Blood pressure control after stroke remains poor in many low-resource settings, increasing recurrent vascular risk. The PINGS trial evaluated whether a low-technology mobile health strategy could improve post-stroke blood pressure management. Results were published in Circulation.

This multicenter, randomized, open-label trial with blinded endpoint assessment enrolled 500 adults aged 18 years or older within 1 month of stroke onset and with blood pressure ≥140/90 mm Hg across 10 Ghana hospitals. Participants were assigned to usual care or a 12-month intervention including home blood pressure monitoring, nurse case management, phone alarm medication reminders, and weekly educational audio messages.

Among participants, the mean (SD) age was 58 (11) years, and 43% were women. The intervention group included 244 patients, and the usual care group included 256. At month 12, mean systolic blood pressure change from baseline favored the intervention group at −5.5 mm Hg (95% CI, −9.6 to −1.4; P=0.008).

Blood pressure control <140 mm Hg was achieved in 67% of the intervention group versus 43% with usual care, a 24% absolute difference (95% CI, 15%-33%; P<0.001). Major adverse cardiovascular events and medication adherence did not differ significantly. Serious adverse events occurred in 11.1% versus 7.0% (P=0.12).

A low-complexity mHealth program with nurse-led task shifting improved blood pressure control after stroke in a resource-limited setting without a significant safety signal. Further study is needed to confirm effects on long-term clinical outcomes.