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What Constitutes Adequate Control of High Blood Pressure? Current Considerations

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Title: What Constitutes Adequate Control of High Blood Pressure? Current Considerations
Authors: Donald E. Casey, Alexander J. Blood, Stephen D. Persell, Daniel Pohlman, Jeff D. Williamson
Source: Mayo Clin Proc Innov Qual Outcomes
Mayo Clinic Proceedings: Innovations, Quality & Outcomes, Vol 8, Iss 4, Pp 384-395 (2024)
Publisher Information: Elsevier BV, 2024.
Publication Year: 2024
Subject Terms: cardiovascular risk, health care delivery, Medicine (General), hypertension, health care disparity, shared decision making, Cardiology, global health, resource allocation, Special Article, 03 medical and health sciences, R5-920, 0302 clinical medicine, Internal Medicine, Medicine and Health Sciences, cardiovascular risk factor, human, uncertainty, risk reduction, practice guideline, stakeholder engagement, blood pressure regulation, coronary atherosclerosis, 3. Good health, consensus, social determinants of health, Public Health, measurement accuracy
Description: An estimated 45% of adult Americans currently have high blood pressure (HBP). Effective blood pressure (BP) control is essential for preventing major adverse events from cardiovascular and other vascular-related diseases, such as chronic kidney disease, stroke and dementia. A large and growing number of medical professional societies, health care organizations, and governmental agencies have now endorsed a clinical practice guideline-based target for adequate control of HBP to a systolic BP of less than 130 mm Hg. However, adequate BP control to this goal has been recently estimated to be as low as 30%. The first and most important steps to guide effective BP control include accurate, standardized BP measurement and formal assessment of overall atherosclerotic cardiovascular disease risk. In addition to appropriate pharmacologic treatment, optimal BP management must also include multifaceted guideline-directed lifestyle modifications. High-quality evidence now supports effective uniform HBP control that is consistently achievable for most of people from diverse backgrounds. This can be accomplished through identification and prioritization of social determinants of health enabled by shared decision making that is delivered via team-based care. Such integrated approaches can have a substantial impact for simultaneously reducing several major modifiable atherosclerotic cardiovascular disease risk factors. Hence, moving the "Big Needle" of improved overall cardiovascular, kidney, and brain health of the US population must no longer be solely relegated to primary care and will require a major and coordinated reprioritization of capital and evidence-based human resource allocations by all health care stakeholder organizations.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 2542-4548
DOI: 10.1016/j.mayocpiqo.2024.06.001
Access URL: https://pubmed.ncbi.nlm.nih.gov/39069971
https://doaj.org/article/5e6fe755c98a4d6692ebcddc96c23207
Rights: CC BY NC ND
Accession Number: edsair.doi.dedup.....4de7718ad478ba1af6ebaa2b03c1fd48
Database: OpenAIRE
Description
Abstract:An estimated 45% of adult Americans currently have high blood pressure (HBP). Effective blood pressure (BP) control is essential for preventing major adverse events from cardiovascular and other vascular-related diseases, such as chronic kidney disease, stroke and dementia. A large and growing number of medical professional societies, health care organizations, and governmental agencies have now endorsed a clinical practice guideline-based target for adequate control of HBP to a systolic BP of less than 130 mm Hg. However, adequate BP control to this goal has been recently estimated to be as low as 30%. The first and most important steps to guide effective BP control include accurate, standardized BP measurement and formal assessment of overall atherosclerotic cardiovascular disease risk. In addition to appropriate pharmacologic treatment, optimal BP management must also include multifaceted guideline-directed lifestyle modifications. High-quality evidence now supports effective uniform HBP control that is consistently achievable for most of people from diverse backgrounds. This can be accomplished through identification and prioritization of social determinants of health enabled by shared decision making that is delivered via team-based care. Such integrated approaches can have a substantial impact for simultaneously reducing several major modifiable atherosclerotic cardiovascular disease risk factors. Hence, moving the "Big Needle" of improved overall cardiovascular, kidney, and brain health of the US population must no longer be solely relegated to primary care and will require a major and coordinated reprioritization of capital and evidence-based human resource allocations by all health care stakeholder organizations.
ISSN:25424548
DOI:10.1016/j.mayocpiqo.2024.06.001