U.S. Surgeon General Dr. Jerome Adams is calling on healthcare providers to improve how they help patients manage their blood pressure, as uncontrolled hypertension becomes more prevalent in American adults.
The nation's top doctor called for a coordinated, multi-faceted response from public health officials, clinical medicine, insurers, community organizations and others to better control hypertension. The effort is a "national public health priority," he said.
HHS on Wednesday released a series of strategies to help providers improve hypertension rates, including raising awareness about the health risks associated with uncontrolled high blood pressure.
Uncontrolled hypertension increases the risk of heart disease and stroke, and contributes to an estimated 500,000 deaths annually in the U.S.
While healthcare providers had made strides in controlling hypertension in the past, Adams told reporters on Wednesday that the progress is "slipping away." Approximately 61 million of the 108 million Americans with hypertension are unable to get their blood pressure under the recommended 130/80 threshold.
"We know what works to control hypertension," Adams said.
An analysis published last month in the Journal of the American Medical Association found the proportion of adults with controlled blood pressure declined from 2014 through 2018, reversing what had been nearly a decade of increase throughout the 2000s.
HHS' report called for stakeholders to reduce or eliminate disparities that could hinder hypertension treatment and management efforts,such as a lack of access to healthcare services.
Adams acknowledged individuals were more reluctant to visit healthcare facilities during the COVID-19 pandemic due to virus risks. But facilities have added safety precautions and increased telehealth use, which Adams said should help clinicians keep better track of their patients and help them manage their conditions.
"We need people to know their numbers and that includes out-of-hospital and out-of-clinic monitoring of your blood pressure even if you do have access to a physician," Adams said.
The report recommended clinicians develop a "comprehensive hypertension treatment protocol" that focused on setting optimal blood pressure targets and providing a team-based care approach. Providers would encourage patients to make lifestyle changes to lower blood pressure, such as increasing physical activity and improving nutrition.
But the report also stressed that providers need to be more efficient in how they monitor and manage hypertension so they can improve patient outcomes.
Dr. Andrew Van Wieren, chief medical officer for Esperanza Health Centers, a federally qualified health center located on Chicago's southwest side, told reporters that his organization has seen a significant increase in patients controlling their hypertension. While only 57% had their hypertension under control in 2015, more than 81% met the threshold in 2019.
Esperanza added a population health tool to its electronic health record system to allow care teams to share monthly disease management information. The FQHC also informs physicians about the latest hypertention guidelines frequently, and medical assistants receive regular training on taking blood pressure measurements, Van Wieren said. Care coordinators frequently call hypertension patients to encourage follow-up care and check in on lifestyle changes.
"Hypertension control isn't easy, and there's no single strategy that works," Van Wieren said. "We believe data-driven and team-based strategies can help other clinics achieve a hypertension control rate above 80% as well."