Getting Blood Pressure Under Control
Many missed opportunities to prevent heart disease and stroke
High blood pressure is a major risk factor for heart disease and stroke, both of which are leading causes of death in the US. Nearly one-third of all American adults have high blood pressure and more than half of them don’t have it under control.* Many with uncontrolled high blood pressure don’t know they have it. Millions are taking blood pressure medicines, but their blood pressure is still not under control. There are many missed opportunities for people with high blood pressure to gain control. Doctors, nurses and others in health care systems should identify and treat high blood pressure at every visit.
*Blood pressure control means having a systolic blood pressure less than 140 mmHg and a diastolic blood pressure less than 90 mmHg, among people with high blood pressure.
Controlling blood pressure has to be a priority.Why is blood pressure control so important to health?
When your blood pressure is high:
- You are 4 times more likely to die from a stroke
- You are 3 times more likely to die from heart disease
Most people with uncontrolled high blood pressure:
- Know they have high blood pressure
- See their doctor
- Take prescribed medicine
Federal government is:
- Joining with the private sector in leading the national Million Hearts™ initiative to prevent a million heart attacks and strokes by 2017 (http:// millionhearts.hhs.gov).
- Working with pharmacists on activities to provide education and counseling to patients with high blood pressure.
- Focusing on the importance of high blood pressure as a Leading Health Indicator. (http://www. healthypeople.gov/2020/LHI/clinicalPreventive. aspx).
- Measuring progress against the specific objectives in Healthy People 2020. (http://www. healthypeople.gov/2020/topicsobjectives2020/ objectiveslist.aspx?topicId=21).
Health care systems where patients are seen and treated can:
- Start having doctors, nurses, and others review patient records, looking for patients who need more attention to control their high blood pressure.
- Create system-wide targets using Healthy People 2020 objectives to achieve blood pressure control.
- Update staff monthly on progress and give feedback on success measures.
- Make it easier for patients to stay on medicines:
- Consider 90-day refills for prescriptions
- Consider no or lower co-payments for medicines
Doctors, nurses and others who treat patients can:
- Flag and monitor patients with high blood pressure or who are at-risk. Report progress on patients using National Quality Forum (NQF) 0018. (http://www.qualityforum.org/MeasureDetails.aspx?actid=0&SubmissionId=1236#p=2&s=n&so=a).
- Counsel patients to take their medicines and make lifestyle changes. Follow their progress.
- Regularly evaluate the blood pressure medicines they take to determine whether these need to be changed.
- Address every blood pressure reading that is high by talking with the patient about taking prescribed medicines, adjusting current medicines and/or encouraging lifestyle changes. Consider once-a-day doses of medicines when possible.
- Take prescribed medicines each day and follow the directions on the bottle. If your blood pressure is still not under control or if you have side effects, talk with your doctor, nurse, or pharmacist about possibly changing your medicine.
- Work to maintain a healthy weight and meet the Physical Activity Guidelines for Americans. (http://www.cdc.gov/physicalactivity/everyone/ guidelines/)
- Follow a heart healthy eating plan with foods lower in sodium.
- Get help to stop smoking. If you don’t smoke, don’t start.
- Measure and write down your blood pressure readings between doctor’s visits. This can be done at home, at a grocery store or at the pharmacy.
- Keep your doctor, nurse, pharmacist or other health care provider informed of your blood pressure readings that you take at home.