Original title: Evaluating Longitudinal Community Health Worker-Led Interventions for Improving Hypertension Management in Urban U.S. Communities: A Rapid Review
Sagar Rastogi, Nisa Maruthur, Maxwell Droznin · September 2026
Many people in underserved cities deal with uncontrolled hypertension, which is dangerously high blood pressure. Everyday structural and financial barriers make managing it difficult. To see what helps, researchers reviewed ten studies where community health workers worked directly with urban residents over time. Community health workers are trusted locals who help neighbors track their health, take their medicine, and find medical care. The review showed that these programs often lowered blood pressure and improved self-management. Six studies found significant drops in blood pressure. People also got better at taking their prescribed medications and checking their blood pressure at home. However, time matters. Programs that ran for at least 6 months consistently lowered blood pressure, while 3-month programs usually did not show significant change. Also, in the three gold-standard randomized trials reviewed, only 1 showed a real difference compared to a control group.
Imagine trying to improve your fitness by working out. If you only exercise for a few weeks, you might not see any change. But if you keep at it for six months, you are much more likely to get stronger. Here, the community health worker program is like the workout, and the program's duration is the length of the exercise regimen. The review found that programs lasting at least six months were more effective than shorter ones.
Uncontrolled hypertension hits underserved urban communities hardest. This review suggests that community health worker programs can help, but only if they run for at least six months and include multiple components like medication support. Policymakers and health organizations should invest in longer, culturally tailored programs, while researchers push for larger trials to confirm these findings.
This review is limited by the small number of studies (10) and the predominance of non-randomized designs. Only 3 RCTs were included, and only 1 showed a significant between-group difference. Heterogeneity prevented meta-analysis. The search was restricted to PubMed and studies from 2015-2025, so some relevant work may have been missed. The findings are suggestive but not conclusive.
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Evaluating Longitudinal Community Health Worker-Led Interventions for Improving Hypertension Management in Urban U.S. Communities: A Rapid Review — Sagar Rastogi, Nisa Maruthur, Maxwell Droznin — AJPM focus — doi:10.1016/j.focus.2026.100527
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper.