What Constitutes Adequate Control of High Blood Pressure? Current Considerations.

Autor:	Casey DE Jr; Jefferson College of Population Health, Philadelphia, PA.; Department of Internal Medicine, Rush Medical College, Chicago, IL.; Division of General Internal Medicine, Rush Medical College, Chicago, IL.; Institute for Healthcare Informatics, University of Minnesota, Minneapolis, MN.; Improving Patient Outcomes for Health (IPO 4 Health), Chicago, IL., Blood AJ; Department of Medicine, Harvard Medical School, Boston, MA.; Brigham and Women's Hospital, Boston, MA.; Cardiac Intensive Care Unit, Newton Wellesley Hospital, Newton, MA.; Mass General Brigham Data Science Office, Boston, MA.; Brigham and Women's Hospital Accelerator of Clinical Transformation, Boston, MA.; Shapiro Cardiovascular Center, Boston, MA., Persell SD; Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.; Center for Primary Care Innovation, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.; Northwestern Medical Group, Northwestern Medicine, Chicago, IL., Pohlman D; Department of Internal Medicine, Rush Medical College, Chicago, IL.; Division of General Internal Medicine, Rush Medical College, Chicago, IL., Williamson JD; Center for Healthcare Innovation, Chicago, IL.; Sticht Center for Healthy Aging and Alzheimer's Prevention, Winston-Salem, NC.; Section of Gerontology and Geriatric Medicine, Department of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings. Innovations, quality & outcomes [Mayo Clin Proc Innov Qual Outcomes] 2024 Jul 04; Vol. 8 (4), pp. 384-395. Date of Electronic Publication: 2024 Jul 04 (Print Publication: 2024).
DOI:	10.1016/j.mayocpiqo.2024.06.001
Abstrakt:	An estimated 45% of adult Americans currently have high blood pressure (HBP). Effective blood pressure (BP) control is essential for preventing major adverse events from cardiovascular and other vascular-related diseases, such as chronic kidney disease, stroke and dementia. A large and growing number of medical professional societies, health care organizations, and governmental agencies have now endorsed a clinical practice guideline-based target for adequate control of HBP to a systolic BP of less than 130 mm Hg. However, adequate BP control to this goal has been recently estimated to be as low as 30%. The first and most important steps to guide effective BP control include accurate, standardized BP measurement and formal assessment of overall atherosclerotic cardiovascular disease risk. In addition to appropriate pharmacologic treatment, optimal BP management must also include multifaceted guideline-directed lifestyle modifications. High-quality evidence now supports effective uniform HBP control that is consistently achievable for most of people from diverse backgrounds. This can be accomplished through identification and prioritization of social determinants of health enabled by shared decision making that is delivered via team-based care. Such integrated approaches can have a substantial impact for simultaneously reducing several major modifiable atherosclerotic cardiovascular disease risk factors. Hence, moving the "Big Needle" of improved overall cardiovascular, kidney, and brain health of the US population must no longer be solely relegated to primary care and will require a major and coordinated reprioritization of capital and evidence-based human resource allocations by all health care stakeholder organizations. Competing Interests: Dr Casey reports participation as follows: National Committee for Quality Assurance (NCQA) Cardiovascular Measure Advisory Panel (no financial remuneration); National Hypertension Control Initiative (NHCI) Advisory Board (no financial remuneration); and Advisory Board for Collaboration Oriented Approach for Controlling High Blood Pressure (COACH) Oregon Health and Science University Grant Number U18 HS026849. Dr Blood reports institutional grants from Eli Lilly, Boehringer Ingelheim, Milestone Therapeutics, and Novo Nordisk; consulting fees from Color Health, Arsenal Capital Partners, Milestone Therapeutics, Novo Nordisk, Signum Technologies, Knownwell Health, Porter Health, and Scriptchain; honoraria from Medscape ; travel support from American College of Cardiology and American Heart Association; U.S. Patent application No 16/636,524 entitled “Smartphone Application for Medical Image Data Sharing and Team Activation”; participation in data safety monitoring board of HI-Pro; equity options in Knownwell and Porter Health. Dr Persell receives research funding paid to Northwestern University from 10.13039/100016274Omron Healthcare, National Institutes of Health, Agency for Healthcare Reseach and Quality, Health Resources and Services Administration, and 10.13039/100007059Northwestern Memorial Healthcare; consulting fees from RAND; and honoraria from Pri-Med, Omron Healthcare, and National Committee for Quality Assurance. Dr Pohlman reports no competing interests. Dr Williamson reports grants from National Institutes of Health, Alzheimer’s Association, and Biogen; honorarium from University of New South Wales and Arbor Acres Retirement Community; and participation in the boards of Impact of Intensive Treatment of Systolic Blood Pressure on Brain Perfusion, Amyloid and Tau in Older Adults, National Institute on Aging; Pharmaceutical Assistance to the Aged and Disabled, National Institute on Aging; and Blood Pressure Control Target in Diabetes, National Research and Development Institute of China. (© 2024 The Authors.)
Databáze:	MEDLINE
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