Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 72, Issue 11, Pages 1278-1293Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2018.07.008
Keywords
antihypertensive agents; dietary sodium; exercise; lifestyle; medication adherence; telemedicine
Categories
Funding
- National Heart, Lung, and Blood Institute [R01-HL-128189, P01-HL-074940]
- American Heart Association [15SFRN2390002]
- Veterans Affairs Health Services Research and Development [VAHSRD 08-027]
- National Institutes of Health [NIH K12-HL-138030, R01-DK093938, R34-DK-102166]
- Johnson Johnson
- Otsuka Pharmaceuticals
- Sanofi
- National Institute of General Medical Sciences [P20GM109036]
- Improved Patient Outcomes
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Hypertension, the leading risk factor for cardiovascular disease, originates from combined genetic, environmental, and social determinants. Environmental factors include overweight/obesity, unhealthy diet, excessive dietary sodium, inadequate dietary potassium, insufficient physical activity, and consumption of alcohol. Prevention and control of hypertension can be achieved through targeted and/or population-based strategies. For control of hypertension, the targeted strategy involves interventions to increase awareness, treatment, and control in individuals. Corresponding population-based strategies involve interventions designed to achieve a small reduction in blood pressure (BP) in the entire population. Having a usual source of care, optimizing adherence, and minimizing therapeutic inertia are associated with higher rates of BP control. The Chronic Care Model, a collaborative partnership among the patient, provider, and health system, incorporates a multilevel approach for control of hypertension. Optimizing the prevention, recognition, and care of hypertension requires a paradigm shift to team-based care and the use of strategies known to control BP. (C) 2018 by the American College of Cardiology Foundation.
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