Saving Lives: Team Management of High Blood Pressure

Tom Frieden, MD, MPH


January 18, 2017

Editorial Collaboration

Medscape &

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About 75 million Americans—nearly 1 in 3 adults—have high blood pressure. Of this group, almost half don't have it under control, including 11 million who don't even know they are hypertensive. Additionally, CDC's recent Vital Signs report reveals that at least 5 million Medicare Part D enrollees age 65 or older are not taking their blood pressure medicine properly, putting their lives at risk.

The good news is that we can do something about this silent killer if we work together. In particular, healthcare systems—including physicians and other healthcare professionals—can play a key role in improving blood pressure control nationwide.

There are things healthcare providers can do to make care convenient for patients and set up systems to succeed. Here are five ways clinicians can support patients and make it more convenient to start and continue care:

  1. Counsel patients on how and why to take medicine as directed, using language that patients and caregivers understand.

  2. Prescribe simple regimens, with the lowest possible number of pills (for example, with combination pills), using once-daily doses whenever possible.

  3. Provide 90-day refills.

  4. Encourage use of home blood pressure cuffs and easy-to-use tools such as blood pressure logs.

  5. Find out if cost is a barrier, and prescribe generic forms of blood pressure medications that are affordable for your patients.

Here are three ways that systems can help support clinicians and patients:

  1. Incorporate effective, detailed blood pressure treatment protocols into clinical practice.

  2. Involve the entire healthcare team. For example, pharmacists have an important role as trusted health advisors. Community health workers can connect patients with local resources to help improve and manage blood pressure. By working as a team across this continuum, you can encourage healthy lifestyle changes and help remove some of the barriers that patients face when taking blood pressure medicine.

  3. Use information technology to identify and support patients who need more attention. For example, electronic health records (EHRs) can be used to provide the entire healthcare team and patient with a clear understanding of the therapies available and possible copays associated with those therapies. Registries can identify patients most at risk. And EHR analytics can identify patients who have elevated readings but no diagnosis or treatment for hypertension—those who are "hiding in plain sight."

The bottom-line is: Too many American adults are not being supported in a way that increases the odds that they will take their blood pressure medicine as directed. This puts their lives at risk. We must do more. After all, improving blood pressure control is the single intervention that could save the most lives in our healthcare system.

To learn more about what you and your practice can do to improve blood pressure control by helping patients take their medicine as directed, visit our Vital Signs page. You'll see our September Vital Signs report, which focuses on how health systems can promote medication adherence. Additional tools and resources for improving antihypertensive medication adherence are available at

Web Resources

Vital Signs, September 2016

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