UCSF Study Finds Simplified Systems Intervention Improves Blood Pressure Control in Safety-Net Settings

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Nearly a third of American adults have high blood pressure, also known as hypertension, putting them at higher risk for heart attacks, strokes, and death. A recent estimate from the Centers for Disease Control reports that high blood pressure—and the many conditions associated with it—contributes to over 400,000 deaths and costs the nation more than $40 billion each year. 

Patients can avoid poor health effects by lowering blood pressure with medication and diet, but more than half of all Americans with hypertension don’t have the condition under control.  A few integrated healthcare systems, such as Kaiser Permanente Northern California, have achieved control rates as high as 90 percent in their patients, but this approach has been considered out of reach for the many low-income and minority patients who rely on less well-resourced safety-net settings for care.

Now, a new study led by UC San Francisco researchers, partnering with clinical leaders in the San Francisco Department of Public Health, shows that a simplified intervention building on the hypertension treatment algorithm used in Kaiser Permanente’s Preventing Heart Attacks and Strokes Every Day (PHASE) program can significantly improve rates of blood pressure control in the city’s safety net clinics.

According to the new research, published July 12, 2018 in Circulation: Cardiovascular Quality and Outcomes, best practices established in well-resourced healthcare systems like Kaiser Permanente can work in safety-net clinics that serve high-risk populations. Rather than being an afterthought, “this is the population to start with. This is where you’ll get the biggest movement,” said Valy Fontil, MD, MAS, the study’s first author and assistant professor of medicine at UCSF and the Center for Vulnerable Populations. 

If implemented across the country, the program could potentially improve blood pressure control in vulnerable populations and, eventually, address racial and socioeconomic disparities in hypertensive-related diseases. “Poor and minority communities are more likely to have high …

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