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Scalable treatment algorithm focused on hypertension management for the University of California

Sandeep P Kishore1, Heather E Martin2, Nicki Friedberg3

  • 1Department of Medicine, University of California San Francisco, San Francisco, California, USA sandeep.kishore@ucsf.edu.

BMJ Open Quality
|March 18, 2026
PubMed

Insights

The UC Way Hypertension Medication Algorithm standardized care for over 90,000 patients, improving hypertension control. This evidence-based protocol prioritized affordable, combination therapies, addressing health disparities in underserved populations.

Area of Science:

  • Health Services Research
  • Clinical Pharmacy
  • Cardiology

Background:

  • Uncontrolled hypertension significantly contributes to morbidity and mortality, especially in underserved communities.
  • Variability in hypertension treatment and associated disparities necessitate standardized care approaches.

Purpose of the Study:

  • To describe the development and implementation of the UC Way Hypertension Medication Algorithm.
  • To evaluate the algorithm's impact on hypertension control and health equity.
  • To share lessons learned for scaling chronic disease management in decentralized health systems.

Main Methods:

  • Co-development of an evidence-based protocol by multidisciplinary experts.
  • Emphasis on medication affordability and first-line two-drug fixed-dose combinations.
  • Implementation through stakeholder engagement, clinician education, and EHR integration.

Main Results:

  • The algorithm now guides treatment for over 90,000 hypertension patients.
  • Associated with improvements in hypertension control.
  • Facilitated standardization and clinician uptake across six academic health centers.

Conclusions:

  • The UC Way Hypertension Medication Algorithm offers a scalable model for optimizing chronic disease management.
  • Standardized, evidence-based protocols can improve hypertension control and promote health equity.
  • Lessons learned are applicable to other decentralized health systems facing similar challenges.

Keywords:
Clinical ProtocolsClinical practice guidelinesEvidence-Based PracticeEvidence-based medicineHealth Equity

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