An Effective Approach to High Blood Pressure Control: A Science Advisory From the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention

Cardiovascular diseases, including heart disease, hypertension, and heart failure, along with stroke, continue to be leading causes of death in the United States.1,2 Hypertension currently affects nearly 78 million* adults in the United States and is also a major modifiable risk factor for other cardiovascular diseases and stroke.1 According to data from the National Health and Nutrition Evaluation Survey (NHANES) in 2007 to 2010, 81.5% of those with hypertension are aware they have it, and 74.9% are being treated, but only 52.5% are under control, with significant variation across different patient subgroups.1,4–7 Of those with uncontrolled hypertension, 89.4% reported having a usual source of health care, and 85.2% reported having health insurance.3 This is the current status, despite the fact that therapies to lower blood pressure and associated risks of cardiovascular events and death have been available for decades, and various education and quality improvement efforts have been targeted at patients and healthcare providers. The direct and indirect costs of hypertension are enormous, considering the number of patients and their families impacted, and the healthcare dollars spent on treatment and blood pressure–related complications.8 Currently, hypertension affects 46% of patients with known cardiovascular disease and 72% of those who have had a stroke, and it is listed as a primary or contributing cause in ≈15% of the 2.4 million deaths in 2009.1 In 2008, the total estimated direct and indirect cost of hypertension was estimated at $69.9 billion.8 Thus, it is imperative to identify, disseminate, and implement more effective approaches to achieve optimal control of this condition. High-quality blood pressure management is multifactorial and requires the engagement of patients, families, providers, and healthcare delivery systems and communities. This includes expanding patient and healthcare provider awareness, appropriate lifestyle …