P-59 The association of the HEARTS regimen with blood pressure control among patients with hypertension attending primary health care facilities at the SouthWest Regional Health Authority, Trinidad.
Author(s):
K Dharamraj, S Ramlal,V Birju-Balraj, K Ramgulam
Year of Presentation:
2026
Objective: To evaluate the association between participation in the HEARTS regimen and short-term blood pressure
(BP) control among hypertensive patients attending primary
health care facilities in South Trinidad.
Methods: A retrospective cross-sectional study was conducted across primary care clinics of the South-West Regional Health Authority, Trinidad and Tobago, between June and December 2025. Hypertensive adults managed under the HEARTS regimen were compared with those receiving routine non-HEARTS care. Eligible participants were ≥18 years with confirmed hypertension and at least two recorded BP measurements since October 2024. A total of 345 participants were included (198 HEARTS; 147 nonHEARTS). BP control was defined as systolic BP <140 mmHg and diastolic BP <90 mmHg. Medication non-adherence was defined as inconsistent or missed medication use, based on clinical documentation. Multivariable regression models assessed associations between HEARTS participation, medication adherence, and BP outcomes.
Results: BP control was similar between groups (HEARTS: 53.0%; non-HEARTS: 54.4%). HEARTS enrolment was not associated with significant short-term changes in systolic or diastolic BP after adjustment. Home BP monitoring was significantly associated with control among nonHEARTS patients (p=0.009) but not within the HEARTS group. Among medication non-adherent patients, those outside HEARTS experienced greater reductions in systolic BP (β = –7.3 mmHg; 95% CI –13.8 to –0.90; p=0.027). No significant diastolic BP effects were observed.
Conclusion: In this real-world primary care evaluation, HEARTS participation was not associated with short-term improvements in BP control. Self-management behaviours, particularly home BP monitoring, were more strongly linked to BP control than programme enrolment. Improving clinical processes is central to closing quality gaps in health service delivery and positively impacting coverage and control indicators. Strengthening programme fidelity, adherence support, and individualized patient engagement may enhance HEARTS effectiveness in Trinidad and Tobago.