Controlling High Blood Pressure Starts with Accurate Measurement

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According to the Centers for Disease Control and Prevention (CDC), 75 million American adults—over a third of the population—are living with high blood pressure.

The health impact of high blood pressure, also called hypertension, is severe. It is a significant risk factor for heart disease and stroke, which are leading causes of death in the United States. The CDC estimates high blood pressure led to over 410,000 deaths in 2014 and costs the nation’s health care system $48.6 billion each year.

Yet, researchers have found that only about half of those individuals with hypertension have the condition under control.

Facing these daunting statistics, federal agencies, physicians and public health advocates are working to shift the paradigm for controlling high blood pressure. One such initiative is Target: BP.

Launched in 2015 by the American Medical Association (AMA) in partnership with the American Heart Association (AHA), Target: BP is starting with the basics to raise awareness about the importance of controlling high blood pressure among primary care practices.

"One of the biggest lessons learned from working with Target: BP was the importance of proper technique in measuring blood pressure."

According to Laken Barkowski, RN, an improvement specialist at AMA, controlling hypertension starts with accurately measuring blood pressure, including using automated and validated devices with the correct cuff size and ensuring patients sit upright.

To help facilitate this process, Target: BP leverages a blood pressure management framework called M.A.P. (Measure, Act, Partner) and is working with primary care practices to help them create blood pressure control plans for their patients. Besides steps for accurate measurement, M.A.P. includes a checklist for how to respond if hypertension is diagnosed and advice on how to partner with patients and communities to control the condition.

The initiative is also working with the Quality Innovation Network-Quality Improvement Organization (QIN-QIO) community to spread these best practices and increase participation.

At a recent event discussing the initiative, Frann Otte, a senior quality improvement facilitator at Telligen—the QIN-QIO serving Colorado, Illinois and Iowa—said that one of the biggest lessons learned from working with Target: BP was the importance of proper technique in measuring blood pressure. Providers appreciated the detailed, easy-to-follow guidance and, as a result, were more open to the other tools and resources available from the initiative.

To date, Target: BP has over 400 participants across the United States. This year, the initiative is launching a public recognition campaign, which, according to its website, seeks to “celebrate physician practices and health systems for achieving blood pressure control rates at or above 70 percent within the populations they serve.”

While initially focused on two quality measures—participation and achievement of the 70 percent goal—additional levels are in the works.

Vikas Bhala, an improvement advisor at AMA, believes the QIO Program will play a critical role in the initiative as it seeks to expand its impact. Besides referring practices to the program, Target: BP will rely on the QIN-QIOs to be its eyes and ears on the ground and help ensure the initiative is headed in the right direction.

“We need the QIN-QIOs to work hand-in-hand with [AMA and AHA] to gather feedback at the local level about what’s working and what’s not within practices,” he said. “This communication will help shape the program’s efforts in a positive way.”