Coronary artery disease and hypertension: outcomes of a pharmacist-managed blood pressure program

Area of Science:

• Cardiology
• Pharmacology
• Public Health

Background:

• Hypertension is a major risk factor for cardiovascular events, particularly in patients with coronary artery disease (CAD).
• Effective blood pressure management is crucial for reducing morbidity and mortality in this high-risk population.
• Current treatment strategies require optimization for better patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of a pharmacist-managed service in enhancing hypertension control.
• To assess the impact of this service on blood pressure reduction and goal achievement in patients with CAD.
• To determine the influence on the utilization of evidence-based medications.

Main Methods:

• A prospective cohort study was conducted within a health maintenance organization.
• Three hundred seventy-six patients with uncontrolled hypertension and established CAD were enrolled.
• A pharmacist-managed, physician-supervised approach was implemented to optimize drug therapy over a 7-month follow-up period.

Main Results:

• Mean systolic blood pressure decreased by 16.1 mm Hg overall (p<0.001), with 47.6% of patients achieving their blood pressure goal.
• Significant blood pressure reductions were observed in both diabetic (14.7 mm Hg) and non-diabetic (18.4 mm Hg) subgroups.
• The achievement of target doses for angiotensin-converting enzyme inhibitors increased substantially (27.1% to 67.0%, p<0.001), while generic antihypertensive drug use remained high (>95%).

Conclusions:

• A pharmacist-managed, physician-supervised population-management strategy effectively improves blood pressure control in patients with CAD.
• This model facilitates clinically significant blood pressure reductions through evidence-based and cost-effective medication management.
• Pharmacist involvement in chronic disease management can lead to improved cardiovascular outcomes.