The hypertension control program of Kaiser Permanente Northern California is cited as a model to emulate in a Science Advisory jointly issued today by the American Heart Association, the Centers for Disease Control, and the American College of Cardiology. A release announcing the advisory was also issued this morning by the three organizations.
The statement is a call to action for healthcare, industry and communities to prioritize people who are receiving treatment but not at controlled levels. It notes that of those with uncontrolled hypertension, nearly 90 percent see a healthcare provider regularly, and 85 percent have health insurance.
High blood pressure affects nearly 78 million Americans and it is a major risk factor for heart disease and stroke. Of those who have high blood pressure, also called hypertension, about 80 percent are being treated but only half have it controlled to a healthy level in national surveys.
The statement says that programs are needed to:
- develop and implement evidence-based treatment algorithms
- establish systems that promote teamwork between patient, physician and other healthcare personnel
- provide education and incentives for control
- provide regular follow-up and treatment intensification as needed
- provide actionable feedback to providers and health systems
- maximize the use of technology
- promote a guideline-based simplified medication regimen
The statement cites Kaiser Permanente Northern California as a system-level paradigm. “Within a large integrated health care delivery system caring for more than 3 million members, a regional hypertension program was implemented involving five major components:
- creation and maintenance of a health system-wide electronic hypertension registry
- tracking hypertension control rates with regular feedback to providers at a facility- and provider-level
- development and frequent updating of an evidence-based treatment guideline
- promotion of single-pill combination therapies
- using medical assistants for follow-up blood pressure checks to facilitate necessary treatment intensification
“Between 2001 and 2009, the number of patients with hypertension increased from 349,937 to 652,763, respectively, but the proportion of hypertensive patients meeting target blood pressure goals improved substantially from 44% to over 80%, and continued to improve to over 87% in 2011.”
The Kaiser Permanente Northern California hypertension control program was the subject of a study by the Kaiser Permanente Division of Research published in JAMA earlier this year.
Kaiser Permanente’s hypertension control program is also featured on the CDC’s Million Hearts® website under Evidence-based Treatment Protocols with a link to the program’s guidelines and treatment algorithm.