Kaiser Permanente rolls up sleeves to help reduce hypertension

OAKLAND, Calif., May 14, 2015 /PRNewswire/ -- May is National High Blood Pressure Prevention Month, but Kaiser Permanente's efforts to fight this potentially deadly condition reflect a year-round commitment.

According to the Centers for Disease Control, nearly 1 in 3 American adults have high blood pressure, also known as hypertension. Worldwide, the condition is responsible for more than 9 million largely preventable deaths per year, mostly from heart attack and stroke.

Hypertension occurs when the force of blood pushing on the walls of arteries is elevated. If not treated, it can result in disability or death. The good news is that high blood pressure can be treated and the risks minimized.

Being overweight, lack of physical activity, too much salt or alcohol, stress, older age, genetics and family history, and various diseases all can contribute to high blood pressure. The condition can be easy to treat by adopting a more healthy lifestyle and by taking a number of well-tolerated, once-daily medications.

Teamwork for effective treatment

Drs. Joseph Young, the Northern California and National Hypertension Lead for Kaiser Permanente, and Joel Handler, the Southern California and prior National Hypertension Lead, have implemented and guided the organization's Hypertension Program Improvement Process, which has raised Kaiser Permanente's hypertension control rate to close to 90 percent across the organization's regions, nearly twice the national average.

"This successful program is evidence that a thoughtful team-based approach improves blood pressure control," said Dr. Young. "High blood pressure is an important modifiable risk factor for heart disease, stroke and kidney disease. High blood pressure affects 29 percent of adults in the Unites States so this work is of paramount importance."

Leveraging integrated tools

Kaiser Permanente has improved hypertension control rates by leveraging its electronic medical record to coordinate outreach to patients with hypertension and manage their care. Some components of its patient-centered care strategy include:

• Walk-in medical assistant blood pressure checks have significantly increased the opportunity to reach out to members with this important test.
• A simple hypertension drug treatment algorithm based upon single-pill drug combination therapy has fostered provider and patient adherence.
• A comprehensive hypertension registry allows population care experts to track patients with uncontrolled hypertension for targeted interventions.
• Patients overdue for refills or those with low adherence receive a telephone call reminder via a recorded message or from a pharmacist.

Targeting disparities

Men and women are about equally likely to develop high blood pressure over their lifetimes, but their risks vary at different ages. African Americans develop high blood pressure more often, and at an earlier age, than whites and Hispanics do. More black women than men have high blood pressure.

Disparities between black and white seniors covered by Kaiser Permanente in the Western United States have been nearly eliminated, according to a study published in the New England Journal of Medicine.

The study, which reviewed national Medicare Advantage data for 2006 and for 2011, found that black enrollees had significantly poorer control of their blood pressure, cholesterol and blood sugar than white enrollees in all regions in 2006. By 2011, these disparities still existed in the North, East and South but researchers reported that disparities in control of blood pressure, LDL cholesterol and glycated hemoglobin between black enrollees and white enrollees have been eliminated in the West among Kaiser Permanente health plan members.

The health care organization is working to share its success with community-based programs to combat high blood pressure. In September of 2014, Kaiser Permanente awarded a $2.55 million grant to support the American Heart Association (AHA) in a broad effort to improve blood pressure control for African-Americans in Atlanta and San Diego over three years, with the aim of creating a model that can be replicated in communities across the country.

A leader in hypertension control

Over the past decade, Kaiser Permanente has worked diligently to lower rates of high blood pressure among its members and patients suffering from hypertension. Much of this work has been recognized nationally:

• Million Hearts Hypertension Champions, 2012-14: Kaiser Permanente Southern California (2014), Kaiser Permanente Northern California (2013), and Kaiser Permanente Colorado (2012) have all been named Million Hearts Hypertension Control Champions by the U.S. Department of Health and Human Services (HHS). The national public-private initiative of HHS calls attention to health care organizations that have improved hypertension control rates across their entire patient population and have verifiable data documenting the improvement.
• Top-Rated by HEDIS: In 2014, all seven Kaiser Permanente commercial health plans were among the top 10 of 330 plans considered for controlling high blood pressure, according to the Healthcare Effectiveness Data and Information Set (HEDIS), a widely used set of performance measures, developed and maintained by the National Committee for Quality Assurance (NCQA).
• JAMA Showcase: A Kaiser Permanente research study published in the Journal of the American Medical Association in 2013 showed that Kaiser Permanente Northern California had nearly doubled the rate of blood-pressure control among adult members with diagnosed hypertension between 2001 and 2009 through one of the largest, community-based hypertension programs in the nation. The program was a multifaceted approach that included, among other interventions, a comprehensive hypertension patient registry and a single-pill combination therapy.

Top 10 tips for controlling high blood pressure

• Have your blood pressure checked regularly.
• If your doctor prescribes medication to control your blood pressure, take the medication as directed. If you are having trouble doing this regularly, ask your doctor what can be done to make it easier.
• Eat a healthy diet that is high in fruits and vegetables and low in sodium, saturated fats, trans fat, and cholesterol.
• Achieve and maintain a healthy body weight.
• Participate in 30 minutes of moderate physical activity on most days of the week.
• Quit smoking—and if you don't smoke, don't start. Smoking magnifies the risks of high blood pressure.
• Avoid second-hand smoke.
• Try to manage stress through activities you find relaxing.
• Limit the amount of alcohol you drink (no more than one drink each day for women and two for men).
• If you and a family member or close friend have high blood pressure, support each other by preparing healthy meals, taking walks and managing stress together.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 10 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

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SOURCE Kaiser Permanente

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