The Counseling African Americans to Control Hypertension Study and Ways to Enhance the Next Wave of Behavioral Interventions

The Counseling African Americans to Control Hypertension (CAATCH) study by Ogedegbe et al in this issue of Circulation represents a carefully done study which had many strengths. It recognized that African Americans have the highest prevalence of hypertension (HTN)1 and that poor hypertension-related outcomes explain most of the racial gap in mortality between African Americans and whites.2 It represents the largest practice-based implementation trial to date of a multilevel evidence-based intervention targeted at blood pressure control in hypertensive African Americans in community health centers (CHCs), where many low income Americans receive their care. In addition, although the individual components of CAATCH (patient education, home BP monitoring, CME, physician chart audit and feedback) have proven efficacious and effective for improving BP control,3 the effectiveness of a combined approach in CHCs has not been rigorously evaluated. The study was adequately powered to detect a difference of at least 4 mmHg for systolic BP and 3 mm Hg for diastolic BP at 12 months between intervention and control arms assuming a 15% attrition rate.