Objective  To investigate the effect of refined self-management intervention on hypertension patients in rural areas of northern Zhejiang province and to provide evidences for hypertension patients management.

  Methods  Using random cluster sampling, we recruited 1 292 hypertension patients registered at 8 township hospitals in a district of northern Zhejiang province during January – March 2016 and assigned them into an intervention group (cases: n = 625) with one-year refined self-management and a control group (controls: n = 667) with routine chronic disease management. Questionnaire interviews, physical examination, and laboratory detections were performed at the beginning and the ending of the intervention in all the participants. The difference-in-difference model (DID) was be used to evaluate the effect of the refined self-management intervention.

  Results  By the end of the intervention, the cases reported significantly increased rates of taking medicine (95.20% vs. 91.20%) and consumption of vegetables every week (96.48% vs. 92.96%) (both P < 0.05) but significantly decreased rate of alcohol drinking, average personal daily consumption of gourmet powder and table salt (P < 0.05 for all); significantly decreased body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), and fasting plasma glucose (FPG) were also detected among the cases after the intervention (P < 0.05 for all). After adjusting for gender, education, occupation, marital status, medical insurance, average annual income, the results of DID analysis revealed significant decreases in waist circumference (3.06 cm), SBP (6.36 mm Hg), DBP (2.75 mm Hg), FPG (1.40 mmol/L), number of cigarette smoked per day (6.04), average personal daily consumption of gourmet powder (1.04 g) and table salt (3.51 g), and rate of alcohol drinking (8.3%) but significant increase in the rate of vegetable consumption per week (5.6%) (all P < 0.05).

  Conclusion  Refined self-management intervention could effectively control blood pressure and promote healthy lifestyle among hypertension patients in rural areas of northern Zhejiang province.