Commitment to Hypertension Control During the COVID-19 Pandemic

Million Hearts Initiative Exemplars

Amena Abbas, MPH; Judy Hannan, RN, MPH; Haley Stolp, MPH; Fátima Coronado, MD, MPH; Laurence S. Sperling, MD


Prev Chronic Dis. 2022;19(8):e47 

In This Article

Abstract and Introduction


Hypertension is a major risk factor for cardiovascular diseases, but 3 of 4 US adults do not have their blood pressure adequately controlled. Million Hearts (US Department of Health and Human Services) is a national initiative that promotes a set of priorities and interventions to optimize delivery of evidence-based strategies to manage cardiovascular disease, including hypertension. The COVID-19 pandemic, however, has disrupted routine care and preventive service delivery. We identified examples of clinical and health organizations that adapted services and care processes to continue a focus on monitoring and controlling hypertension during the pandemic. Eight Hypertension Control Exemplars were identified and interviewed. They reported various adapted care strategies including telemedicine, engaging patients in self-measured blood pressure monitoring, adapting or implementing medication management services, activating partnerships to respond to patient needs or expand services, and implementing unique patient outreach approaches. Documenting these hypertension control strategies can help increase adoption of adaptive approaches during public health emergencies and routine care.


Hypertension is a major risk factor for several chronic diseases, including stroke, heart disease, and other CVDs.[1] Blood pressure consistently at or above 130/80 mm Hg is considered hypertensive.[1] It is also a significant primary or contributary cause of death in the US.[2] Furthermore, estimates indicate that approximately 50% to 75% of adults with hypertension do not have their blood pressure adequately controlled.[3]

Infections with SARS-CoV-2, the virus that causes COVID-19, has resulted in approximately 900,000 deaths to date and has had an enormous effect on health and health care in the US.[4] In March 2020, shelter-in-place orders went into effect, and states declared a state of emergency as a result of considerable community transmission of COVID-19.[5] Disruptions in routine and nonemergent medical care were reported with substantial decreases in patient visits and restricted hours of operation.[6] An estimated 41% of US adults initially avoided or delayed medical care because of COVID-19 concerns or were encouraged to postpone routine appointments with their health care team if determined to be at high risk for COVID-19.[7] Underlying serious health conditions, including hypertension, possibly increase the likelihood of severe COVID-19–related illness.[8] Thus, it is imperative that, even during disruptions in care, hypertension control remains a priority.