3 steps to achieve BP control in your patients

Over 100 million U.S. adults have high blood pressure, and less than half have it under control. Follow these three key steps to help prevent heart attacks, heart failure, strokes, kidney failure and more.

To help physicians help patients gain control of their hypertension—a condition that costs the nation an estimated $131 billion annually in the form of health care services, medication and missed days of work—the AMA and the American Heart Association (AHA) partnered to create Target: BP.

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The national initiative urges medical practices, health service organizations and patients to prioritize blood pressure control at a time when the condition accounts for more death from cardiovascular disease than any other modifiable risk factor and as it is second only to cigarette smoking as a preventable cause of death in the United States.

Target: BP outlines three key steps physicians should take to help patients rein in high blood pressure.

Measure blood pressure accurately, every time

Accurate measurements and recordings are essential to categorizing a patient’s blood pressure and assessing the cardiovascular risk accurately.

Clinicians can avoid common errors that lead to inaccurate readings by ensuring the patient is properly positioned every time they take blood pressure readings. Are the patient’s legs uncrossed? Is the cuff placed over a bare arm? Does it fit properly? Is the patient’s bladder full? (It shouldn’t be.) Is the patient sitting still and quiet? If those things don’t occur, the reading could be off anywhere from 2 to 50 mm Hg.

Physicians and health professionals can further ensure the accuracy of blood-pressure assessment by having the patient use 24-hour ambulatory blood pressure monitoring or self-monitoring. Also, physicians can use electronic health records to identify patients with undiagnosed or undertreated hypertension.

Act rapidly to address high blood-pressure readings

Once you’ve assessed a patient, follow evidence-based treatment protocols to get blood pressure under control. Target: BP outlines the specific actions physicians can take to address each category of abnormal blood pressure: elevated, stage 1 hypertension and stage 2 hypertension. Actions include nonpharmacologic lifestyle changes, prescribing medication when appropriate and frequent follow-up with patients.

Partner with patients, families and communities

Those tackling their high blood pressure are more likely to stick to a treatment plan, make lifestyle changes and come in for follow-up visits if physicians work with the patients, their families and community resources.

Physicians and the care team need to focus on a patient’s overall health—maintaining healthy weight, dietary habits, sodium intake, physical activity, alcohol consumption and smoking habits—and outline ways patients can reduce their risk for cardiovascular disease.

The environment needs to be a blame-free one where patients are recognized for achieving treatment goals and encouraged to answer questions honestly. Physicians also need to guide patients and their families to resources that can help support the recommended lifestyle changes and help patients stick to the treatment plans.

Why these 3 steps are so critical

This strategy is so effective because it helps eliminate the three challenges known to prevent effective treatment for high blood pressure from taking place.

  • Measuring BP accurately every time cuts the uncertainty about whether the condition exists.
  • Acting rapidly to manage high BP pushes through the inertia that occurs if a physician doesn’t initiate or escalate treatment when patients’ blood pressures remain uncontrolled.
  • Partnering chips away at the treatment nonadherence problem because the communication and support make it more likely that a patient will follow a prescribed plan, including medication and lifestyle changes.

The Target: BP Recognition Program celebrates physician practices and health systems for recurring recognition for all participating sites that submit their BP-control data as well as those that achieve hypertension-control rates of 70 percent or higher in their adult patients. The AHA and AMA recognized nearly 800 organizations in 2018. Be part of the 2019 Recognition Program by registering now.