New Concepts in Hypertension Management: A Population-Based Perspective

Abstract

Hypertension (HTN) is the most common chronic disease in the U.S., and the standard model of office-based care delivery has yielded suboptimal outcomes, with approximately 50% of affected patients not achieving blood pressure (BP) control. Poor population-level BP control has been primarily attributed to therapeutic inertia and low patient engagement. New models of care delivery utilizing patient-generated health data, comprehensive assessment of social health determinants, computerized algorithms generating tailored interventions, frequent communication and reporting, and non-physician providers organized as an integrated practice unit, have the potential to transform population-based HTN control. This review will highlight the importance of these elements and construct the rationale for a reengineered model of care delivery for populations with HTN.

Hypertension control status and quality of care for hypertension among patients availing treatment from private sector: A cross-sectional study in urban field practice area of JIPMER, Puducherry

“…The criteria recommend that BP measurement needs to be done at an interval of 3–6 months among those who have achieved control status where it needs to be measured at monthly interval for those whose BP is not adequately controlled. [8] Around 4% of the study participants had sought all their recommended follow-up examinations in the last 1 year. Almost two-third (64%) of the study participants had not visited their private practitioner even once in the last 1 year for their follow-up examinations.…”

“…New models of care delivery utilising patient-generated health data, computerised algorithms generating tailored interventions, comprehensive control of social health determinants, frequent communication and reporting and non-physician providers as an integrated practice unit will be emerged out. [8]…”

Barriers and facilitators to the implementation of a community-based hypertension improvement project in Ghana: a qualitative study of ComHIP

“…In addition, policy makers' reservations on the sustainability of the SMS component in the Ghanaian context signals added attention must be given to securing support, including financial and political buy-in from local actors. More extensive ICT-based "digital medicine" approaches for the management of hypertension have been introduced in higher income countries with generally positive results [28][29][30]. Despite less robust infrastructure in LMICs such as Ghana, measures similar to those introduced by ComHIP should be implemented, tested and accompanied by sensitive evaluation to learn how to integrate them.…”

Blood pressure measurements for treating hypertension: which method counts the most?

“…We have recently focused on patient-generated health data and the potential of advances in technology to improve chronic disease care, including for HTN (figure 1). 10 Additionally, we have demonstrated the importance in HTN control and patient engagement using digital tools 9 10. In fact, a digital HTN programme is feasible and associated with significant improvements in BP control rates as well as lifestyle changes 8–10…”