Long-term Impact of RAMP-HT on Cardiovascular Outcomes and Mortality

Overview

This study evaluated the 10-year effectiveness of the Risk Assessment and Management Programme for Hypertension (RAMP-HT) in Hong Kong. Patients receiving RAMP-HT plus usual care had significantly lower incidence rates of cardiovascular diseases (CVD) and all-cause mortality compared to those receiving usual care alone.

Background

Hypertension is a leading global risk factor for cardiovascular diseases and mortality. Multidisciplinary, risk-stratified management programs like RAMP-HT aim to improve hypertension care by supplementing usual primary care with protocol-driven interventions. While short-term benefits on blood pressure control have been demonstrated, long-term effects on complications and mortality remain unclear. This study addresses this gap by emulating a target trial using electronic health records over a decade.

Data Highlights

Key Findings

• RAMP-HT participants had a 9% relative risk reduction in cardiovascular disease compared to usual care (HR 0.91, 95% CI 0.89–0.93).
• All-cause mortality risk was reduced by 12% in the RAMP-HT group versus usual care (HR 0.88, 95% CI 0.86–0.90).
• The incidence rate of CVD was 16.54 cases/1000 person-years in RAMP-HT versus 18.40 in usual care.
• The incidence rate of all-cause mortality was 9.41 cases/1000 person-years in RAMP-HT versus 12.23 in usual care.
• The study included 337,990 patients matched one-to-one by propensity scores to minimize confounding.
• RAMP-HT integrates multidisciplinary care with risk stratification and nurse-led cardiovascular risk assessments supplementing usual primary care.

Clinical Implications

Integrating a structured, multidisciplinary risk assessment and management program like RAMP-HT into usual primary care can significantly reduce long-term cardiovascular complications and mortality in patients with hypertension. This supports adopting risk-stratified, team-based care models in managing hypertension to improve patient outcomes over extended periods.

Conclusion

The RAMP-HT program, when added to usual care, is associated with meaningful reductions in cardiovascular events and all-cause mortality over 10 years. These findings advocate for the broader implementation of multidisciplinary, risk-based hypertension management in primary care.

References

1. Long-term Assessment of Hypertension-Related Complications Following a Decade of a Risk Assessment and Management Program: Insights from a Target Trial Emulation