This study is a randomized controlled trial evaluating whether telehealth-based coaching and navigation delivered by community health workers can improve cardiovascular outcomes among adults presenting to Emergency Departments (EDs) in Karachi with severe hypertension. Participants are randomly assigned either to receive a standard referral to primary care or to receive structured telephone-based navigation and behavioral coaching from trained community health workers.
The primary objective is to determine whether the CONNECT-HTN intervention reduces the rate of major adverse cardiovascular events (MACE) over the follow-up period. Secondary objectives include evaluating changes in blood pressure over time and examining patterns of follow-up in outpatient primary care. Outcome assessments are conducted by an independent team blinded to treatment assignment.
The study aims to provide evidence on the effectiveness of a scalable telehealth-supported community health worker model for improving long-term outcomes among patients with severe hypertension in low-resource urban settings.
Age
18–any
Sex
ALL
Healthy volunteers
Not accepted
You may be eligible if
Eligible patients
Must be over the age of 18 years
Have an ED triage SBP ≥ 180 and/or DBP ≥ 110, with a repeat similar reading ≥30 minutes after triage
May have received treatment for elevated BP, but must have no evidence of end-organ damage (defined as dialysis dependence, acute stroke, acute coronary syndrome, acute kidney injury, or papilledema)
Have a functional status of either fully active (independent in daily activities) or mildly restricted but ambulatory and able to work (washing, toileting, dressing, feeding, mobility).
May be admitted for deranged BP only with no complications, or may be stable for discharge per treating emergency physician
Include referrals from the clinic to the ED with SBP/DBP values in the inclusion range
Can provide informed consent. Intervention is accessible to individuals of all literacy levels
Can receive phone calls and in-person visits. Smartphone ownership not required (intervention compatible with analog phones)
You may not be if
Given that hypertension is defined and treated differently, we will exclude
pregnant patients
terminally ill patients, as well as
those requiring admission to the hospital due to severe complications (other than deranged BP).
Clareo Health | Coaching and Navigation by Community Health Workers (CHWs) Through Telehealth for High-risk Hypertension
