The efficacy of a novel, integrated, community-based model of care using culturally appropriate health-care assistants to manage hypertension in Māori and Pacific patients with diabetes and chronic kidney disease (CKD) was compared with that of conventional care in achieving blood pressure (BP) targets and delaying progression of cardiac and renal end-organ damage. The study cohort consisted of 65 Māori and Pacific patients (aged 47–75 years) with type 2 diabetes, moderate CKD (>0.5 g proteinuria/day, serum creatinine 130–300 μmol/L) and hypertension, who were randomised to usual care (n=32) or community/ intervention care (n=33) for 12 months. Community care patients were visited monthly by a nurse-led health care assistant for BP measurement. By 12 months, the community care patients had achieved a significantly greater reduction in office systolic BP (−21 mmHg vs −12 mmHg; p=0.04) and in 24h urine protein (−1.4 g vs +0.1 g; p=0.04). The number of prescribed antihypertensives was greater in these patients at 12 months (3.4 vs 2.3; p<0.01). Left ventricular mass and left atrial volume progressed in the usual care group, but not in the intervention group.
