An Effective Approach to High Blood Pressure Control

Abstract

Effective Approach to High Blood Pressure Control 879 ambitious national goals at a population level. In this article, we describe the value of hypertension treatment algorithms, pro-vide criteria for effective hypertension management algorithms, describe an AHA/American College of Cardiology (ACC)/CDC– recommended treatment algorithm based on current guidelines, and describe examples of other specific algorithms that have been associated with improved blood pressure on a large scale. As described previously, despite the strong evidence and con-sensus regarding the treatment and control of high blood pres-sure, 9,12 as well as the availability of many different therapeutic options, achieving success in hypertension control at both the individual patient level and, even more importantly, the popu-lation level, has remained a major challenge nationally. Although there is no single explanation for the poor hyper-tension control seen in many patient subgroups, the fragmenta-tion of health care for many patients and the lack of consistent implementation of system-level solutions in clinical practice and healthcare delivery systems appear to be important con-tributors. Efforts focused primarily on educating patients and providers about hypertension and the benefits of its treatment have not been sufficient in bringing hypertension under control. Similarly, interventions targeting only physicians have not led to consistent and meaningful improvements on a large scale. 13