Improved Blood Pressure Control to Reduce Cardiovascular Disease Morbidity and Mortality: The Standardized Hypertension Treatment and Prevention Project

Abstract

Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. While hypertension can be successfully diagnosed and treated, only one in seven persons with hypertension have controlled blood pressure. To meet the challenge of improving the control of hypertension, particularly in low- and middle-income countries, the authors developed the Standardized Hypertension Treatment and Prevention Project, which involves a health systems–strengthening approach that advocates for standardized hypertension management using evidence-based interventions. These interventions include the use of standardized treatment protocols, a core set of medications along with improved procurement mechanisms to increase the availability and affordability of these medications, registries for cohort monitoring and evaluation, patient empowerment, team-based care (task shifting), and community engagement. With political will and strong partnerships, this approach provides the groundwork to reduce high blood pressure and cardiovascular disease-related morbidity and mortality.

Clinical Perspective on Antihypertensive Drug Treatment in Adults With Grade 1 Hypertension and Low-to-Moderate Cardiovascular Risk: An International Expert Consultation

“…19,20,21,22,23,24,25,26,27,28,29,30,31,32 This version was sent to 55 select experts, some declined to participate. The authors, contemplate that this document could evolve as new information emerges.…”

“…Our attainable goal is a practical and standardized algorithm to raise the quality of medical care of patients with hypertension and hence, improve control and outcomes. 24,26,27 …”

“…Individual 19 and population interventions 112,113 are not opposing, but synergistic strategies; hypertension management should always take into account the balance between clinical and the public health approaches, an issue particularly relevant for low-middle income countries. 24,26,27,114 The cost perspective is a critical component of this balance, because governments and individuals need to prioritize how their limited funds are best spent. 9,24,26,27 B.…”

“…24,26,27,114 The cost perspective is a critical component of this balance, because governments and individuals need to prioritize how their limited funds are best spent. 9,24,26,27 B. This consultation, properly aligned with current global context of the cardiovascular prevention comes at a unique time in hypertension management philosophy and approach.…”

“…This consultation, properly aligned with current global context of the cardiovascular prevention comes at a unique time in hypertension management philosophy and approach. 9,24,26,27,115,116,117,118 Indeed, several relevant partners led by the World Health Organization launched an initiative to improve cardiovascular health named HEARTS. 24 The HEARTS technical package covers six elements: healthy lifestyle (counsel on CVR factors and self-care), evidence-based treatment protocols (simple and standardized protocols), access to essential medicines and technology (a core set of affordable medicines and basic technologies), risk-based management (total cardiovascular risk assessment, treatment and referral), team care and task-sharing (patient-centered care through a team approach and community participation), and systems for monitoring (patient and programme monitoring and evaluation).…”