Controlling High Blood Pressure: An Evidence-Based Blueprint for Change.

Area of Science:

• Public Health
• Cardiovascular Medicine
• Health Services Research

Background:

• National data reveal inadequate and deteriorating control of high blood pressure (HBP) in the United States.
• The COVID-19 pandemic has likely worsened HBP control and exposed critical weaknesses in the US healthcare delivery system.
• Suboptimal HBP management affects 115 million Americans, leading to increased mortality, cardiovascular events, and healthcare costs.

Purpose of the Study:

• To present an evidence-based Blueprint for Change to redesign the US health delivery system for improved HBP control.
• To outline a systems-based approach integrating current clinical practice guidelines and quality measures.
• To leverage national quality improvement initiatives for better HBP management.

Main Methods:

• Development of a comprehensive health delivery system redesign model.
• Incorporation of evidence-based strategies including proper BP measurement, cardiovascular risk assessment, and team-based care.
• Emphasis on patient-centered approaches, addressing social determinants of health, and shared decision-making.

Main Results:

• The proposed blueprint offers a systemic solution to address the HBP crisis.
• It integrates key components of care delivery, from measurement to patient engagement.
• The model aims to build upon and enhance existing national quality improvement efforts.

Conclusions:

• A fundamental redesign of the US healthcare system is necessary to effectively manage high blood pressure.
• The proposed blueprint provides a framework for systemic change to improve HBP control and reduce cardiovascular burden.
• Implementing this model offers a critical opportunity to mitigate mortality, cardiovascular events, and costs associated with HBP.