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Review
. 2018 Sep 11;72(11):1278-1293.
doi: 10.1016/j.jacc.2018.07.008.

Prevention and Control of Hypertension: JACC Health Promotion Series

Robert M Carey  1 , Paul Muntner  2 , Hayden B Bosworth  3 , Paul K Whelton  4
Affiliations
Review

Prevention and Control of Hypertension: JACC Health Promotion Series

Robert M Carey et al. J Am Coll Cardiol. .

Abstract

Hypertension, the leading risk factor for cardiovascular disease, originates from combined genetic, environmental, and social determinants. Environmental factors include overweight/obesity, unhealthy diet, excessive dietary sodium, inadequate dietary potassium, insufficient physical activity, and consumption of alcohol. Prevention and control of hypertension can be achieved through targeted and/or population-based strategies. For control of hypertension, the targeted strategy involves interventions to increase awareness, treatment, and control in individuals. Corresponding population-based strategies involve interventions designed to achieve a small reduction in blood pressure (BP) in the entire population. Having a usual source of care, optimizing adherence, and minimizing therapeutic inertia are associated with higher rates of BP control. The Chronic Care Model, a collaborative partnership among the patient, provider, and health system, incorporates a multilevel approach for control of hypertension. Optimizing the prevention, recognition, and care of hypertension requires a paradigm shift to team-based care and the use of strategies known to control BP.

Keywords: antihypertensive agents; dietary sodium; exercise; lifestyle; medication adherence; telemedicine.

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Figures

Central Illustration.
Central Illustration.. Prevention and Control of Hypertension.
Factors associated with hypertension awareness, treatment, and control, and the components of a systems-level algorithm designed to increase blood pressure (BP) control. Carey, R.M. et al. J Am Coll Cardiol. 2018;72(11):1278-93.
Figure 1:
Figure 1:. Schematic Depiction of the Major Determinants of BP in Primary Hypertension and Their Interactions in Adults.
Genetic/epigenetic, environmental, and social determinants interact to increase BP in virtually all hypertensive individuals and populations. BP = blood pressure. SD = social determinants.
Figure 2:
Figure 2:. Schematic Illustration of the CCM, Including Multilevel Interventions to Prevent and Control Hypertension.
Adapted with permission from Wagner (132). CCM = chronic care model; HT = hypertension.
See this image and copyright information in PMC

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References

    1. Forouzanfar MH, Liu P, Roth GA, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990–2015. JAMA 2017;317:165–82. - PubMed
    1. GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2016;390:1345–422. - PMC - PubMed
    1. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA 2004;291:844–50. - PubMed
    1. Klag MJ, Whelton PK, Randall BL, et al. Blood pressure and end-stage renal disease in men. N Engl J Med 1996;334:13–8. - PubMed
    1. Hsu CY, McCulloch CE, Darbinian J, Go AS, Iribarren C. Elevated blood pressure and risk of end-stage renal disease in subjects without baseline kidney disease. Arch Intern Med 2005;165:923–8. - PubMed

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