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Keep on Track: A Volunteer‐Run Community‐Based Intervention to Lower Blood Pressure in Older Adults

Uncontrolled hypertension in older adults is a common yet preventable threat to healthy aging. Improvements in blood pressure (BP) control and related health outcomes require innovative approaches that reach beyond the clinical environment. Keep on Track (KOT), a volunteer‐run, community‐based BP‐monitoring program that aims to lower BP of community‐dwelling older adults through senior center programming, is described and evaluated. KOT is based on a New York City (NYC) Department for the Aging program that has been in existence for more than 20 years and is evaluated in six senior centers in low‐ to middle‐income neighborhoods in NYC. Program design includes monitoring sessions every other week to measure and record participant BP. BP education is provided using low‐literacy materials, and medication adherence is encouraged. Over 6 months of observation, 244 participants enrolled (mean age 73). Of the 181 (74%) with hypertension at baseline, 92% were previously aware of their condition, 78% were treated, and 31% were controlled. BP control among the treated was 42%. Forty‐three percent of enrollees (n=105) were multiple‐visit participants who experienced on average a 3.9‐mmHg reduction in systolic BP (SBP) between the first and last program visit (95% confidence interval (CI)=−7.6 to −0.1, P=.04). Participants with an initial SBP greater than 160 mmHg (n=20) experienced on average a 20.9‐mmHg reduction in SBP (95% CI=−32.4 to −9.4, P<.001). Areas for program improvement include greater attention to peer counseling and timely communication with participants' healthcare providers. Volunteer‐run, community‐based BP monitoring in senior centers may provide an effective, replicable model for reducing BP in older adults.