Community-Based Interventions for Hypertension Control in Latin America and the Caribbean: A Systematic Review of Randomized Controlled Trials.

Abstract

Hypertension remains a leading cause of cardiovascular disease in Latin America and the Caribbean (LAC), where control rates are persistently low. Community-based strategies are promising approaches to overcome barriers to care. To evaluate the effectiveness of community-based interventions for hypertension prevention and control among adults in LAC. A systematic review was conducted according to the PRISMA 2020 guidelines. PubMed, LILACS, Scopus, and SciELO were searched for randomized controlled trials (RCTs) published between January 2010 and October 2025. Eighteen RCTs (n = 12 134 participants) were included. Interventions comprised community health worker (CHW) programs, lifestyle counseling, mobile health messaging, and salt substitution. Multicomponent CHW-led interventions demonstrated the greatest impact, with systolic blood pressure (SBP) reductions of 5 to 13 mmHg and significantly improved control rates. Digital messaging interventions consistently enhanced medication adherence. Educational and lifestyle programs showed variable but often positive effects on SBP. Community-based interventions, particularly integrated CHW-led models supported by digital tools, are effective for improving hypertension control in LAC. Scaling these evidence-based strategies within primary healthcare systems can help reduce the regional cardiovascular disease burden.