Phone-Based Intervention Under Nurse Guidance for Control of Hypertension After Stroke: A Randomized Multicenter Phase 3 Trial in Ghana

Circulation, Ahead of Print. BACKGROUND:Addressing the rising burden of stroke in low-income countries will require pragmatic and scalable interventions targeting major risk factors.

Under routine care settings, <10% of adults living with hypertension ever achieve blood pressure control, accentuating risks for adverse vascular events. The effectiveness of mobile health–centered, nurse-led interventions for the control of hypertension among patients with recent stroke in a resource-limited African setting is unknown.METHODS:The PINGS (Phone-Based Intervention Under Nurse Guidance After Stroke) trial compared the efficacy and safety of usual care versus a 12-month intervention comprising home blood pressure self-monitoring with nurse case management for elevated home blood pressure recordings, use of phone alarms as medication reminders, and once-weekly education about cardiovascular risk reduction delivered by regular telephonic audio messages in selected Ghanaian dialects.

This was a multicenter, randomized, open-label, blinded end point evaluation trial conducted at 10 hospitals between October 23, 2020, and April 5, 2024. We enrolled 500 patients ≥18 years with stroke within 1 month of onset and elevated blood pressure ≥140 or ≥90 mm Hg.