Meeting Higher Standards for Lowering Blood Pressure

Wednesday, November 15, 2017

As measure of high blood pressure is changed, Rush receives honor for controlling it

If you weren’t already among the 72 million people in the United States thought to have high blood pressure before last week, there’s a good chance you now have it too. On Nov. 13, the American Heart Association and the American College of Cardiology announced new joint guidelines that lowered the measure of high blood pressure — or hypertension, as it’s also known — from a reading of 140/90 to 130/80.

The change raises the estimated number of adults in the U.S. with high blood pressure to 103 million, or 46 percent of the country’s adult population. The revised guidelines are intended to motivate more people to take action to reduce their blood pressure — and with it their risk of heart disease and stroke, the two leading causes of death worldwide.   

“The new guidelines are telling us to be aware of a silent but growing health problem for millions of Americans and that this is the time to act, and not wait until readings are in a range that is harmful,” says Michael Hanak, MD, assistant professor in the Department of Family Medicine at Rush University Medical Center. “Doctors also should also use the new guidelines to educate patients that periodically checking blood pressure outside the physician’s office is a great way to stay engaged with their care, and serves as a reference point during physician office visits so we do not inaccurately attribute elevated readings to the walk from their car or a stressful day.”

The AHA and ACC’s developed the new guidelines over the last several years in collaboration with nine other organizations of health professionals. A committee of 21 experts reviewed more than 900 published studies before writing the guidelines, which were published Nov. 13 in the AHA’s journal Hypertension

The most important of the studies was the Systolic Blood Pressure Intervention Trial, or SPRINT, which found that lowering blood pressure below the recommended levels also greatly the number of cardiovascular incidents and deaths in people more than 50 years old. 

While about one in five of the additional people classified with high blood pressure will need medication for their condition, the guidelines emphasize lifestyle changes to address the problem. The guidelines include specific recommendations for increasing exercise, losing weight, drinking less and eating better (including potassium-rich foods such as bananas, avocados and dark leafy green vegetables).

“Well before sustained high blood pressures lead to adverse health effects, patients and their physicians should seek out prevention opportunities,” Hanek says. “Lifestyle changes made early not only can address blood pressure, but also can address diabetes prevention.”

Rush University Medical Group named Hypertension Control Champion

Rush University Medical Center is especially skilled at helping people with hypertension manage their blood pressure. The federal Centers for Disease Control and Prevention recently recognized this skill when it named Rush University Medical Group (RUMG) — which includes all Medical Center-employed physicians and advanced practice nurses — a 2017 Million Hearts Hypertension Control Champion on Nov. 7.

RUMG is one of only 24 nationwide recipients of the award, which honors organizations or providers who focused on proven strategies to help achieve blood pressure control at rates at or above the target of 70 percent of their patients.

RUMG achieved control rates of 74 percent by using a variety of approaches, including the following:

  • Making high blood pressure control a priority
  • Using evidence-based treatment guidelines and protocols
  • Using health care teams to increase the frequency of contact with patients
  • Consistently and strategically using electronic health records that include clinical decision support tools, patient reminders and registry functionality
  • Staying engaged with patients by offering walk-in blood pressure screening while deploying  patient navigators to ensure proper follow-up care

“High blood pressure puts a person at a greater risk for a heart attack, stroke, and other health conditions like kidney disease,” says Hanak, who is the co-chair of the RUMG Quality Committee. “This designation, and the continued national recognition by the CDC for our hypertension control practices, demonstrates our commitment to providing the highest quality care for our patients.”