Family-Based Program 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, according to research presented at the American Heart Association's Scientific Sessions 2025. The Healthy Family Program, conducted across 80 villages in rural China, demonstrated that involving entire families in blood pressure management could provide an effective approach to cardiovascular disease prevention in communities with limited healthcare resources.

The six-month program included approximately 30-50 families per village, with half of the villages randomly assigned to receive the intervention. Participants aged 40-80 years received regular blood pressure monitoring, low-sodium salt substitutes, and educational sessions on healthy lifestyle habits. "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.

The program's design involved training local health workers as family health instructors, who then trained one person from each household to become 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. Family leaders monitored blood pressure regularly and entered measurements into the app, while all participants received free low-sodium, potassium-enriched salt substitutes to replace regular cooking salt.

Even family members without diagnosed high blood pressure participated in the program, measuring their blood pressure at regular intervals and following diets prepared with low-sodium salt. The community health instructors and family leaders collaborated to promote healthy lifestyles through educational sessions covering salt reduction, weight management, physical exercise, and blood pressure control. After the initial six-month period, educational sessions and free salt substitutes were discontinued to test whether participants could maintain healthy habits independently.

The study's most significant finding showed that adults in participating villages achieved an average 10 mm Hg reduction in systolic blood pressure during the six-month program compared to those in non-participating villages. Perhaps more importantly, six months after the program ended, the average systolic blood pressure for people in participating villages remained 3.7 mm Hg lower than the control group, suggesting sustained adoption of healthy habits. "In many cultures, families share the responsibility of caring for one another and promoting a healthy lifestyle," Du noted, emphasizing the critical role family leaders played in supporting healthy diets and lifestyle changes.

The study involved 8,001 adults across rural mainland China, with specific protocols for blood pressure monitoring based on initial readings. Participants with readings of 160/100 mm Hg or higher measured blood pressure the following day, while those with normal readings below 120/80 mm Hg repeated measurements every three months. The program excluded adults with terminal illnesses or pregnancy plans. Additional information about the study is available in the American Heart Association Scientific Sessions 2025 Online Program Planner at https://professional.heart.org/en/meetings/scientific-sessions.

While the results are promising, researchers noted several limitations. The study was conducted specifically in rural China, so more research is needed to determine applicability to other populations and healthcare systems. The six-month intervention period was insufficient to measure actual reductions in heart attacks, strokes, or cardiovascular deaths. Some participants moved to cities for work during the study, potentially affecting results, and the program required local government support for implementation. "This approach could transform how we prevent heart disease in communities worldwide," Du said, suggesting that involving entire families and communities rather than treating individuals could reduce cardiovascular risk, particularly in areas with limited healthcare resources.