Applying Population Health Approaches to Undiagnosed Hypertension

摘要

High blood pressure is a major cause of cardiovascular disease and stroke. There is abundant evidence that treating hypertension gready reduces the disease burden it causes, and there are many effective and often highly affordable treatments for it. However, this condition often goes undiagnosed and uncontrolled. Using the criteria of the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, approximately 32% of the adult population of the United States has hypertension.Unfortunately, 16% of are not aware of it, 24% are not currently treated, and 46% are uncontrolled.With the changes in criteria as to what constitutes hypertension presented in the recent American College of Cardiology/American Heart Association (ACC/AHA) 2017 guideline, the prevalence of adults with hypertension rises to 46%, and the numbers of people recommended for treatment or who are considered to be above their treatment goal are increased.The problem of nondiagnosis of hypertension can be addressed by promoting regular screening and by systematic reassessment of individuals who have been found to have elevated blood pressure. Even though blood pressure measurements are routinely obtained in health care settings, opportunities to diagnose and treat hypertension when blood pressure is found to be elevated are often squandered. Clinicians do not always act on elevated readings, and patients may not follow up when advised to do so.