Equitably Promoting a Hypertension Control Method
High blood pressure is a major risk factor for heart disease, heart attack, and stroke.
Hypertension, or high blood pressure, affects half of all adults in the United States and three of every four aged 60 and over. It is a significant risk factor for heart disease, heart attack, and stroke, and that risk varies by race and ethnicity. Black Americans are almost twice as likely as white Americans to have a first stroke, and they have the highest death rate due to stroke. When new effective hypertension control methods are developed, the Hypertension Management Program (HMP) at the Centers for Disease Control and Prevention (CDC) is eager to see if they can be scaled and shared with other regions and hospitals. The CDC heard about a promising program developed at Kaiser Permanente Colorado. After conducting a rigorous evaluation, HMP wanted to test its effectiveness in smaller health systems that have fewer resources and serve populations with greater risk for hypertension.
NORC evaluated Kaiser Permanente’s hypertension program at two test sites.
We solicited nominations from health centers interested in adopting a new hypertension control program. Out of dozens of candidates, we selected two, a federally qualified health center in South Carolina and a safety-net hospital in Tennessee. Both were high-burden, lower-resource health care settings.
We then introduced the program to each site, helped train their staff, and supported them through the program launch. We clearly explained the potential benefits for the patients, helping ensure buy-in from the staff. We followed up each month to help troubleshoot problems. After about a year, we evaluated the programs to see if they helped control patients’ high blood pressure.
The program delivered statistically significant improvements in hypertension control.
Over a 16-month period at the South Carolina site, the hypertension control rate increased by 3 percentage points, a meaningful increase that translated to 119 individuals who were able to start effectively managing their hypertension. The study also found the program was cost-effective. The CDC concluded that the project demonstrated the program “can be implemented effectively in a [federally qualified health center] and achieve significant improvements in hypertension control rates.” The CDC’s report added that the South Carolina health center’s experience showed the potential for the program "to be scaled and spread to other health care settings serving patient populations that are disproportionately affected by hypertension. Because of the COVID-19 pandemic, the safety net hospital in Tennessee was unable to complete the study.
NORC developed an online, interactive toolkit to help health systems that want to implement this team-based, patient-centered, integrated care model to better control high blood pressure.