Family-Based Intervention Reduces Blood Pressure by 10 mm Hg in Rural Chinese Communities

A family-based health intervention program in rural China achieved an average 10 mm Hg reduction in systolic blood pressure among participants, with benefits persisting six months after the program concluded, according to research presented at the American Heart Association's Scientific Sessions 2025. The findings suggest that family-centered approaches could transform cardiovascular disease prevention in resource-limited communities worldwide.

The Healthy Family Program, conducted across 80 rural Chinese villages, involved approximately 30-50 families per village and enrolled 8,001 adults aged 40-80 years. Half of the villages received the family-focused intervention, which combined regular blood pressure monitoring, low-sodium salt substitutes, and educational sessions on healthy lifestyle habits. The program's design emphasized involving entire families rather than targeting only individuals with diagnosed hypertension.

"Most blood pressure programs focus on treatment for people with high blood pressure, whereas our study included the whole family regardless of their blood pressure levels," said Professor Xin Du, M.D., Ph.D., co-principal investigator of the study and director of the Center of Heart Failure and Cardiomyopathy at Beijing Anzhen Hospital, Capital Medical University.

The intervention employed a multi-level approach where local health workers received training to become family health instructors. These instructors then trained one person from each household to serve as a "family leader" responsible for implementing the program within their family. Each participating family received a free blood pressure monitoring device and access to a smartphone app that provided automatic feedback on readings and medical care recommendations. The program also provided free low-sodium, potassium-enriched salt substitutes to replace regular cooking salt.

Family leaders monitored blood pressure regularly and entered measurements into the digital app. Participants with initial blood pressure readings of 160/100 mm Hg or higher were required to measure again the following day, while those with readings of 140-159/90-99 mm Hg were instructed to measure within one week. Family members with normal blood pressure (below 120/80 mm Hg) were instructed to repeat measurements every three months.

The program's educational component included sessions on healthy lifestyle habits such as reducing salt intake, weight management, physical exercise and blood pressure control. After six months, the educational sessions and free salt substitutes were discontinued to test whether families could maintain healthy habits independently, though the digital app, blood pressure monitors and weight scales remained available.

Six months after the program ended, the average systolic blood pressure for people in participating villages remained 3.7 mm Hg lower compared to non-participants, indicating sustained behavioral changes. "In many cultures, families share the responsibility of caring for one another and promoting a healthy lifestyle," Du noted. "Family leaders played a critical role in implementing the program by supporting a healthy diet high in vegetables, fruits and legumes, and low in sodium, fat and sugar."

The study's community-based approach demonstrates potential for broader application in regions with limited healthcare resources. "This approach could transform how we prevent heart disease in communities worldwide," Du said. "By involving entire families and communities rather than treating individuals, we can likely reduce everyone's risk of heart attack and stroke, especially in areas where health care resources are limited."

Researchers caution that the study was conducted in rural China, so additional research is needed to determine if similar results would apply to other populations and healthcare systems. The intervention lasted only six months, which was insufficient to measure actual reductions in heart attack, stroke or death from heart disease. Some participants moved to cities for work during the study, potentially affecting results, and the program required local government support for implementation.

The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. Additional information about the American Heart Association's cardiovascular research and initiatives is available at https://www.heart.org.