with a between-group difference of \u22125.1 mm Hg (95% CI, \u22126.9 to \u22123.2; P<0.001). At 18 months, 81.4% of intervention participants reported using single-pill combination therapy compared with 22.6% in the standard care group. Improvements in medication adherence were more frequent with the intervention (25.3% versus 18.7%), as were improvements in satisfaction with antihypertensive medications (64.1% versus 37.6%) and hypertension-related care (61.1% versus 37.9%). No significant differences were observed in physical or mental health-related quality-of-life scores.<\/p>\n\n\n\n
The benefits also persisted after the structured intervention ended. At 24 months, the between-group difference in systolic blood pressure reduction remained significant at \u22126.0 mm Hg (95% CI, \u22129.2 to \u22122.7; P<0.001). Blood pressure control below 130\/80 mm Hg was maintained in 55.8% of intervention participants compared with 34.2% receiving standard care. Single-pill combination use also remained higher in the intervention group (74.9% versus 22.0%), supporting the potential sustainability of this approach in routine clinical practice.<\/p>\n\n\n\n
The reduction in systolic blood pressure was generally consistent across prespecified subgroups, including country, urban and rural settings, age, sex, and major clinical comorbidities. Serious adverse events, defined as death or hospitalization, occurred in 7.9% of intervention participants and 9.9% receiving standard care (P<\/em>=0.33), with no statistically significant differences in other selected adverse events.<\/p>\n\n\n\nThe findings provide important evidence supporting the implementation of single-pill combination therapy through coordinated team-based care in resource-constrained settings. Unlike conventional efficacy trials evaluating specific antihypertensive combinations, CATCH examined a practical care-delivery strategy incorporating medication simplification, clinician training, community health workers, and home monitoring. However, the multicomponent intervention makes it difficult to isolate the contribution of individual components. Randomization before patient recruitment also introduced potential selection bias, while the restriction to two countries may limit generalizability.<\/p>\n\n\n\n
The CATCH trial demonstrates that integrating single-pill combination therapy with structured team-based care can achieve substantial, sustained improvements in hypertension control, supporting broader implementation of simplified, coordinated treatment strategies, particularly in low- and middle-income countries.<\/p>\n\n\n\n
The investigator-initiated trial was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (UG3\/UH3 HL152373).<\/p>\n","protected":false},"excerpt":{"rendered":"
A strategy combining single-pill antihypertensive therapy with comprehensive team-based care significantly improved blood pressure control compared with standard care among adults with uncontrolled hypertension in Colombia and Jamaica, according to findings from the Caribbean and South American Team-Based Strategy to Control Hypertension (CATCH) trial. The findings were presented on November 8, 2026, during the Late-Breaking […]<\/p>\n","protected":false},"author":40615,"featured_media":139936,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"aside","meta":{"footnotes":"","_ppma_block_editor_authors":""},"categories":[1093],"tags":[1094,47,185],"tmauthors":[1095],"ppma_author":[1069],"class_list":{"0":"post-139935","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-aha-2026","8":"tag-aha2026","9":"tag-featured","10":"tag-news","11":"post_format-post-format-aside","12":"author-hassan-adam-alhassan-md"},"authors":[{"term_id":1069,"user_id":40615,"is_guest":0,"slug":"hassan-adam-alhassan-md","display_name":"Hassan Adam Alhassan MD","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/8cc8318e58bf0ad1548b042cbb04e2e62466d8fe5780d7b1f138246f2c21b2b5?s=96&r=g","avatar_alt":"","avatar_decorative":"","author_category":"1","first_name":"Hassan","last_name":"Adam Alhassan","user_url":"","job_title":"Clinical Fellow Electrophysiology BIDMC","description":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/139935","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40615"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=139935"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/139935\/revisions"}],"predecessor-version":[{"id":139937,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/139935\/revisions\/139937"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/139936"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=139935"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=139935"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=139935"},{"taxonomy":"tmauthors","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftmauthors&post=139935"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=139935"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}