Featured Research

from universities, journals, and other organizations

Team-based approaches needed to fight high blood pressure

Date:
November 15, 2013
Source:
American Heart Association
Summary:
Despite proven treatments, blood pressure control is still a challenge in the United States. Local, regional and national programs that use coordinated care and multiple resources, including an evidence-based hypertension treatment algorithm, are needed to reduce and control blood pressure.

Uncontrolled high blood pressure rates continue to grow despite the availability of proven treatments, but collaborative approaches can be effective in fighting this deadly disease, according to a science advisory from the American Heart Association, the American College of Cardiology and the Centers for Disease Control and Prevention.

The advisory is a call to action for healthcare systems and providers to work in closer partnership with patients, and it calls for local, regional and national programs that offer coordinated care using multiple resources to achieve better blood pressure control in all patients.

"Despite access to health care, effective therapies that have been available for 50 years, and various education and quality improvement efforts that have been targeted at patients and healthcare providers, achieving success in hypertension control is still a challenge," said Alan S. Go, M.D., Director of the Comprehensive Clinical Research Unit at Kaiser Permanente Northern California and lead author of the advisory.

High blood pressure -- readings at or above 140/90 millimeters of mercury -- affects about 1 in 3 Americans and is a major risk factor for heart disease and stroke. Of those who have high blood pressure, also called hypertension, about 75 percent are being treated but only half have it controlled to a healthy level, according to national surveys.

The advisory recommends that healthcare, industry and communities prioritize people with high blood pressure who are receiving treatment but haven't achieved their target blood pressure. The writing group members note that of those with uncontrolled hypertension, nearly 90 percent see a healthcare provider regularly, and 85 percent have health insurance.

"A multi-partner environment may be beneficial to reach people with high blood pressure and ensure that their condition is being treated maximally, and to reduce disparities in high blood pressure control," said Willie Lawrence, M.D., co-author, AHA spokesperson and Chief of Cardiology, Research Medical Center, Kansas City.

According to the advisory, efforts to educate patients and providers have not been sufficient in bringing hypertension under control. Similarly, interventions targeting only physicians have not led to sufficiently consistent and meaningful improvements.

"The tools to control blood pressure have long been available, but hypertension control requires patient and physician involvement within a supportive system," said John G. Harold, M.D., MACC, president of the American College of Cardiology. "We are advocating a team approach that reduces barriers for patients and leverages the power of electronic health records to improve cardiovascular health."

So what works? More recent studies suggest that comprehensive hypertension programs that coordinate care using multiple resources may lead to better overall blood pressure control.

The advisory also provides examples of successful programs that could be emulated. One is a Kaiser Permanente program that increased the proportion of its patients with hypertension with well-controlled blood pressure from 44 percent in 2001 to more than 87 percent in 2011. The program focused on five main elements: creating a system-wide hypertension registry, providing regular feedback on hypertension control rates to providers, implementing and frequently updating an evidence-based treatment algorithm, using single-pill combination therapies and using medical assistants for follow-up blood pressure checks in order to help patients receive necessary treatment adjustments efficiently. Lifestyle changes for patients were strongly recommended as well.

The advisory provides eight principles for developing an effective high blood pressure treatment algorithm (and uses them to provide a usable example of such an algorithm):

1. Base the components and processes on the best available science.

2. Format the algorithm in a manner that is simple to update as new evidence becomes available.

3. Use a feasible, simple implementation strategy.

4. Include a patient version at appropriate scientific and language literacy level.

5. Consider costs of diagnosis, monitoring, and treatment.

6. Use a format easily incorporated within a team approach to health care.

7. Use a format able to be incorporated into electronic health records for clinical decision support.

8. Include a disclaimer to ensure that the algorithm is not used to counter the treating healthcare provider's best clinical judgment.

"The message for large and small practices and systems is: 'Use an approach that includes an evidence-based treatment algorithm and you can improve blood pressure control for your patients,'" said CDC Director Tom Frieden, M.D., M.P.H. "Pick from any one of a number of available protocols, or develop your own -- just use an evidence-based one."

Several existing algorithms for hypertension treatment in large healthcare settings are available for public use in the resources and tools section of the Million Heartsฎ initiative Web site at http://millionhearts.hhs.gov/resources/protocols.html.

"Arming healthcare providers, health systems, and communities with proven tools, algorithms, strategies, programs, and other best practices, along with expertise and technical assistance for improving blood pressure awareness, treatment and control is essential to reducing the tremendous burden of cardiovascular risk," said the statement authors.


Story Source:

The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length.


Journal References:

  1. Alan S. Go, MD; MaryAnn Bauman, MD; Sallyann M. Coleman King, MD, MSc; Gregg C. Fonarow, MD, FAHA, FACC; Willie Lawrence, MD, FAHA, FACC; Kim A. Williams, MD, FAHA, FACC; Eduardo Sanchez, MD. An Effective Approach to High Blood Pressure Control A Science Advisory From the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. J Am Coll Cardiol., November 2013
  2. Alan S. Go, Maryann Bauman et al. An Effective Approach to High Blood Pressure Control. Hyptertension, November 2013

Cite This Page:

American Heart Association. "Team-based approaches needed to fight high blood pressure." ScienceDaily. ScienceDaily, 15 November 2013. <www.sciencedaily.com/releases/2013/11/131115094904.htm>.
American Heart Association. (2013, November 15). Team-based approaches needed to fight high blood pressure. ScienceDaily. Retrieved September 23, 2014 from www.sciencedaily.com/releases/2013/11/131115094904.htm
American Heart Association. "Team-based approaches needed to fight high blood pressure." ScienceDaily. www.sciencedaily.com/releases/2013/11/131115094904.htm (accessed September 23, 2014).

Share This



More Health & Medicine News

Tuesday, September 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Liberia Pleads for Help to Fight Ebola

Liberia Pleads for Help to Fight Ebola

AP (Sep. 22, 2014) — Liberia's finance minister is urging the international community to quickly follow through on pledges of cash to battle Ebola. Bodies are piling up in the capital Monrovia as the nation awaits more help. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Ebola Doctor Says Border Controls Critical

Ebola Doctor Says Border Controls Critical

AP (Sep. 22, 2014) — A Florida doctor who helped fight the expanding Ebola outbreak in West Africa says the disease can be stopped, but only if nations quickly step up their response and make border control a priority. (Sept. 22) Video provided by AP
Powered by NewsLook.com
Global Ebola Aid Increasing But Critics Say It's Late

Global Ebola Aid Increasing But Critics Say It's Late

Newsy (Sep. 21, 2014) — More than 100 tons of medical supplies were sent to West Africa on Saturday, but aid workers say the global response is still sluggish. Video provided by Newsy
Powered by NewsLook.com
Sierra Leone in Lockdown to Control Ebola

Sierra Leone in Lockdown to Control Ebola

AP (Sep. 21, 2014) — Sierra Leone residents remained in lockdown on Saturday as part of a massive effort to confine millions of people to their homes in a bid to stem the biggest Ebola outbreak in history. (Sept. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins