Our Healthcare System Fails Patients with Hypertension
Between the Care that we Have, and the Care that We Could Have, Lies not just a Gap, but a Chasm!
Every day in the United States Americans die needlessly because our leaders have failed to implement the proven systems that dramatically improve high blood pressure control. Nearly half the adult population has high blood pressure which contributes to the development of sudden death, heart attack, stroke, kidney failure, and other devastating chronic diseases. The slide above comes from the CDC. None of the people who have lifestyle intervention alone recommended are at the target blood pressure. Only 26% of patients who receive lifestyle recommendation plus medication have their pressure controlled. Kaiser Permanente of Northern California controlled blood pressure to less than 140/90 in 90% of 750,000 patients. That is the benchmark.
There is one single way of consistently meeting the benchmark—a team of nurses and pharmacists focused on achieving blood pressure control. That is the way Kaiser Permanente achieves it. Every patient who visits their system has a blood pressure measurement. If their pressure is high, they are referred to the team. I have never seen hypertension control rates of 90% in provider organizations that are not using teams and protocols focused on chronic diseases. Poor hypertension control is not a matter of nonadherent patients or inadequate providers. It is a failure to develop the systems to control high blood pressure. We can improve health and save money very simply by implementing the systems that are proven to improve blood pressure control. When we fail to do that, we are not effective advocates for our patients. Between the care that we have, and the care that we could have lies not just a gap, but a chasm.
Where do we find a team. I’m just being handed medication with no mention of lifestyle. (Salt reduction 🙄🙄) But I live the lifestyle recommended in my study of this issue. For many years. (I’m 74). I’m also kind of uncomfortable with too many docs on my case as personal trust in medicine has been extremely eroded the last decade. I pray things change.
Yup. Your neighbor Lady Jean is a perfect example. This injustice must be brought to its end.