Algorithm-based blood pressure interventions, such as a recent primary care hypertension treatment program in Australia, may be effective in helping patients adhere to hypertension treatment, according to a recent study in the Journal of Hypertension.
The study showed that a more intensive and structured approach— including more frequent primary care visits and higher treatment doses—can control an individual’s blood pressure more effectively than a traditional regimen using fewer adjustments to treatment and fewer primary care visits.
The study examined 1,562 patients in 119 primary care clinics in Australia. Patients in the structured treatment program had mandatory visits at the six-, 10-, 14- and 18-week marks after entering the study, then a final follow-up at week 26.
Nearly half of the patients in the structured care program reached their blood pressure targets, compared to fewer than one-third of the patients who received usual care, according to the study.
The intervention method examined was the VIPER-BP Study (Valsartan Intensified Primary Care Reduction of Blood Pressure), which evaluated how different approaches to high blood pressure management helped patients meet their target blood pressure levels. VIPER-BP used a systematic program to treat blood pressure according to the risk of each individual patient. The program used standardized, guideline-based pharmalogical treatment. To achieve individual blood pressure targets, physicians used computer-assisted, intensified follow-up and re-evaluated treatment methods at every appointment.
“One in three participants randomized to the VIPER-BP intervention was exposed to the optimal level of protocol adherence and this was associated with markedly better BP [blood pressure] control,” the study said. “These data reinforce the potential to better tailor management to individual needs in order to optimize BP management in primary care.”
Similarly, the AMA is focusing on improving health outcomes around hypertension by applying systematic, evidence-based treatment protocols. With May being National High Blood Pressure Education Month, physicians can focus on how their practices measure blood pressure and talk to patients about managing their high blood pressure.
Clinic sites in Maryland and Illinois are part of a pilot program to implement principles of safe design into the ambulatory setting to improve blood pressure control for patients with hypertension. The AMA is collaborating with researchers at Johns Hopkins Medicine and the pilot sites to develop and test a set of evidence-based recommendations for physicians to incorporate into their practices or community health centers.
Elements of a program called Project ReD CHiP (Reducing Disparities and Controlling Hypertension in Primary Care) at Johns Hopkins’ Center to Eliminate Cardiovascular Health Disparities are also being incorporated into the AMA’s work to improve health outcomes around hypertension. At the conclusion of its work, the AMA will have resources to help practices engage patients in better self-management, particularly at the community level.
