AHA/ACC/CDC Science Advisory on effective coordinated care efforts to reduce hypertension

Go AS, Bauman MA, Coleman King SM, et al.
Hypertension. 2013;  published online November 15 2013, doi:10.1161/HYP.0000000000000003

Despite proven treatments, blood pressure control is still a challenge in the United States and hypertension rates continue to rise. The American Heart Association (AHA), the American College of Cardiology (ACC) and the Centers for Disease Control and Prevention (CDC) got together to compose a Science Advisory on how to best organise coordinated care using multiple resources, to achieve better blood pressure control in all patients.

This AHA/ACC/CDC science advisory is intended to complement and support clinical guidelines, providing clinicians and health systems with tools to improve treatment and control of hypertension. 
It is a call for action for healthcare providers to work in closer partnership with patients, and it hopes to stimulate local, regional and national programs to offer coordinated care. Broad-based efforts should improve hypertension awareness, treatment, and the proportion of patients treated and controlled.  To date, efforts to educate patients and providers have not been sufficient in bringing hypertension under control, according to the advisory. Similarly, interventions targeting only physicians have not led to sufficiently consistent and meaningful improvements. Recent study insights suggests that comprehensive hypertension programs that coordinate care using multiple resources may lead to better overall blood pressure control.

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 advisory includes a template outlining a general approach to develop an effective, evidence-based treatment algorithm, and provides a usable example of such an algorithm: Controlling Hypertension in Adults. It is intended to be a critical part of a multipronged, systematic approach to controlling hypertension, as it facilitates clinical decision-making, provides a default approach with proven benefits, and engages multiple providers in a coordinated manner.

“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.”

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