Community-Based Interventions for Hypertension Control in Latin America and the Caribbean: A Systematic Review of Randomized Controlled Trials

BACKGROUND: Hypertension remains a leading cause of cardiovascular disease in Latin America and the Caribbean (LAC), where control rates are persistently low. Community-based strategies are promising approaches to overcome barriers to care. OBJECTIVE: To evaluate the effectiveness of community-based interventions for hypertension prevention and control among adults in LAC. METHODS: A systematic review was conducted according to the PRISMA 2020 guidelines. PubMed, LILACS, Scopus, and SciELO were searched for randomized controlled trials (RCTs) published between January 2010 and October 2025. RESULTS: Eighteen RCTs (n = 12 134 participants) were included. Interventions comprised community health worker (CHW) programs, lifestyle counseling, mobile health messaging, and salt substitution. Multicomponent CHW-led interventions demonstrated the greatest impact, with systolic blood pressure (SBP) reductions of 5 to 13 mmHg and significantly improved control rates. Digital messaging interventions consistently enhanced medication adherence. Educational and lifestyle programs showed variable but often positive effects on SBP. CONCLUSIONS: Community-based interventions, particularly integrated CHW-led models supported by digital tools, are effective for improving hypertension control in LAC. Scaling these evidence-based strategies within primary healthcare systems can help reduce the regional cardiovascular disease burden.