3 steps for acting rapidly to control high blood pressure


Recently, AMA Wire® has focused coverage on how to measure blood pressure accurately, the first action to appropriately managing high blood pressure. Once a patient’s hypertension is confirmed, physicians and their practice staff should act rapidly to help bring that blood pressure under control. Here are three recommended steps to take:

  1. Make an explicit change in the patient’s care plan before your interaction ends.
  2. Ensure there will be a follow-up interaction every two to four weeks until blood pressure is less than 140/90 mmHg.
  3. Use an evidence-based protocol, such as the U.S. Department of Health and Human Service’s Million Hearts® initiative framework, to guide selection of antihypertensive medications.

These actions are from the second part of a checklist called the “M.A.P. framework” to improve outcomes around hypertension, being developed and tested by physicians in a pilot program taking place in Maryland and Illinois. The M.A.P. calls for physicians and care teams to take action around these three concepts:

  • Measure accurately
  • Act rapidly
  • Partner with patients to promote patient self-management

The pilot is part of the AMA’s Improving Health Outcomes initiative, in which the AMA and participating physicians and care teams are working with researchers at the Johns Hopkins Armstrong Institute for Patient Safety and Quality and the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities to develop and test evidence-based recommendations.

Along with clinical changes, the pilot practices are establishing clinical-community linkages, where physicians refer patients to community resources that can help them improve their blood pressure. For example, one Baltimore physician set up a fitness clinic in her office, in which patients can meet with her for 40 minutes to discuss weight loss goals, diet and nutrition and identify nearby locations where they can safely exercise. The practices are also testing different ways to maintain contact with patients outside of office visits and empowering patients to take control of their blood pressure.