[Correspondence] Cardiovascular risk in hypertension: open questions about HOPE 4

Summary: With great interest we read the encouraging results of the HOPE 4 trial by Jon-David Schwalm and colleagues.1 However, we agree with Tanzeen H Jafar and colleagues2 that the generalisability of the findings is limited because the non-physician health workers were privately paid by the study, and drugs were provided for free. Our work in Kenya shows that non-physician health workers are often overburdened, and that drugs are frequently out of stock in public facilities and pricey in private health facilities, leading to high out-of-pocket expenditure.

Source: The Lancet

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