Chamila Mettananda, Naveen Fernando, Senara Dissanayake, Randula Mallawa, Thiloka Kariyawasam, Aloka Perera, Ranjan Premaratna, Suranga Manilgama, Senaka Ranasinghe, Nirosha Hettiarachchi, Priyamali Jayasekara, Dilusha Lamabadusuriya, Thushara Matthias, Kolitha Jayasundara, Warsha Zoysa, Isuru Wickramasinghe, Keshari De Saram, Ravini Premaratna, Upeksha Fernando, Sanjalee Ranawaka, Bolatito Ogbeide, Amila Herath, Champika Wickramasinghe
Despite established guidelines, blood pressure(BP) control remains suboptimal worldwide. Poor implementation of guidelines is identified as a contributing factor. "Protocol-based BP management(PB-BPM)" is a suggested solution and has been implemented in Sri Lanka. However, data on the efficacy of PB-BPM are sparse in South Asia. We assessed the efficacy of PB-BPM in the outpatient clinics of the primary and secondary/tertiary healthcare facilities in Sri Lanka by analysing BP data of those with 6 or more months' follow-up by 31st December 2025. Controlled BP was defined as <140/90 mmHg per the WHO guideline. We compared mean BP and the percentage with controlled BP between baseline and the end of follow-up. BP control of 13097 patients (male 3480(26.6%, mean age 64( ± 10.2) were studied. Mean systolic BP(SBP p < 0.001), diastolic BP(DBP p < 0.001), and the percentage with controlled BP (p < 0.001) improved significantly at follow-up compared to baseline. Mean reduction in SBP/ DBP was more in primary compared to secondary/tertiary care facilities (p < 0.001/ p < 0.001), with high baseline SBP(r = 0.671, p < 0.001) and DBP(r = 0.639, p < 0.001). In conclusion, PB-BPM improved BP control among outpatients managed at state hospitals in Sri Lanka, with greater efficacy observed in primary healthcare facilities and among patients with high baseline BP.