This post was authored by Kim Allan Williams, Sr., MD, FACC, vice president of the ACC.

It is estimated that about 78 million U.S. adults have high blood pressure. With no warning signs and no symptoms, it is often called “the silent killer.”

According to data from the National Health and Nutrition Evaluation Survey from 2007-2010, 81.5 percent of those with hypertension were aware they had it, and 79.9 percent were being treated, but only 52.5 percent were under control, with significant variation across different patient subgroups.

With the U.S. population aging, the worsening of the obesity epidemic and the rising prevalence of diabetes mellitus, the prevalence of hypertension is expected to increase 7.2 percent by 2030, according to data from the Centers for Disease Control and Prevention (CDC).

Since efforts to educate patients and providers have not been sufficient in bringing hypertension under control, today the ACC, American Heart Association (AHA) and the CDC released a science advisory highlighting several comprehensive hypertension programs that coordinate care using multiple resources that have been shown to lead to better overall blood pressure control.

The statement is also as a call to action for broad-based efforts to improve hypertension awareness, treatment, and the proportion of patients treated and controlled. My colleagues and I note that there is a clear need to provide enhanced, evidence-based, blood pressure treatment systems for providers, including standardization of protocols and algorithms, incentives for improved performance based on achieving and maintaining patients at blood pressure goals, and technology-facilitated clinical decision support and feedback.

A number of algorithm examples are provided that can be readily implemented in diverse health care settings. In particular, the treatment algorithm (found here) is based on the best available science.  It is easy to update as new, better information becomes available, simple for clinicians to implement and for patients to understand.  It considers costs of diagnosis, monitoring and treatment. It can also be incorporated into an Electronic Health Record for use as clinical decision support, but is not meant to be a substitute for a physician's clinical judgment.

By providing the tools and resources that can be implemented in team-based approaches, I only hope that we will start to see our patient’s high blood pressure numbers subside.

The ACC’s CardioSmart.org also has a patient resource center for high blood pressure, along with a “Living with High Blood Pressure” interactive guide. Encourage patients to sign up for the November blood pressure challenge on CardioSmart.org.

 

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