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Better Blood Pressure Control: A National Priority

February 10, 2014

Editor’s Note: On Nov. 15, 2013, Medscape interviewed Tom Frieden, M.D., director of the Centers for Disease Control and Prevention, on how health care providers and individuals can better control high blood pressure. The following is a condensed version of the interview. For the full version, visit Medscape’s website to read the article or watch a video of the interview.

Frieden: One in three adults in this country has high blood pressure. That's nearly 67 million people, and more than 35 million of them don't have it under control. In fact, high blood pressure contributes to more than 1,000 deaths every day. We are making progress, but not nearly fast enough. Control is now increasing at about 1 percent per year. We need to ramp that up to 5 percent per year. High blood pressure control has to be a priority for every patient at every visit.

There are ways that we can make a big difference, and we are learning about that, using health information technology (IT), registries, prompts, alerts and reports; and making every single member of the health care team involved -- including the patient and the pharmacist -- working together to control blood pressure.

We have launched Million Hearts to prevent 1 million heart attacks and strokes by 2017.

Medscape: Why do you believe that the United States continues to have suboptimal results in detecting and controlling high blood pressure?

Frieden: High blood pressure is a silent killer. Many patients don't realize that they have a problem. In fact, many doctors may underdiagnose high blood pressure. Perhaps the patient is there for another reason; the blood pressure is elevated, but high blood pressure is not diagnosed. In fact, we have found that people with uncontrolled hypertension have usually seen a doctor at least twice in the past year. This is the case because many times, high blood pressure is hiding in plain sight. Even though there are multiple elevated readings in the medical record, they are not detected or diagnosed and patients are not put on treatment.

Furthermore, blood pressure can be difficult to control. It can be hard to find the right treatment or mix of drugs. The patient may not start medications, may not take medications as prescribed or may stop medicines if they have unpleasant side effects.

Focusing on high blood pressure has to be our priority. Health IT and a team effort are key. Registries and regular check-ins can address many of the problems that lead to uncontrolled blood pressure and avoidable heart attacks and strokes.

To read or watch the rest of the interview, visit Medscape’s website.