[Integrated Care Protocol: Hypertension]

Area of Science:

• Cardiology
• Public Health
• Internal Medicine

Background:

• Hypertension is a leading cardiovascular risk factor, causing severe complications like stroke, heart failure, and kidney failure.
• Approximately 30% of adults over 20 have hypertension, with 40% unaware due to asymptomatic onset.
• Treatment adherence and control remain suboptimal, with only half of diagnosed patients receiving treatment and half of those achieving target blood pressure (<14/90 mmHg).

Purpose of the Study:

• To introduce the Integrated Care Protocols (PAI) initiative by the Mexican Institute of Social Security for managing major diseases.
• To outline a multidisciplinary approach integrating three levels of medical care for hypertension management.
• To detail updated diagnostic and therapeutic strategies for hypertension, including special populations.

Main Methods:

• The protocol integrates care across primary, secondary, and tertiary levels.
• It emphasizes the roles of a multidisciplinary team: doctors, nurses, social workers, psychologists, and nutritionists.
• Includes updated guidelines on diagnostic criteria, blood pressure measurement (office and out-of-office), pharmacotherapy (mono-, dual-, triple-therapy), non-drug interventions, and follow-up.

Main Results:

• Presents an algorithmic approach for diagnosis and treatment of hypertension.
• Addresses the diagnostic workup for secondary hypertension.
• Covers specific management strategies for hypertension in pregnancy, hypertensive crises, elderly patients, and those with ischemic or nephropathic conditions.

Conclusions:

• The Integrated Care Protocols (PAI) offer a structured, multidisciplinary framework for improving hypertension management.
• Updated guidelines and algorithmic approaches aim to enhance diagnostic accuracy and therapeutic efficacy.
• This initiative seeks to improve hypertension control rates and mitigate associated cardiovascular complications.